Frontoorbital advancement by gradual distraction

1998 ◽  
Vol 89 (6) ◽  
pp. 1058-1061 ◽  
Author(s):  
Shinichi Hirabayashi ◽  
Yasushi Sugawara ◽  
Atsushi Sakurai ◽  
Kiyonori Harii ◽  
Susam Park
Keyword(s):  
Surgical Treatment ◽  
Illustrative Case ◽  
Content Type ◽  
Craniofacial Structure ◽  
Number Of Patients ◽  
Frontoorbital Advancement ◽  
Coronal Synostosis ◽  
A New Technique ◽  
Partial Resorption ◽  
Gradual Distraction

✓ A substantial number of patients with coronal synostosis who undergo frontoorbital advancement still require additional surgical treatment to correct increased intracranial pressure or unsatisfactory craniofacial structure. However, frontoorbital advancement currently requires elevation of the frontal as well as the orbital bone, which can result in a fragile dura mater and partial resorption of the advanced bone. Thus the dura is easily torn by dissection and the advanced bone is further resorbed and deformed during repeated craniofacial operations. To avoid these drawbacks and to create an easier second surgical treatment via the intracranial approach, a new technique for frontoorbital advancement is presented. In this technique frontoorbital bone is advanced as a single unit, without elevation from the underlying dura, by means of gradual distraction. The details of the technique and an illustrative case are reported.

Indications for surgical treatment of putaminal hemorrhage

1990 ◽  
Vol 73 (4) ◽  
pp. 518-525 ◽  
Author(s):  
Kazuhiko Fujitsu ◽  
Masato Muramoto ◽  
Yoshihiro Ikeda ◽  
Yoshinori Inada ◽  
Iru Kim ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Time Course ◽  
Ct Scans ◽  
Content Type ◽  
Neurological Condition ◽  
Number Of Patients ◽  
Putaminal Hemorrhage ◽  
Time Courses ◽  
Precise Time ◽  
Fine Print

✓ Serial computerized tomography (CT) scans were correlated with a precise time-course analysis of the neurological condition of 180 patients with hypertensive putaminal hemorrhage. All patients entered the study within 3 hours of the ictus. In this series, 111 patients were treated conservatively and 69 surgically. The neurological condition of each patient was measured by means of a newly proposed grading system for intracerebral hemorrhage-intracranial hemorrhage (ICH grade) which is a modification of the Glasgow Coma Scale. Serial CT scans revealed that most hemorrhages were completed within 6 hours after ictus. Based on the ICH grade at 6 hours postictus, a clinical classification of the severity of putaminal hemorrhage was defined: fulminant, rapidly progressive, slowly progressive, and nonprogressive. According to this classification, precise time courses of the ICH grade were compared between the conservative and surgical treatment groups in a 7-day postictal period. Activities of daily living at 6 months after ictus were also compared. Surgical treatment for a rapidly progressive hemorrhage appears to be beneficial if undertaken in patients under 65 years of age. Surgery in a slowly progressive hemorrhage should be considered only in a small number of patients who deteriorate neurologically with conservative treatment. In this series of patients, surgical treatment of fulminant and nonprogressive hemorrhage was not likely to improve the quality of life or functional recovery. Regardless of treatment modality, CT provided evidence that patients with anterior capsular hemorrhage (16% in this series) showed good recovery of motor and speech function.

Cranial remodeling to treat craniosynostosis by gradual distraction with a new device

2002 ◽  
Vol 96 (4) ◽  
pp. 654-659 ◽  
Author(s):  
Keisuke Imai ◽  
Hiroyuki Komune ◽  
Chiaya Toda ◽  
Takeru Nomachi ◽  
Eiji Enoki ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Solid Model ◽  
Content Type ◽  
New Device ◽  
Distraction Device ◽  
Frontoorbital Advancement ◽  
Perioperative Complication ◽  
Gradual Distraction ◽  
Fine Print

Object. The authors describe their experience in remodeling the shape of the cranium in children with craniosynostosis by using gradual distraction. In half of the cases, a new distraction device developed by the authors was used. Methods. Twenty children with craniosynostosis underwent frontoorbital advancement and cranial remodeling assisted by gradual distraction. There were five children with brachycephaly, two with oxycephaly, five with scaphocephaly, two with plagiocephaly, one with combined scaphocephaly and plagiocephaly, and five with trigonocephaly. Four cases were syndromic and 16 were nonsyndromic. The patients ranged in age from 3 to 50 months (mean 14.5 months) at the first surgery. Simulated surgery was first performed on a three-dimensional solid model made of polyurethane, which accurately represented cranial flexibility, to determine the most favorable osteotomy line. Distraction was initiated 1 week postoperatively. The speed and extent of advancement (maximum extension 45 mm) were predetermined on the basis of previously reported criteria and the results of simulated surgery. Postoperatively, the cranial configuration was favorable in all cases. Spontaneous remodeling of irregularities and/or gaps apparent after distraction was found to occur 2 to 5 months after removal of the distraction devices, especially in patients with trigonocephaly or scaphocephaly. No major perioperative complication was observed in any patient. There were minor complications in six of the first 10 cases, including exposure of the device, shaft slippage, and fluid discharge. A new device was developed and used on the last 10 patients treated; it successfully eliminated device exposure and shaft slippage. A 3-year follow-up review confirmed that there was no relapse of advanced bones. Conclusions. Highly satisfactory results were achieved in cases of both syndromic and nonsyndromic craniosynostosis when gradual distraction was performed.

