scholarly journals Nasofrontal Mucocele Following after Craniotomy Procedure

2020 ◽  
Vol 2 (3) ◽  
pp. 9-15
Author(s):  
Tommy Rizky Hutagalung ◽  
Abdurrahman Mouza
Keyword(s):  
Trauma Surgery ◽  
Intracranial Extension ◽  
New Bone Formation ◽  
Orbital Cavity ◽  
Depressed Fracture ◽  
Previous Condition ◽  
History Of ◽  
Left And Right ◽  
Frontal Sinuses ◽  
Sinus Ostium

Introduction : Mucocele is a chronic, expanding, mucosa-lined lesion of the paranasal sinus characterized by mucous retention that can be infected becoming a mucopyocele. They originate from obstruction of the sinus ostium by congenital anomalies, infection, inflammation, allergy, trauma (including surgery) or a benign or malignant tumor.  The frontal sinuses are most commonly affected, and subsequently ethmoidal sinuses. Case Report : A 56 years old man, presented with a lump on the left and right forehead accompanied by a protruding left eye since 6 months and is getting wors.  Patient with a history of craniectomy debridement surgery indicated for open depressed fracture due to an accident 12 years ago, then underwent a titanium mesh cranioplasty 11 years ago.  From examination of the head CT scan revealed a solid mass lesion filling the left and right frontal sinuses expands into the left orbital cavity. Bifrontal craniotomy was performed on the patient. Discussion :  Mucoceles are mucous-secreting expansive pseudocystic formations, and capable of expansion by virtue of a dynamic process of bone resorption and new bone formation. They result from obstruction of a sinus ostium and frequently are related to a previous condition as chronic sinusitis, trauma, surgery or expansible lesion. With continued secretion and accumulation mucus, the increasing pressure causes atrophy or erosion of the bone of the sinus, allowing the mucocele to expand in the path of less resistance. This may be into the orbit, adjacent sinuses, nasal cavity, intracranial or through the skin; intracranial and orbital extension were demonstrated in this patient. Conclusion : Frontal mucoceles are benign and curable, but early diagnosis and treatment of them is important. Open surgery remains a valid procedure in frontal mucoceles with orbital and/or intracranial extension and in cases where the district anatomy is unfavourable for a purely endonasal approach.

scholarly journals Enucleation of Extraconal Frontomucocele: A Tripple-Window Approach

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Irfan M ◽  
Dinsuhaimi S ◽  
Roselinda AR ◽  
Rani AS
Keyword(s):  
Ct Scan ◽  
Frontal Sinus ◽  
Sport Injury ◽  
Orbital Cavity ◽  
Adjacent Structures ◽  
History Of ◽  
Frontal Sinuses ◽  
Window Approach ◽  
Bony Erosion

Mucoceles are expansile masses originating in the sinuses. They are relatively unusual, occurring most frequently at fronto-ethmoidal region. They are locally destructive. This expansile lesion caused bony erosion and displaces the adjacent structures. We report a case of a patient who presented to our clinic with bulging of his left eye and worsening of the left vision. This was preceded by history of sport injury to his left supraorbital ridge. CT scan revealed that there was an extraconal lesion at the superolateral part of the left orbital cavity which pushed the orbit inferomedially, which consistent with left frontomucocele. He underwent enucleation of the lesion via 3 windows created namely at the left supraorbital ridge, anterior table of left frontal sinus and through the septum separating the frontal sinuses.

PREDICTORS OF NEUROLOGICAL COMPLICATIONS AFTER CARDIAC SURGICAL INTERVENTIONS IN OLDERY PATIENTS

2020 ◽  
pp. 319-324
Author(s):  
О. В. Каменская ◽  
А. С. Клинкова ◽  
В. В. Ломиворотов ◽  
В. А. Шмырев ◽  
А. М. Чернявский
Keyword(s):  
Intraoperative Monitoring ◽  
Cerebral Oxygenation ◽  
Artery Bypass ◽  
Neurological Complications ◽  
Myocardial Infarctions ◽  
Bypass Grafting ◽  
Surgical Interventions ◽  
Increased Risk ◽  
History Of ◽  
Left And Right

