scholarly journals Mid Facial Degloving Procedure: Managing A Case of Multiple Mid Face Fractures with Significant External Deformity

2015 ◽  
Vol 21 (1) ◽  
pp. 51-56
Author(s):  
Akhil Chndra Biswas ◽  
Feroz Ahmed ◽  
ASM Lutfar Rahman ◽  
Rajan Karmakar ◽  
Farid Uddin Milki ◽  
...  
Keyword(s):  
Intraoperative Complications ◽  
Central Compartment ◽  
Neoplastic Disease ◽  
Open Rhinoplasty ◽  
Craniofacial Skeleton ◽  
Field Exposure ◽  
Technical Problems ◽  
History Of ◽  
Surgical Field ◽  
Midfacial Degloving

Purpose: The midfacial degloving approach (MFDA) is the primary option for surgical treatment of midface lesion. Usually most benign and malignant paranasal sinus (PNS) tumours are unilateral. So the classic MFDA does not fit for every case. Modifications of the classical MFDA are then tailored accordingly for surgical field exposure to achieve the goal. MFDA was first suggested by Portmann in 1927, but the modern technique had its origin in 1974 with the report by Casson and colleagues. It was not until Conley and Price first suggested that the technique be used for the excision of neoplastic disease in 1979 that its use was fully realized. It can be of great benefit for the management of various lesions, mainly tumors, of the facial cavities, paranasal sinuses, nasopharynx, orbits, and central compartment of the anterior and middle cranial fossae, allowing adequate bilateral maxillary and lower nasal cavity exposure without cosmetic dysfunction.Patients: A male patient of 20 years was admitted with history of faciomaxillary trauma having significant external deformity. Under GA open rhinoplasty and reduction & immobilization of fractured segments were done with adequate exposure of midface using midfacial degloving procedure.Result: We have performed MFDA in one case only for the first time. Utilizing sublabial gingivobuccal incision, a complete transfixion incision, intercartilaginous incision with mucosal detachment of the pyriform aperture nasomaxillary skeleton along with zygoma were exposed adequately. No technical problems and no intraoperative complications related to the surgical procedure were encountered. Cosmetic outcome was also satisfactory.Conclusion: Midfacial degloving can be considered as an excellent, useful, and safe approach for many lesions of the midface that has a low complication rate with excellent cosmetic outcomes. It provides excellent exposure to the midportion of the craniofacial skeleton, yet avoids external incisions and should be in every head and neck surgeon’s armamentarium.Bangladesh J Otorhinolaryngol; April 2015; 21(1): 51-56

Rhytidectomy After Parotidectomy

2017 ◽  
Vol 35 (2) ◽  
pp. 92-98
Author(s):  
Boris Paskhover ◽  
Benjamin C. Paul ◽  
David B. Rosenberg
Keyword(s):  
Patient Satisfaction ◽  
Facial Nerve ◽  
Intraoperative Complications ◽  
Case Series ◽  
Surgical Anatomy ◽  
Retrospective Case ◽  
Neck Lift ◽  
Parotid Surgery ◽  
History Of ◽  
Surgical Field

A history of prior parotidectomy is typically thought to substantially increase the risk of facial nerve injury for patients undergoing subsequent facelift surgery. For this reason, surgeons are often hesitant and may even elect not to perform facelift surgery on such patients. However, we have developed a safe and predictable operation for performing the post-parotidectomy rhytidectomy. Here, we present our rationale, approach, and results for performing this operation. This review is a retrospective case series. In total, 1200 facelifts from 2012 to 2016 performed by a single surgeon (D.B.R.) were reviewed. From these, 9 patients were identified as having had parotid surgery prior to rhytidectomy. Rhytidectomy was performed in 8 of 9 cases with a deep-plane, bilaminar approach. There were no intraoperative complications. One patient had a direct neck lift. There were no cases of revision. There were no cases of facial nerve damage including paresis or paralysis; 100% patient satisfaction was noted. Rhytidectomy with a deep-plane approach may be performed safely in patients who have undergone prior parotidectomy. Although there were no complications, revisions, postoperative asymmetry, or dissatisfaction in the patients in this study, it must be stressed that there is no substitute for a thorough appreciation of the surgical anatomy in combination with consideration of the changes to the surgical field that occur with parotid surgery.