Late surgical treatment of unilateral coronal synostosis using methyl methacrylate

1987 ◽  
Vol 66 (6) ◽  
pp. 793-799 ◽  
Author(s):  
John A. Persing ◽  
Arthur J. Cronin ◽  
Johnny B. Delashaw ◽  
Milton T. Edgerton ◽  
Scott L. Henson ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Methyl Methacrylate ◽  
Risk Of Infection ◽  
Growth Limitation ◽  
Facial Bone ◽  
Content Type ◽  
Late Treatment ◽  
Coronal Synostosis ◽  
Surrounding Bone ◽  
Fine Print

✓ Three techniques combining the shaping of calvarial and facial bone with onlay of methyl methacrylate are presented for use in the late treatment of unilateral coronal synostosis deformities. The procedures described are suggested as possible alternatives to extensive bone repositioning procedures. They have the advantage of being quicker and are therefore potentially safer operations. Acrylic is malleable and does not resorb; thus, permanent superior esthetic results may be achieved. The two most serious risks when using this technique are infection and limitation of growth. The risk of infection may be reduced by attaching the acrylic implant securely to surrounding bone, under sterile conditions, beneath well-vascularized skin. Growth limitation may be obviated by not placing acrylic across sutures in children with enlarging skulls.

Microendoscopic posterior cervical laminoforaminotomy for unilateral radiculopathy: results of a new technique in 100 cases

2001 ◽  
Vol 95 (1) ◽  
pp. 51-57 ◽  
Author(s):  
Tim E. Adamson
Keyword(s):  
Surgical Treatment ◽  
Baseline Level ◽  
Cervical Radiculopathy ◽  
New Technique ◽  
Herniated Disc ◽  
Foraminal Stenosis ◽  
Content Type ◽  
Disc Herniations ◽  
A New Technique ◽  
Fine Print

Object. In this report the author presents surgery-related outcomes after application of a new technique. A posterior microendoscopic laminoforaminotomy was used for the surgical treatment of unilateral cervical radiculopathy secondary to intervertebral disc herniations and/or spondylotic foraminal stenosis. The results of this procedure are compared with those achieved using traditional laminoforaminotomy and anterior cervical discectomy with or without fusion. Methods. One hundred consecutive patients who experienced unilateral cervical radicular syndromes, which were refractory to conservative therapy, and in whom imaging studies had confirmed lateral canal or foraminal compression, underwent surgical treatment. An endoscopy-assisted posterior laminoforaminotomy was performed using a microendoscopic visualization system for removal of herniated disc and foraminal decompression while the patient was in the sitting position. Excellent or good results were obtained in 97 patients, who returned to their preoperative employment and baseline level of physical activity. One patient returned to work but was unable to perform at baseline level; two patients returned to prior sedentary work but continued to have some activity-related pain and paresthesias. Two patients reported experiencing intermittent paresthesias or numbness, but this did not limit their activities. There were two cases of dural punctures, one case of superficial wound infection, and no deaths. Conclusions. The microendoscopic posterior laminoforaminotomy is an effective alternative for the treatment of unilateral cervical radiculopathy secondary to lateral or foraminal disc herniations or spondylosis. In this group of patients, it is preferable because it does not require the sacrifice of a cervical motion segment, has a low incidence of complications, and is associated with a much quicker return to unrestricted full activity than that obtained with other techniques.

Country of origin branding: an integrative perspective

2016 ◽  
Vol 25 (4) ◽  
pp. 322-336 ◽  
Author(s):  
Roderick J. Brodie ◽  
Maureen Benson-Rea
Keyword(s):  
Country Of Origin ◽  
Theoretical Framework ◽  
Illustrative Case ◽  
Business Relationships ◽  
Content Type ◽  
Brand Meaning ◽  
Value Propositions ◽  
Illustrative Case Study ◽  
Strategic Perspective