Для выявления предикторов неврологических осложнений в госпитальный период после коронарного шунтирования (КШ) проанализированы данные 92 больных 70 лет и старше с ИБС. Интраоперационно проведен мониторинг церебральной оксигенации ( rSO , %). На этапе вводной анестезии средний уровень rSO по правому и левому полушариям составлял 64-65% без значительных изменений во время операции. Снижение rSO во время искусственного кровообращения (ИК) связано с увеличением риска развития неврологических осложнений в раннем послеоперационном периоде. При снижении rSO во время ИК на 20% и более относительно исходных значений по левому и правому полушариям риск неблагоприятных неврологических событий возрастает в 7 и 9 раз соответственно. Два и более инфаркта миокарда в анамнезе в 3 раза увеличивают риск неврологических осложнений после КШ. To identify predictors of neurological complications in the hospital period after coronary artery bypass grafting (CABG), 92 patients with coronary heart disease aged 70 years and over were analyzed. Intraoperative monitoring of cerebral oxygenation ( rSO , %) was carried out. At the stage of induction anesthesia, the average level of rSO for left and right hemispheres was 64-65 % without significant changes during the operation. A decrease in rSO during cardiopulmonary bypass (CPB) was associated with increased risk of neurological complications. The risk of neurological complications increase 7-fold and 9-fold with a decrease in rSO by 20 % or more during CPB relative to baseline for left and right hemispheres, respectively. A history of two or more myocardial infarctions increases 3-fold the risk of neurological complications after CABG.

scholarly journals Non traumatic spinal epidural haematoma

2019 ◽  
Vol 18 (4) ◽  
pp. 255-258
Author(s):  
Naureen Abdul Khalid ◽  
◽  
Nainal Shah ◽  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Trauma Surgery ◽  
Epidural Haematoma ◽  
Rare Condition ◽  
Sudden Onset ◽  
Resonance Imaging ◽  
Spinal Epidural Haematoma ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Epidural

Spinal epidural haematoma is a rare condition, which may be due to trauma, surgery, epidural catheterisation or disorders of coagulation. We report a case of 60 year old lady who was on warfarin for Atrial fibrillation (AF) presented with history of non-traumatic sudden onset pain in both legs and difficulty in walking. Magnetic resonance imaging (MRI) spine demonstrated epidural haematoma which was treated conservatively. Another dilemma was anticoagulation for AF. We examine the options to manage such case.

Abstract 18021: Functional Substrates as the Strongest Predictor of Outcomes in Patients Presenting for Ventricular Arrhythmia Ablation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Justin Hayase ◽  
Yonatan Faiwiszewski ◽  
Stephen Vampola ◽  
Aron Bender ◽  
Gordon Ho ◽  
...  
Keyword(s):  
Ventricular Arrhythmia ◽  
Patient Outcomes ◽  
Roc Analysis ◽  
Youden Index ◽  
History Of ◽  
Forward Stepwise ◽  
Left And Right ◽  
Insight Into ◽  
Procedural Outcome

Introduction: Recent work has shown that rotor characteristics can distinguish sustained versus non-sustained ventricular fibrillation (VF). However, the significance of functional VF substrates on patient outcomes is not studied. Methods: In 26 consecutive patients presenting for ventricular arrhythmia ablation procedures, 64-electrode basket catheters were inserted into both the left and right ventricles and VF was induced and defibrillated at 11±3 seconds. Computational phase analysis was performed and each VF cycle was characterized as rotor, focal, or disorganized activation. Follow-up data were analyzed for arrhythmia recurrence and compared to rotor stability. Forward stepwise regression analysis incorporating age, history of CHF, history of a-fib, history of prior MI, number of VTs induced, and presence of post-procedure inducible VT was performed to determine the strongest predictor of procedural outcome. Results: Of 26 patients, 19 had sustained VF, and 16 underwent attempted ablation (7 VT, 9 PVC). Optimization of the Youden index for the ROC analysis regarding rotor stability and procedural outcome demonstrated that maximum rotor stability of > 14.5 rotations (corresponding to total rotor prevalence of 71%) provided optimal sensitivity of 85% and specificity of 87% for arrhythmia recurrence. Among these, greater rotor stability was significantly associated with ventricular arrhythmia recurrence (86% versus 11%, p = 0.01) (Table 1), and was the strongest predictor of outcomes. Recurrence was independent of presenting arrhythmia. Conclusions: Functional VF/VT metrics were the strongest predictor of ventricular arrhythmia outcomes compared to traditional predictors in this series of patients. This suggests that functional substrate characteristics may provide added insight into recurrence mechanisms. Whether they may identify a target for future interventions requires further study.

scholarly journals Prevalence of ADHD in Accident Victims: Results of the PRADA Study

2019 ◽  
Vol 8 (10) ◽  
pp. 1643 ◽  
Author(s):  
Kittel-Schneider ◽  
Wolff ◽  
Queiser ◽  
Wessendorf ◽  
Meier ◽  
...  
Keyword(s):  
General Population ◽  
Incidence Rate ◽  
Adult Adhd ◽  
Demographic Data ◽  
Trauma Surgery ◽  
Self Report ◽  
Stimulant Treatment ◽  
Surgery Patient ◽  
Increased Risk ◽  
History Of