Midfacial Degloving Approach to the Nose, Sinuses, and Skull Base

1996 ◽  
Vol 10 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Gady Har-El ◽  
Frank E. Lucente
Keyword(s):  
Complete Removal ◽  
Central Compartment ◽  
Neoplastic Disease ◽  
Common Complication ◽  
Nasal Valve ◽  
Traumatic Injuries ◽  
Traumatic Lesions ◽  
Bilateral Surgery ◽  
Medial Maxillectomy ◽  
Midfacial Degloving

Thirty-seven patients with a variety of neoplastic, vascular, and traumatic lesions of the midfacial skeleton, orbits, and central compartment of the anterior and middle cranial fossae were managed surgically via the midfacial degloving approach. Excellent exposure was achieved in all patients. Complete removal of the lesion was achieved in all patients with neoplastic disease. Successful repair of the defect was achieved in all patients with traumatic injuries. The most common complication related to midfacial degloving was temporary infraorbital anesthesia or hypesthesia. Only one patient developed symptomatic nasal valve stenosis. Midfacial degloving has important advantages over other procedures, especially in cases where bilateral surgery is required or when the avoidance of midfacial incisions and scars is important. In the subgroup of inverted papilloma, midfacial degloving is currently our procedure of choice for en-block medial maxillectomy and ethmoidectomy.

scholarly journals Transperineal total mesorectal excision for rectal cancer on the residual rectum after multiple abdominal surgeries in a patient with Crohn’s disease: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shin Emoto ◽  
Shigenori Homma ◽  
Tadashi Yoshida ◽  
Nobuki Ichikawa ◽  
Yoichi Miyaoka ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intraoperative Complications ◽  
Rectal Stump ◽  
Stage I ◽  
Colonoscopic Examination ◽  
Case Presentation ◽  
History Of ◽  
Blood Loss Volume

Abstract Background The improved prognosis of Crohn’s disease may increase the opportunities of surgical treatment for patients with Crohn’s disease and the risk of development of colorectal cancer. We herein describe a patient with Crohn’s disease and a history of multiple surgeries who developed rectal stump carcinoma that was treated laparoscopically and transperineally. Case presentation A 51-year-old man had been diagnosed with Crohn’s disease 35 years earlier and had undergone several operations for treatment of Crohn’s colitis. Colonoscopic examination was performed and revealed rectal cancer at the residual rectum. The patient was then referred to our department. The tumor was diagnosed as clinical T2N0M0, Stage I. We treated the tumor by combination of laparoscopic surgery and concomitant transperineal resection of the rectum. While the intra-abdominal adhesion was dissected laparoscopically, rectal dissection in the correct plane progressed by the transperineal approach. The rectal cancer was resected without involvement of the resection margin. The duration of the operation was 3 h 48 min, the blood loss volume was 50 mL, and no intraoperative complications occurred. The pathological diagnosis of the tumor was type 5 well- and moderately differentiated adenocarcinoma, pT2N0, Stage I. No recurrence was evident 3 months after the operation, and no adjuvant chemotherapy was performed. Conclusion The transperineal approach might be useful in patients with Crohn’s disease who develop rectal cancer after multiple abdominal surgeries.

scholarly journals Two cases of intraoperative hemodynamic instability during combined thoracoscopic-laparoscopic surgery for esophagogastric junction carcinoma

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Makiko Tani ◽  
Yoshikazu Matsuoka ◽  
Mayu Sugihara ◽  
Ayaka Fujii ◽  
Tomoyuki Kanazawa ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Esophagogastric Junction ◽  
Intraoperative Complications ◽  
Proximal Gastrectomy ◽  
Tension Pneumothorax ◽  
Hemodynamic Instability ◽  
Laparoscopic Proximal Gastrectomy ◽  
Surgical Field ◽  
Coronary Ischemia ◽  
Thoracic And Abdominal

Abstract Background Intraoperative complications during combined thoracoscopic-laparoscopic surgery for esophagogastric junction (EGJ) carcinoma have not been reported as compared to those during surgery for esophageal carcinoma. We present two cases which had surgery-related hemodynamic instability during laparoscopic proximal gastrectomy and intra-mediastinal valvuloplastic esophagogastrostomy (vEG) with thoracoscopic mediastinal lymphadenectomy for EGJ carcinoma. Case presentation In case 1, the patient fell into hypotension with hypoxemia during laparoscopic vEG due to pneumothorax caused by entry of intraabdominal carbon dioxide. In case 2, ventricular arrythmia and ST elevation occurred during laparoscopic vEG. Pericardium retraction to secure surgical field during reconstruction compressed the coronary artery, which caused coronary malperfusion. These two events were induced by the surgical procedure, characterized by the following: (1) connection of the thoracic and abdominal cavities and (2) cardiac displacement during vEG. Conclusion These cases indicated tension pneumothorax and coronary ischemia are possible intraoperative complications specific to combined thoracoscopic-laparoscopic surgery for EGJ carcinoma.

