Comparison between Conventional Microdissection and CO2 Laser in the Treatment of Vocal Cord Polyp

Background: Vocal cord polyp usually arises from the epithelium and the lamina propria. Minimally invasive dissection procedures are employed to treat these vocal cord polyp for an effective outcome. Two types of microsurgical techniques were developed gradually and practiced namely, the conventional laryngeal microsurgery, which involves the use of cold instruments and the laryngeal laser micro-surgery. Objective: To compare the conventional cold dissection and CO2 laser methods in treatment of vocal cord polyp. Methods: A randomized prospective study was conducted at the Department of Otolayngology- Head & Neck Surgery, at Bangabondhu Sheikh Muzib Medical University (BSMMU) between July 2017 and June 2019. A total of 60 cases were studied on the following parameters: a. Visual analysis on stroboscopy b. Voice analysis –GRBAS (grade, roughness, breathiness, asthenia, strain) indices c. Duration of surgery d. Peroperative bleeding. Results: During first postoperative assessment, both groups had the normal symmetrical waves, while 50% of cases still had aperiodicity but all patients had the near normal periodicity in the second postoperative assessment. Regarding glottic closure, during preoperative assessment, almost all patients had incomplete glottic closure due to mass lesion as polyps. During first postoperative assessment, glottic closure was found to be better in group B (83% of cases) than group A (76% of cases), while during second postoperative assessment, all patients of both groups had around 95% glottic closure. The mean duration oflaser technique (7.1 ± 1.1 minutes) was less than the conventional technique time (15.6 ± 1.9 minutes), also mean of operative bleeding of laser technique (zero pack) is less than the conventional two(2 packs). Conclusion: There is no significant difference between both groups in all parameters except operative time and bleeding, as laser technique has less time and clear field. Bangladesh J Otorhinolaryngol; April 2021; 27(1): 17-24

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Evaluating the utility of a CO2 surgical laser for piglet castration to reduce pain and improve wound healing: a pilot study

Journal of Animal Science ◽

10.1093/jas/skaa320 ◽

2020 ◽

Vol 98 (11) ◽

Author(s):

Abbie V Viscardi ◽

Charley A Cull ◽

Michael D Kleinhenz ◽

Shawnee Montgomery ◽

Andrew Curtis ◽

...

Keyword(s):

Wound Healing ◽

Co2 Laser ◽

Blood Parameters ◽

Healing Time ◽

Prostaglandin E ◽

Laser Technique ◽

Significant Difference ◽

Thermal Tissue Damage ◽

Improve Wound Healing ◽

Surgical Laser

Abstract CO2 surgical lasers are widely used for procedures in veterinary and human medicine. There is evidence to suggest surgery using a CO2 laser reduces pain and swelling and improves healing time compared with surgery with a scalpel. Millions of piglets in North America are surgically castrated each year using a scalpel. Therefore, piglet welfare may be improved by making refinements to the surgical procedure. The objectives of this preliminary study were to determine the ability of a CO2 surgical laser to (1) reduce pain and (2) improve wound healing of piglets undergoing surgical castration. Two-day-old male Yorkshire × Landrace piglets were used and randomly assigned to 1 of 3 treatments (n = 10 piglets/treatment group): surgical castration with the CO2 laser, surgical castration with a scalpel, or sham (uncastrated control). Piglets were video recorded in their pens for 1 hr preprocedure and from 0 to 2, 6 to 8, and at 24 hr postprocedure for behavior scoring. Surgical site images were collected at baseline, 0, 8, 24, 48, 72, 96, 120, 144, and 168 hr postcastration for wound healing assessment. Infrared thermography images of the surgical site were also taken at baseline, 0, 0.5, 8, and 24 hr postprocedure to assess inflammation. Finally, blood was collected from each piglet at baseline and 0.5 hr postcastration to assess cortisol levels, prostaglandin E metabolite and pig-major acute phase protein concentration. Laser-castrated piglets displayed more pain behaviors across the observation period than scalpel-castrated piglets (P = 0.05). Laser-castrated piglets also displayed significantly more agonistic behavior than both scalpel-castrated piglets (P = 0.005) and sham piglets (P = 0.036); yet, laser-castrated piglets had significantly lower temperatures at the site of incision compared with scalpel-castrated piglets (P = 0.0211). There was no significant difference in wound healing or any of the blood parameters assessed between laser-castrated and scalpel-castrated piglets. There was evidence of thermal tissue damage on the scrotum of piglets that were castrated using the CO2 laser. This may have resulted in the unremarkable healing time and the increased pain behavior observed in this study. The surgical laser technique should be refined before conclusions can be made regarding the utility of a CO2 laser for piglet castration.