Background: Recent research has shown an increased risk of accidents and injuries in ADHD patients, which could potentially be reduced by stimulant treatment. Therefore, the first aim of our study was to evaluate the prevalence of adult ADHD in a trauma surgery population. The second aim was to investigate accident mechanisms and circumstances which could be specific to ADHD patients, in comparison to the general population. Methods: We screened 905 accident victims for ADHD using the ASRS 18-item self-report questionnaire. The basic demographic data and circumstances of the accidents were also assessed. Results: Prevalence of adult ADHD was found to be 6.18% in our trauma surgery patient sample. ADHD accident victims reported significantly higher rates of distraction, stress and overconfidence in comparison to non-ADHD accident victims. Overconfidence and being in thoughts as causal mechanisms for the accidents remained significantly higher in ADHD patients after correction for multiple comparison. ADHD patients additionally reported a history of multiple accidents. Conclusion: The majority of ADHD patients in our sample had not previously been diagnosed and were therefore not receiving treatment. The results subsequently suggest that general ADHD screening in trauma surgery patients may be useful in preventing further accidents in ADHD patients. Furthermore, psychoeducation regarding specific causal accident mechanisms could be implemented in ADHD therapy to decrease accident incidence rate.

Malignant melanoma arising in the frontal sinuses

1997 ◽  
Vol 111 (4) ◽  
pp. 376-378 ◽  
Author(s):  
Samuel M. Jayaraj ◽  
Jonathan D. Hern ◽  
George Mochloulis ◽  
Graham C. Porter
Keyword(s):  
Malignant Melanoma ◽  
Natural History ◽  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Poor Prognosis ◽  
Review Of The Literature ◽  
History Of ◽  
Frontal Sinuses ◽  
Sinonasal Malignant Melanoma

AbstractSinonasal malignant melanoma is rare and usually occurs in the nasal cavity. Presentation is often varied and occurs late in the natural history of the disease, resulting in a poor prognosis. A case is reported of a patient with malignant melanoma arising from the frontal sinus who presented with a forehead swelling and progressive confusion. A review of the literature on malignant melanoma in the nasal cavity and paranasal sinuses regarding its presentation, site of origin and principles of management is discussed.

“We’re Doing It Ourselves”

2016 ◽  
Vol 16 (2) ◽  
pp. 162-174 ◽  
Author(s):  
Suleiman Osman
Keyword(s):  
New York ◽  
Community Gardens ◽  
Tree Planting ◽  
Budget Cuts ◽  
Parks And Recreation ◽  
Self Help ◽  
New Public ◽  
History Of ◽  
Left And Right ◽  
Do It Yourself

While the privatization of parks has been controversial since the 1980s, the origins of public–private parks in New York City were complex. During the 1970s fiscal crisis, the Parks and Recreation Department suffered severe budget cuts and was forced to reduce services drastically. Faced with parks that were falling apart, thousands of volunteers in block associations and community groups began to maintain parks on their own. They pioneered radical forms of “do-it-yourself” urbanism with guerrilla horticulture, community gardens, children-fashioned adventure playgrounds, tree-planting drives, makeshift ambulances, and volunteer patrols. By the early 1980s, these “self-help” efforts coalesced into new public–private parks. The history of public–private parks is thus one of privatizations in the plural and points to an array of antistatist impulses that emerged on both the left and right in the 1970s.

scholarly journals An Unusually Large Object Removed From the Upper Esophagus in a Patient With Self Harm Syndrome

2020 ◽  
pp. 014556132095370
Author(s):  
Michael J. Lai ◽  
Jace Morganstein ◽  
Nathan Deckard ◽  
Yekaterina Koshkareva
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Tertiary Care ◽  
Trauma Surgery ◽  
Care Hospital ◽  
Upper Aerodigestive Tract ◽  
Large Object ◽  
Toilet Paper ◽  
History Of ◽  
Self Harm

A 32-year-old female with a history of bipolar disorder and schizophrenia was transported to our tertiary-care hospital after swallowing a large toilet paper holder bracket. Removal of the large foreign body required coordination between anesthesiology, otolaryngology, and trauma surgery. A tracheostomy airway was established, and the object was removed transorally. The object was found to be a toilet paper holder bracket measuring 7.5 cm × 5.4 cm × 5.4 cm with a 2.6 cm screw protruding from the end. A review of articles describing the removal of foreign bodies from the upper aerodigestive tract found our object to be the largest foreign body ingestion described in literature. One report suggested that 18% of adult patients with foreign body ingestions had primary neuropsychiatric disorders. Our patient’s psychiatric disorder was a major underlying factor leading to the ingestion, with our patient reporting hallucinations instructing her to ingest household objects.