scholarly journals Multiple Cartilaginous Exostoses In A Pediatric Dog

2019 ◽  
Vol 47 ◽  
Author(s):  
José Artur Brilhante Bezerra ◽  
Ramon Tadeu Galvão Alves Rodrgues ◽  
Isabelle De Oliveira Lima ◽  
Luanda Pâmela César De Oliveira ◽  
Carlos Eduardo Bezerra De Moura ◽  
...  
Keyword(s):  
Physical Examination ◽  
Neurological Dysfunction ◽  
Lateral Part ◽  
Histopathological Analysis ◽  
Neoplastic Disease ◽  
Nerve Roots ◽  
Palpable Mass ◽  
Histopathological Findings ◽  
Adjacent Structures ◽  
History Of

Background: Multiple cartilaginous exostosis (MCE) is a rare neoplastic disease in dogs that is characterized by the presence of osteochondromas in multiple bones. MCE is a disorder of development during growth and maturation, the real etiology of which has yet to be elucidated, but is believed to have a genetic basis. Usually affected animals have a history of a palpable mass on the bone surface, causing anatomical deformities and compression of adjacent structures. Since MCE is a rare neoplastic disease in dogs it may be difficult to recognize in the clinic. The aim of this study was to report a case of MCE in a pediatric dog.Case: A female 4-month-old Rottweiler dog with a history of bone neoformation on the left hind limb, anorexia, weight loss, and difficulty walking received clinical care. The disease had its initial onset 2 months prior. At physical examination, the animal showed paresis of the hind limbs and a bony tumor on the lateral part of the left tibia. A complete blood cell count and serum biochemical profile were obtained. The only abnormality diagnosed was hyperproteinemia due to hyperglobulinemia. Other diagnostic tests were not authorized and the animal was euthanized. At the necropsy, an intrathoracic neoformation was observed from the sixth to the eighth rib on the right antimer. Some tumors were also observed on the fourth lumbar vertebra and between the first and the second sacral vertebra, and a left tibial tumor, which had been observed at physical examination. The sagittal section of the spine revealed the presence of extradural compression of the spinal cord due to vertebral proliferations with compression of the nerve roots. All of the proliferations had macroscopic similarities, being firm, sessile, irregular, and with complete adherence to deep planes. Tumor samples were submitted to histopathological analysis and the tissue morphology was compatible with osteochondroma. Based on the clinical, necroscopical, and histopathological findings, a diagnosis of MCE was established.Discussion: In MCE, animals less than one year of age are the most frequently affected, as was observed in the case reported. Clinical signs in MCE usually result from poor bone and cartilaginous anatomical formations and from compression of adjacent tissue structures. In the described patient, the proliferations located in the vertebrae and tibia and the consequent compression of nerve roots and nerves caused the neurological deficits. Unlike in canines, the etiology of MCE in humans is already well established and it is classified as an autosomal dominant genetic disorder. The diagnosis is usually obtained through the association of clinical examination with radiographic and histopathological findings. However, in the animal studied, since it was not possible to perform radiographs, confirmation was obtained only after performing histopathological examination of the neoformations, which is considered the standard for the diagnosis of MCE. Although it corresponds to a benign neoplastic process affecting dogs during their growth stage, it may significantly decrease the animal’s quality of life. In this situation, the prognosis of MCE is considered to be reserved to bad, and animals are often referred for euthanasia, as occurred in the animal under discussion, due to the progression of neurological dysfunction. Early recognition of MCE in routine pet hospital practice is of fundamental importance in order to properly institute treatment and monitoring.