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Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-019-0125-4 ◽

2019 ◽

Vol 55 (1) ◽

Author(s):

Mohamed I. Refaat ◽

Amr K. Elsamman ◽

Adham Rabea ◽

Mohamed I. A. Hewaidy

Keyword(s):

Patient Satisfaction ◽

Blood Loss ◽

Minimally Invasive ◽

Invasive Technique ◽

Decompression Surgery ◽

Microsurgical Decompression ◽

Significant Difference ◽

Duration Of Surgery ◽

Group A ◽

Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

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Fixation stability and implant-associated complications in periacetabular osteotomy: a comparison of screw and K-wire fixation

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-021-04112-7 ◽

2021 ◽

Author(s):

Vincent Justus Leopold ◽

Juana Conrad ◽

Robert Karl Zahn ◽

Christian Hipfl ◽

Carsten Perka ◽

...

Keyword(s):

Soft Tissue ◽

Screw Fixation ◽

Periacetabular Osteotomy ◽

Implant Migration ◽

Major Complications ◽

Significant Difference ◽

Duration Of Surgery ◽

Wire Fixation ◽

Fixation Stability ◽

Screw Group

Abstract Aims The aim of this study was to compare the fixation stability and complications in patients undergoing periacetabular osteotomy (PAO) with either K-wire or screw fixation. Patients and methods We performed a retrospective study to analyze a consecutive series of patients who underwent PAO with either screw or K-wire fixation. Patients who were treated for acetabular retroversion or had previous surgery on the ipsilateral hip joint were excluded. 172 patients (191 hips: 99 K-wire/92 screw fixation) were included. The mean age at the time of PAO was 29.3 years (16–48) in the K-wire group and 27.3 (15–45) in the screw group and 83.9% were female. Clinical parameters including duration of surgery, minor complications (soft tissue irritation and implant migration) and major complications (implant failure and non-union) were evaluated. Radiological parameters including LCE, TA and FHEI were measured preoperatively, postoperatively and at 3-months follow-up. Results Duration of surgery was significantly reduced in the K-wire group with 88.2 min (53–202) compared to the screw group with 119.7 min (50–261) (p < 0.001). Soft tissue irritation occurred significantly more often in the K-wire group (72/99) than in the screw group (36/92) (p < 0.001). No group showed significantly more implant migration than the other. No major complications were observed in either group. Postoperative LCE, TA and FHEI were improved significantly in both groups for all parameters (p = < 0.0001). There was no significant difference for initial or final correction for the respective parameters between the two groups. Furthermore, no significant difference in loss of correction was observed between the two groups for the respective parameters. Conclusion K-wire fixation is a viable and safe option for fragment fixation in PAO with similar stability and complication rates as screw fixation. An advantage of the method is the significantly reduced operative time. A disadvantage is the significantly higher rate of implant-associated soft tissue irritation, necessitating implant removal. Level of evidence III, retrospective trial.

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4K 3-dimensional video microscope system (orbeye) for transsphenoidal pituitary surgery

Acta Neurochirurgica ◽

10.1007/s00701-021-04762-x ◽

2021 ◽

Author(s):

Roman Rotermund ◽

Jan Regelsberger ◽

Katharina Osterhage ◽

Jens Aberle ◽

Jörg Flitsch

Keyword(s):