Purpose A new conceptualization of the process of country of origin (COO) branding based on fresh theoretical foundations is developed. This paper aims to provide a strategic perspective that integrates extant views of COO branding, based on identity and image, with a relational perspective based on a process approach to developing collective brand meaning. Design/methodology/approach A systematic review of the literature on COO branding and geographical indicators is undertaken, together with a review of contemporary research on branding. Our framework conceptualizes COO branding as an integrating process that aligns a network of relationships to co-create collective meaning for the brand’s value propositions. Findings An illustrative case study provides empirical evidence to support the new theoretical framework. Research limitations/implications Issues for further research include exploring and refining the theoretical framework in other research contexts and investigating broader issues about how COO branding influences self and collective interests in business relationships and industry networks. Practical implications Adopting a broadened perspective of COO branding enables managers to understand how identity and image are integrated with their business relationships in the context of developing collective brand meaning. Providing a sustained strategic advantage for all network actors, an integrated COO branding process extends beyond developing a distinctive identity and image. Originality/value Accepted consumer, product, firm and place level perspectives of COO branding are challenged by developing and verifying a new integrated conceptualization of branding.

En bloc petrosectomy using a Gigli saw for petroclival lesions

1995 ◽  
Vol 83 (3) ◽  
pp. 559-560 ◽  
Author(s):  
Tomio Sasaki ◽  
Makoto Taniguchi ◽  
Ichiro Suzuki ◽  
Takaaki Kirino
Keyword(s):  
Facial Nerve ◽  
Semicircular Canals ◽  
Petrous Bone ◽  
New Technique ◽  
En Bloc ◽  
Content Type ◽  
A New Technique ◽  
Transtentorial Approach ◽  
Fine Print

✓ The authors report a new technique for en bloc petrosectomy using a Gigli saw as an alternative to drilling the petrous bone in the combined supra- and infratentorial approach or the transpetrosal—transtentorial approach. It is simple and easy and avoids postoperative cosmetic deformity. This technique has been performed in 11 petroclival lesions without injuring the semicircular canals, the cochlea, or the facial nerve.

“The cut and thrust of industrial relations” – bullying by another name?

2018 ◽  
Vol 33 (1) ◽  
pp. 2-13 ◽  
Author(s):  
Pat Drake
Keyword(s):  
Women Leaders ◽  
Industrial Relations ◽  
Illustrative Case ◽  
University Leadership ◽  
Public Identity ◽  
Content Type ◽  
Female Self ◽  
Emotional Work ◽  
Differences Of Opinion ◽  
A Site

Purpose The purpose of this paper is to offer a feminography, that is a “narration of a female self in a feminist age” (Abrams, 2017) by presenting a conceptual analysis, derived from experience, of email providing a form of discourse – that the author calls finger-speak – through which unexamined gender positioning caricatures a person’s identity. In so doing, the paper provides an illustrative case of a female manager being positioned through email to “know her place, perform it and feel it” (Hey, 2011). Design/methodology/approach An analysis of email foregrounds “finger-speak” as a form of digital conversation and through which people in universities may be positioned publicly but without their consent in relation to unexamined norms and assumptions. For women, it is argued, these norms are ageist and sexist. In this paper, fragments of finger-speak are collated to provide a reading of how mixing gendered norms with apparent differences of opinion constructs, via unexamined sexism, a public identity and then undermines it. Findings Through the case presented, the author argues that, because of a shared but unarticulated shadow over women as leaders, email lays the ground for subsequent scapegoating in such a manner that the woman takes responsibility for structural challenges that rightly belong to the organisation. Originality/value The contribution that email makes to constructing female identity in public is new, complementing other work that publicly characterises women leaders, through film (Ezzedeen, 2015), and through published writing such as autobiography (Kapasi et al., 2016). Emotional work undertaken by women in university leadership is so far under-represented in public, and email is a site through which this work becomes visible.

scholarly journals Surgical treatment for common hepatic aneurysm. Original one-step technique

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 898-904
Author(s):  
Bruno Amato ◽  
Renato Patrone ◽  
Gennaro Quarto ◽  
Rita Compagna ◽  
Roberto Cirocchi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hepatic Artery ◽  
Distal Part ◽  
Intraoperative Ultrasound ◽  
Section Area ◽  
One Step ◽  
A New Technique ◽  
Open Surgical Treatment ◽  
The Right ◽  
Vascular Stapler

AbstractIntroductionHepatic artery aneurysms are rare, and their treatment represents a challenge for the surgeons.Materials and methodsA new technique is presented for common hepatic artery (CHA) aneurysm: it requires minimal vascular surgical dissection and only one linear vascular stapler is applied at the bottom of aneurysm. Aneurysm exclusion is easily obtained, which allowed retrograde thrombosis. Liver blood supply is ensured to the right and left hepatic artery, through the gastroduodenal artery, and can be previously monitored, with temporary clamping of the section area, by visual control, enzyme evaluation and intraoperative ultrasound examination. We reported an open surgical treatment, with simultaneous removal of hepatic and adrenal metastases, secondary to colon cancer.ResultsThe duration of vascular surgery was 30 min and did not involve complications. Postoperative controls confirmed the efficacy of the procedure.DiscussionThis original technique can be added to the various open and endovascular techniques so far described for the treatment of a CHA aneurysm. It is advisable as open surgery, mostly in case of associated pathologies.ConclusionsThe authors believe that this “one shot” technique by vascular staple of the distal part of CHA is minimally invasive and effective to obtain the exclusion of the aneurysm.