The Estimate of the Impact of Coccyx Resection in Surgical Field Exposure During Abdominal Perineal Resection Using Preoperative High-Resolution Magnetic Resonance

2018 ◽  
Vol 42 (11) ◽  
pp. 3765-3770
Author(s):  
Guilherme Pagin São Julião ◽  
Cinthia D. Ortega ◽  
Bruna Borba Vailati ◽  
Francisco A. B. Coutinho ◽  
Gustavo Rossi ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
High Resolution ◽  
Field Exposure ◽  
Perineal Resection ◽  
Surgical Field ◽  
The Impact ◽  
Abdominal Perineal Resection

Game Models in Various Applications

2014 ◽  
pp. 44-128 ◽  
Keyword(s):  
Game Theory ◽  
Academic Research ◽  
Viable Alternative ◽  
Theoretic Approach ◽  
Original Game ◽  
Technical Problems ◽  
Research Areas ◽  
History Of ◽  
Game Theoretic ◽  
Game Theoretic Approach

Recently, game-theoretic models have become famous in many academic research areas. Therefore, many applications and extensions of the original game theoretic approach appear in many of the major science fields. Despite all the technical problems, the history of game theory suggests that it would be premature to abandon the tool, especially in the absence of a viable alternative. If anything, the development of game theory has been driven precisely by the realization of its limitations and attempts to overcome them. This chapter explores these ideas.

scholarly journals Voices from the Uncanny Valley

2018 ◽  
Vol 4 (1) ◽  
pp. 45-64
Author(s):  
Tiina Männistö-Funk ◽  
Tanja Sihvonen
Keyword(s):  
Historical Context ◽  
Uncanny Valley ◽  
Cultural Issues ◽  
Technological Systems ◽  
Negative Effects ◽  
Late 19Th Century ◽  
Technical Problems ◽  
Talking Heads ◽  
History Of ◽  
Gender Aspects

Abstract Voice is a powerful tool of agency - for humans and non-humans alike. In this article, we go through the long history of talking heads and statues to publicly displayed robots and fortune-tellers, as well as consumer-oriented products such as the late 19th century talking dolls of Thomas Edison. We also analyse the attempts at making speaking machines commercially successful on various occasions. In the end, we investigate how speech producing devices such as the actual digital assistants that operate our current technological systems fit into this historical context. Our focus is on the gender aspects of the artificial, posthuman voice. On the basis of our study, we conclude that the female voice and other feminine characteristics as well as the figures of exoticized and racialized ‘Others’ have been applied to draw attention away from the uncanniness and other negative effects of these artificial humans and the machinic speech they produce. Technical problems associated with the commercialization of technologically produced speech have been considerable, but cultural issues have played an equally important role.

The History of Mastectomy

2011 ◽  
Vol 77 (5) ◽  
pp. 566-571 ◽  
Author(s):  
Marios Loukas ◽  
R. Shane Tubbs ◽  
Nadine Mirzayan ◽  
Michelle Shirak ◽  
Ashley Steinberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
20Th Century ◽  
Upper Limb ◽  
Breast Tissue ◽  
Surgical Techniques ◽  
Radical Mastectomy ◽  
Large Impact ◽  
Surgical Tools ◽  
History Of ◽  
Surgical Field

The mastectomy that is performed today is a procedure born from hundreds of years of discoveries, inventions, and amendments to existing surgical techniques. The reasons for performing this extreme surgery have changed as well, ranging from unilateral breast removal to allow greater upper limb functionality to bilateral removal of the breasts or breast tissue in individuals predisposed to breast cancer or in individuals who have already been diagnosed. The additions of surgical tools and anesthetics to the field of medicine further transformed the surgical field in general and had a large impact on the mastectomy. William Halsted's radical mastectomy served as the basis of most future breast removal techniques, and it the method recognized today as the “radical mastectomy.” Most radical surgeries are currently used for prophylaxis, whereas less invasive lumpectomies have eclipsed breast removal surgeries as of the latter half of the 20th century.

scholarly journals A brief history of aneurysm clips

2001 ◽  
Vol 11 (2) ◽  
pp. 1-4 ◽  
Author(s):  
Deon F. Louw ◽  
Wilson T. Asfora ◽  
Garnette R. Sutherland
Keyword(s):  
History Of ◽  
Surgical Field ◽  
Closing Pressure ◽  
Selection Of

In this communication the authors outline the development of aneurysm clips from those originally used by Walter Dandy to those currently in use. The history is rich in contributions from neurosurgical pioneers and innovators. As a result, the modern neurosurgeon has a wide selection of biocompatible aneurysm clips with known closing pressure, of variable sizes and shapes, and a selection of clip applicators that do not obstruct the surgical field.

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