3D Visualization ◽

Remission Rate ◽

Subjective Evaluation ◽

Pituitary Surgery ◽

Image Resolution ◽

Wide Range ◽

Significant Difference ◽

Duration Of Surgery ◽

Video Microscope ◽

Transsphenoidal Pituitary Surgery

Abstract Background In previous reports on experiences with an exoscope, this new technology was not found to be applicable for transsphenoidal pituitary surgery. As a specialized center for pituitary surgery, we were using a 4K 3D video microscope (Orbeye, Olympus) to evaluate the system for its use in transsphenoidal pituitary surgery in comparison to conventional microscopy. Method We report on 296 cases performed with the Orbeye at a single institution. An observational study was conducted with standardized subjective evaluation by the surgeons after each procedure. An objective measurement was added to compare the exoscopic and microscopic methods, involving surgery time and the initial postoperative remission rate in matched cohorts. Results The patients presented with a wide range of pathologies. No serious events or minor complications occurred based on the usage of the 4K 3D exoscope. There was no need for switching back to the microscope in any of the cases. Compared to our microsurgically operated collective, there was no significant difference regarding duration of surgery, complications, or extent of resection. The surgeons rated the Orbeye beneficial in regard to instrument size, positioning, surgeon’s ergonomics, learning curve, image resolution, and high magnification. Conclusions The Orbeye exoscope presents with optical and digital zoom options as well as a 4K image resolution and 3D visualization resulting in better depth perception and flexibility in comparison to the microscope. Split screen mode offers the complementary benefit of the endoscope which may increase the possibilities of lateral view but has to be evaluated in comparison to endoscopic transsphenoidal procedures in the next step.

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Surgical Morbidity of Neck Dissection after Chemoradiotherapy in Advanced Head and Neck Cancer

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949710600205 ◽

1997 ◽

Vol 106 (2) ◽

pp. 117-122 ◽

Cited By ~ 38

Author(s):

James P. Newman ◽

Willard E. Fee ◽

David J. Terris ◽

Richard L. Goode ◽

Harlan A. Pinto ◽

...

Keyword(s):

Head And Neck ◽

Surgical Procedures ◽

Complication Rate ◽

Organ Preservation ◽

Surgical Complication ◽

Control Group ◽

Surgical Morbidity ◽

Significant Difference ◽

Duration Of Surgery ◽

Lower Complication

The use of chemotherapy and irradiation for organ preservation attempts to eliminate the need for extensive surgery in patients with advanced squamous cell carcinoma of the head and neck (SCCHN). We sought to characterize the morbidity of surgery in patients who needed surgery after treatment with induction chemotherapy followed by simultaneous chemotherapy and radiotherapy (chemoradiotherapy). The surgical morbidity within the first 30 postoperative days of 17 patients treated in an organ preservation approach between July 1991 and December 1994 was compared with a control group of patients undergoing similar surgical procedures during the same period. The organ preservation study patients underwent surgical procedures consisting of 18 neck dissections and 5 resections of the primary site. Six patients in the organ preservation study group experienced 8 surgical complications within the first 30 postoperative days, and most complications were minor. There was no significant difference in the duration of surgery or length of hospitalization between study patients and matched controls. Our surgical complication rate (35.3%) was higher but not statistically different from that of the control group, and compared favorably to reports of surgical morbidity (44% to 61%) in the literature on patients treated with chemoradiotherapy. The lower complication rate seen in this study may be a reflection of early surgical intervention as part of our organ preservation study scheme, the preponderance of neck dissections performed, and the limited number of pharyngeal procedures performed.

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Split face comparative study of microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars

QJM ◽

10.1093/qjmed/hcab093.001 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mohamed Abd Elnaeem Sallam ◽

Khaled El Zawahry ◽

Abdul Rahman Muhammed Ali Mustafa

Keyword(s):

Carbon Dioxide ◽

Co2 Laser ◽

Carbon Dioxide Laser ◽

Platelet Rich Plasma ◽

Fractional Co2 Laser ◽

Acne Scars ◽

Significant Difference ◽

Before And After ◽

The Face ◽

Fractional Carbon Dioxide Laser

Abstract Background Acne scars, is a challenge for dermatologists, despite having multiple treatment modalities like microneedling, dermabrasion, Fractional CO2 Laser, dermal fillers, etc. However, monotherapy has been hardly satisfactory because of the polymorphism seen with the scars. Objective Comparison between microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars. Patients and methods This study was carried out in department of dermatology, venereology and andrology, in Kobry El-Kobba Military complex during the period (from September 2018 to July 2020 ) on 20 patients of both sexes aged from 20 to 60 years old presenting with Goodman and Baron Grade II, III, IV acne scars . Results The study revealed a statistically significant difference (p = 0.017) between Goodman and Baron scar grades on the right side of the face before and after treatment indicating that microneedling with platelet rich plasma was effective in improving acne scars. Also, there is a statistically significant difference (p = 0.010) between Goodman and Baron scar grades on the left side of the face before and after treatment, indicating that fractional CO2 laser with platelet rich plasma was effective in improving acne scars. Conclusion and recommendation Further controlled and randomized studies are needed to validate our findings in a larger cohort of patients and longer follow up. Also, number of sessions might be more than 3 sessions.