Outcomes of Surgical and Nonsurgical Treatment for Colorectal Cancer in Nonagenarian Patients

2021 ◽  
pp. 000313482199506
Author(s):  
Youngbae Jeon ◽  
Kyoung-Won Han ◽  
Won-Suk Lee ◽  
Jeong-Heum Baek
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Mortality ◽  
Nonsurgical Treatment ◽  
Perioperative Outcomes ◽  
Rank Test ◽  
Kaplan Meier ◽  
Number Of Patients

Purpose This study is aimed to evaluate the clinical outcomes of surgical treatment for nonagenarian patients with colorectal cancer. Methods This retrospective single-center study included patients diagnosed with colorectal cancer at the age of ≥90 years between 2004 and 2018. Patient demographics were compared between the operation and nonoperation groups (NOG). Perioperative outcomes, histopathological outcomes, and postoperative complications were evaluated. Overall survival was analyzed using Kaplan-Meier methods and log-rank test. Results A total of 31 patients were included (16 men and 15 women), and the median age was 91 (range: 90‐96) years. The number of patients who underwent surgery and who received nonoperative management was 20 and 11, respectively. No statistical differences in baseline demographics were observed between both groups. None of these patients were treated with perioperative chemotherapy or radiotherapy. Surgery comprised 18 (90.0%) colectomies and 2 (10.0%) transanal excisions. Short-term (≤30 days) and long-term (31‐90 days) postoperative complications occurred in 7 (35.0%) and 4 (20.0%) patients, respectively. No complications needed reoperation, such as anastomosis leakage or bleeding. No postoperative mortality occurred within 30 days: 90-day postoperative mortality occurred in two patients (10.0%), respectively. The median overall survival of the operation group was 31.6 (95% confidence interval: 26.7‐36.5) and that of NOG was 12.5 months (95% CI: 2.4‐22.6) ( P = 0.012). Conclusion Surgical treatment can be considered in carefully selected nonagenarian patients with colorectal cancer in terms of acceptable postoperative morbidity, with better overall survival than the nonsurgical treatment.

scholarly journals Perfil Epidemiológico da Espondilodiscite Tratada Cirurgicamente

2016 ◽  
Vol 29 (5) ◽  
pp. 319 ◽  
Author(s):  
Joaquim Soares do Brito ◽  
António Tirado ◽  
Pedro Fernandes
Keyword(s):  
Staphylococcus Aureus ◽  
Mycobacterium Tuberculosis ◽  
Surgical Treatment ◽  
Epidemiologic Study ◽  
Neurological Impairment ◽  
Tuberculous Infection ◽  
Paravertebral Abscess ◽  
Number Of Patients ◽  
Epidemiological Profile ◽  
Relative Constant

<p><strong>Introduction:</strong> The term spondylodiscitis aims to describe any spinal infection. Medical treatment is the gold standard; nevertheless, surgical treatment can be indicated. The aim of this work was to study the epidemiological profile in a group of patients with spondylodiscitis surgically treated in the same medical institution between 1997 and 2013. <br /><strong>Material and Methods:</strong> Eighty five patients with spondylodiscitis were surgically treated in this period. The authors analysed clinical data and image studies for each patient.<br /><strong>Results:</strong> We treated 51 male and 34 female patients with an average age of 48 years old (min: 6 - max: 80). The lumbar spine was more often affected and <em>Mycobacterium tuberculosis</em> the most frequent pathogen. The number of cases through the years has been grossly stable, with a slight increase of dyscitis due to <em>Staphylococcus aureus</em> and decrease of the dyscitis without pathogen identification. Paravertebral abscess was identified in 39 patients and 17 had also neurological impairment, mostly located in the thoracic spine and with tuberculous aetheology. Immunosuppression was documented in 10 patients. <br /><strong>Discussion:</strong> In this epidemiologic study we found a tuberculous infection, male gender and young age predominance. Despite a relative constant number of patients operated over the years, pyogenic infections due to <em>Staphylococcus aureus</em> seems to be uprising. Paravertebral abscess and neurological impairment are important dyscitis complications, especially in tuberculous cases.<br /><strong>Conclusion:</strong> Spinal infections requiring surgical treatment are still an important clinical condition. <em>Mycobacterium tuberculosis</em> and <em>Staphylococcus aureus</em> represent the main pathogens with a growing incidence for the latest.</p>

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