3079Subclinical progression of biventricular cardiomyopathy in patients with systemic sclerosis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Stronati ◽  
F Guerra ◽  
L Zuliani ◽  
L Manfredi ◽  
A Ferrarini ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Systemic Sclerosis ◽  
Right Ventricle ◽  
Speckle Tracking ◽  
Left Ventricular ◽  
Myocardial Deformation ◽  
Left Ventricular Ejection ◽  
History Of ◽  
Left And Right

Abstract Background Systemic sclerosis (SSc) is a progressive autoimmune disease which has been proven to affect the heart. While it is widely known that the disease can cause pulmonary artery hypertension and therefore secondary right heart impairment, new studies have detected a subclinical heart involvement of both the left and right ventricles. The similar changes in myocardial deformation of both chambers assessed by speckle tracking imaging are consistent with the definition of SSc-related cardiomyopathy as a standalone entity with peculiar characteristics. Purpose The aim of the present study is to describe the progression of myocardial deformation as assessed through speckle tracking in patients with SSc and no pulmonary hypertension. Methods Prospective, longitudinal study on 48 patients affected by SSc. Patients with a history of heart failure, known structural heart disease, atrial fibrillation, and pulmonary hypertension were excluded. For every patient, standard echocardiographical and speckle-tracking derived variables for the systolic and diastolic function of the left ventricle (LV) and right ventricle (RV) were acquired at baseline and after 15±6 months. Results While common parameters of systolic function (Simpons's left ventricular ejection fraction, right ventricular fractional area change, TAPSE, tricuspidal S') did not change during follow-up, mean global longitudinal strain (GLS) significantly worsened for both left (from −19.1%±4.2% to −17.2%±5.0%) and right ventricle (from −17.9%±5.2% to −15.9%±4.8%) over 15 months. The increased impairment seen in SSc patients was homogeneous across endocardial layers (LV: from −21.8%±4.8% to −18.8%±5.2%; RV: from −20.6%±4.5% to −19.4%±4.9%), midventricular layers (LV: from −19.2%±4.5% to −17.7%±4.9%; RV: from −17.7%±4.7% to −16.7%±4.6%) and epicardial layers (LV: from −16.3%±4.7% to −16.0%±4.3%; RV: from −15.4%±5.0% to −14.6%±4.1%), as well as across myocardial segments (Figure 1). No difference in progression rate was seen between the diffuse and limited version of SSc, nor between different serotypes. Figure 1 Conclusions While traditional echocardiographical parameters are useless in order to follow the natural history of SSc-related cardiomyopathy during its early stages, GLS impairment progresses during a 15-month follow-up and involves similarly both the left and right ventricle. Whether, how, and how much the altered myocardial deformation contributes to the incidence of pulmonary arterial hypertension in these patients is still to be assessed. Acknowledgement/Funding Marche Polytechnic University

Stenurus minor (Metastrongyloidea: Pseudaliidae) infections of the cranial sinuses of the harbour porpoise, Phocoena phocoena

1998 ◽  
Vol 76 (7) ◽  
pp. 1209-1216 ◽  
Author(s):  
Jacqueline Faulkner ◽  
Lena N Measures ◽  
Fred G Whoriskey
Keyword(s):  
Parasite Load ◽  
Phocoena Phocoena ◽  
Mean Intensity ◽  
Gross Lesions ◽  
Left And Right ◽  
Frontal Sinuses ◽  
Young Of The Year ◽  
By Catch ◽  
The Right ◽  
Minor Infection

Seventy-eight harbour porpoises, Phocoena phocoena (33 females, 45 males), were obtained in summer (June-September) as incidental by-catch from the cod fishery in the Gulf of St. Lawrence and examined for the presence of cranial sinus nematodes. Stenurus minor (Kühn, 1829) Baylis and Daubney, 1925 were present in the cranial sinuses of all adult porpoises (>1 year old, N = 66, mean intensity = 2362, range = 87-8920) and absent in all young of the year (<1 year old, N = 12). Only fifth-stage worms were observed and these were equally distributed between the right and left sides of the skull (mean intensity = 1158 and 1213 in the left and right side, respectively). However, S. minor were approximately twice as numerous in the frontal sinuses as in the ear sinuses. Mean intensities of S. minor were similar among all infected porpoises. Parasite load had no apparent effect on porpoise body condition (measured as percent blubber mass of the carcass). No gross lesions associated with the presence of numerous S. minor in the cranial sinuses were observed. There was an inverse relationship between the intensity of S. minor infection and mean worm length, which is suggestive of a "crowding effect." Mean worm length was 17.8 ± 0.2 mm in lightly infected porpoises and 16.1 ± 0.2 mm in heavily infected animals.

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