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The Effectiveness of Equipment Provisions on Rural Middle School Students’ Physical Activity During Lunch Recess

Journal of Physical Activity and Health ◽

10.1123/jpah.2019-0661 ◽

2021 ◽

Vol 18 (3) ◽

pp. 287-295

Author(s):

Hyeonho Yu ◽

Pamela H. Kulinna ◽

Shannon C. Mulhearn

Keyword(s):

Physical Activity ◽

Middle School ◽

Middle School Students ◽

Visual Analysis ◽

Leisure Activity ◽

Environmental Intervention ◽

School Students ◽

Baseline Phase ◽

Significant Difference ◽

Eighth Grade Students

Background: Environmental provisions can boost students’ discretionary participation in physical activity (PA) during lunchtime at school. This study investigated the effectiveness of providing PA equipment as an environmental intervention on middle school students’ PA levels and stakeholders’ perceptions of the effectiveness of equipment provisions during school lunch recess. Methods: A baseline–intervention research design was used in this study with a first baseline phase followed by an intervention phase (ie, equipment provision phase). A total of 514 students at 2 middle schools (school 1 and school 2) in a rural area of the western United States were observed directly using the System for Observing Play and Leisure Activity in Youth instrument. Interviews were conducted with stakeholders. Paired-sample t tests and visual analysis were conducted to explore differences in PA levels by gender, and common comparison (with trustworthiness measures) was used with the interview data. Results: The overall percentage of moderate to vigorous PA levels was increased in both schools (ranging from 8.0% to 24.0%). In school 2, there was a significant difference in seventh- and eighth-grade students’ moderate to vigorous PA levels from the baseline. Three major themes were identified: (1) unmotivated, (2) unequipped, and (3) unquestionable changes (with students becoming more active). Conclusions: Environmental supports (access, equipment, and supervision) significantly and positively influenced middle school students’ lunchtime PA levels.

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Distal Tibia Metaphyseal Fractures: Which is Better, Intra-medullary Nailing or Minimally Invasive Plate Osteosynthesis?

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.09.004 ◽

2018 ◽

Vol 24 (1) ◽

pp. 66-71

Author(s):

Kawalkar Abhijit Chandrakant ◽

Badole Chandrashekher Martand

Keyword(s):

Intramedullary Nailing ◽

Weight Bearing ◽

Distal Tibia ◽

Tibial Fractures ◽

Minimally Invasive Plate Osteosynthesis ◽

Early Weight Bearing ◽

Significant Difference ◽

Duration Of Surgery ◽

Tibia Fractures ◽

Distal Tibia Fractures

Introduction Tibia fractures are the most common long bone fractures encountered by the orthopedic surgeons and distal tibia fractures have the second highest incidence of all tibia fractures after the middle third of tibia the distal tibial fractures are unique and are considered as most challenging fractures to treat due to its proximity to the ankle joint and its superficial nature. The objective of this study is to compare two osteosynthesis systems developed for surgical treatment of distal tibia fractures: the intramedullary nailing and the MIPPO technique. Methods The study was conducted between Jan 2011 to Dec 2012. 63 patients with extra-articular distal tibia fracture treated with intramedullary nailing and MIPPO technique were reviewed retrospectively and clinical outcome was evaluated according to American Orthopaedic Foot and Ankle Score. Results 31 patients were treated with intramedullary nail & 32 with MIPPO technique. Fibular fixation was done in cases where fibular fracture was at or below the level of tibial fractures. We found no difference in terms of time for fracture union, mal-union, non-union, duration of surgery and amount of blood loss. But there was significant difference in terms of infection and duration of hospital stay. Also weight bearing was possible much earlier in intramedullary group as compared to the MIPPO group. Conclusion Thus we conclude that intramedullary nailing is better choice of implant in patients with extra- articular distal tibia fractures & helps in early weight bearing and ambulation of patient with fewer complications.

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Comparison of patient and surgeon satisfaction in patients undergoing knee arthroscopy with peripheral nerve block versus spinal anesthesia

Journal of Clinical and Investigative Surgery ◽

10.25083/2559.5555/6.2.10 ◽

2021 ◽

Vol 6 (2) ◽

pp. 148-152

Author(s):

Seray Turkmen ◽

◽

Mehmet Mutlu

Keyword(s):

Peripheral Nerve ◽

Spinal Anesthesia ◽

Nerve Block ◽

Knee Arthroscopy ◽

Femoral Nerve Block ◽

Femoral Nerve ◽

Rescue Analgesia ◽

Significant Difference ◽

Duration Of Surgery ◽

Surgeon Satisfaction

Objective. This study aims to compare two different methods of regional anesthesia applied for knee arthroscopy in terms of patient and surgeon satisfaction. Materials and Methods. Eighty patients who underwent knee arthroscopy either with spinal anesthesia (SA) or unilateral sciatic and femoral nerve block (SFNB) were included in the study. A nurse conducted a blind study questionnaire to assess the surgeon and patient satisfaction from anesthesia performed at the end of the surgery. Pain score, demographical data, duration of surgery, motor and sensory block duration, time of first rescue analgesia were recorded and analyzed statistically. Results. A statistically significant difference was found between the patient (p = 0.001; p <0.01) and surgeon (p = 0.022; p <0.05) satisfaction rates, these being lower in the group with SFNB comparable to patients with spinal anesthesia. There was a statistically significant difference between the first analgesic requirements of the patients according to the groups (p = 0.001; p <0.01). The first analgesic requirement of the patients who received SFNB was later than in the case of patients who received spinal anesthesia. Conclusions. Patient and surgeon satisfaction with SA was significantly higher than SFNB. The peripheral nerve blocks are inadequate for patient and surgeon satisfaction for knee arthroscopy compared to SA.

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The assessment of the stability of the corneal structure after LASIK correction of myopia by different optical zone diameters

Vojnosanitetski pregled ◽

10.2298/vsp140627029m ◽

2016 ◽

Vol 73 (6) ◽

pp. 572-576 ◽

Cited By ~ 1

Author(s):

Milorad Milivojevic ◽

Vladimir Petrovic ◽

Miroslav Vukosavljevic ◽

Ivan Marjanovic ◽

Mirko Resan

Keyword(s):

Structural Parameters ◽

Preoperative Assessment ◽

Laser In Situ Keratomileusis ◽

Group I ◽

Significant Difference ◽

Optical Zone ◽

Corneal Structure ◽

The Stability ◽

Corneal Thinning

Background/Aim. Enlargement of optical zone (OZ) diameter during laser in situ keratomileusis (LASIK) correction of myopia postoperatively improves the optical outcome, however, it also leads to the increased stroma tissue consumption - progressive corneal thinning. The aim of this investigation was to present the possibility of safe OZ enlargement without impairing the structural stability of the cornea, while obtaining an improved optical outcome with LASIK treatment of shortsightedness. Methods. Preoperative assessment of the cornea structure and prediction of the ablated stroma tissue consumption was conducted in 37 patients (74 eyes) treated for shortsightedness by means of the LASIK method. With the eyes that, according to their cornea structure, had the capacity for OZ diameter enlargement of 0.5 mm, LASIK treatment was performed within the wider OZ diameter of 7.0 mm compared to the standard 6.5 mm. The following two groups were formed, depending on the diameter of the utilized OZ: the group I (the eyes treated with the OZ 6.5 mm, n = 37) and the group II (the eyes treated with the OZ 7.0 mm, n = 37). Results. No significant difference in the observed structural parameters of the cornea was detected between the groups of patients treated with different OZ diameters. The values of all the parameters were significantly bellow the threshold values for the development of postoperative ectasia. Conclusion. Diameter enlargement of the treated OZ, if there is a preoperative cornea capacity for such enlargement, will not impair the postoperative stability of the cornea structure, and will significantly improve the optical outcome.

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