scholarly journals Efficacy of Trans-nasal Endoscopic Sphenopalatine Artery Ligation in the Management of Recurrent Posterior Epistaxis

KYAMC Journal ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 133-137
Author(s):  
Muntasir Mahbub ◽  
Md Mahbubur Rahman
Keyword(s):  
Treatment Modalities ◽  
Recurrent Bleeding ◽  
Artery Ligation ◽  
Female Ratio ◽  
Bleeding Point ◽  
Sphenopalatine Artery ◽  
Recurrent Epistaxis ◽  
Nasal Bleeding ◽  
Endoscopic Ligation ◽  
Male To Female

Background: Recurrent posterior epistaxis is a challenging problem for most otolaryngologists. Of the several proposed treatment modalities, endoscopic ligation of SPA (Sphenopalatine artery) provides a simple and effective solution with relatively minor complications. Objectives: Aim of this study was to find out the success rate and complications of endoscopic ligation of SPA in the management of recurrent posterior epistaxis. Materials and Methods: This was an observational study conducted from Jan 2019 to Jan 2021. Total 60 patients were included in this study. Inclusion criteria were - recurrent epistaxis (at least 4 episodes in last 2 months) with bleeding point not seen in anterior rhinoscopy, Failure of previous conservative management with medications and nasal packing, age between 18–60 years of both sexes. All the patients underwent trans-nasal endoscopic Sphenopalatine artery ligation, and patients were followed up for 12 weeks to identify repeated bleeding and to evaluate complications. Results: In this study male to female ratio was 1.5:1. Mean age of study group was 44.66 (±8.62) years. No recurrent bleeding occurred in 51 (85%) and in 9 (15%) nasal bleeding occurred in the 2 months postoperative period. Anesthesia of incisor teeth occurred in 18 patients (30%), 22 patients (37%) complained about increased nasal crusting. Conclusion: Endoscopic ligation of Sphenopalatine artery shows good outcome in prevention of further episodes of epistaxis in most patients. Although some minor complications can occur, these are manageable. KYAMC Journal. 2021;12(3): 133-137

scholarly journals Audit of the workload in a maxillofacial and oral surgical unit in Johannesburg

2021 ◽  
Vol 76 (04) ◽  
pp. 194-200
Author(s):  
Kamal Sukha ◽  
Mzubanzi Mabongo
Keyword(s):  
High Volume ◽  
Treatment Modalities ◽  
Global Studies ◽  
Microsoft Excel ◽  
Cross Sectional ◽  
Female Ratio ◽  
Respective Treatment ◽  
Male To Female ◽  
Surgical Unit

Maxillofacial and oral surgical (MFOS) audits are able to provide data to both current and prospective patients regarding the quality of care an institution is capable of providing. The more frequently performed MFOS procedures can be determined and the allocation of funding and resources can therefore be achieved more appropriately. To conduct an audit to evaluate the workload and scopeof practice of the MFOS unit of the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) for the year 2015 by quantifying MFOS conditions and the respective treatment modalities. The study was retrospective and cross-sectional. Data was retrieved from the patient logbook of the unit which was then entered into a Microsoft Excel Spreadsheet. Pie graphs and bar charts representing the data were then generated. A total of 1 750 patients were treated in the unit. The male to female ratio was 1.3:1 and the majority of these patients were in their 3rd and 4th age decade. Most patients required a tooth extraction mainly for an impacted 3rd molar. Dentoalveolar surgery was the most commonly performed procedure followed by the treatment of facial fractures. Pathological and other MFOS conditions were less commonly encountered. The CMJAH MFOS unit treats a high volume of patients according to comparisons with global studies.

Sphenopalatine and Anterior Ethmoidal Artery Ligation for Severe Epistaxis

2009 ◽  
Vol 118 (9) ◽  
pp. 639-644 ◽  
Author(s):  
Alexander Asanau ◽  
Andrei P. Timoshenko ◽  
Paul Vercherin ◽  
Christian Martin ◽  
Jean-Michel Prades
Keyword(s):  
Sphenopalatine Artery ◽  
Recurrent Epistaxis ◽  
Severe Epistaxis ◽  
Group A ◽  
Ethmoidal Artery ◽  
Short And Long Term ◽  
Anterior Ethmoidal Artery ◽  
Group B ◽  
Endoscopic Ligation

Objectives: We describe the surgical treatment of severe epistaxis and evaluate the recurrence of bleeding in a nonrandomized retrospective trial. Methods: We performed a retrospective study comparing bilateral endoscopic ligation of the sphenopalatine artery alone (ELSPA) and bilateral endoscopic ligation of the sphenopalatine artery with concomitant bilateral external ligation of the anterior ethmoidal artery (ELSPEA) in the management of persistent epistaxis. Clinical and hematologic information, preoperative and surgical care, and short- and long-term outcomes were analyzed. The main outcome measure was recurrence of epistaxis in the short- and long-term follow-up periods. Results: Forty-five patients were enrolled in the study. There were 20 patients in group A (ELSPA) and 25 in group B (ELSPEA). Three patients in group A and no patients in group B had long-term (more than 2 weeks after surgery) re-bleeding. The difference between the two groups was not statistically significant (p > 0.05). Conclusions: We conclude that ELSPA and ELSPEA are effective, well-tolerated, reliable procedures if performed by an experienced surgeon. Their failure can be explained by anatomic lateral nasal wall variations and perioperative technical difficulties. They can be appropriate methods to treat severe recurrent epistaxis refractory to repeated nasal packing.

scholarly journals Familial spontaneous pneumothorax: importance of screening for Birt–Hogg–Dubé syndrome

2019 ◽  
Vol 57 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Yanguo Liu ◽  
Huajie Xing ◽  
Yu Huang ◽  
Shushi Meng ◽  
Jun Wang
Keyword(s):  
Recurrence Rate ◽  
Spontaneous Pneumothorax ◽  
Clinical Characteristics ◽  
Primary Spontaneous Pneumothorax ◽  
Treatment Modalities ◽  
Onset Age ◽  
Female Ratio ◽  
The Mean ◽  
Male To Female ◽  
Bhd Syndrome

Abstract OBJECTIVES The goal of this study was to investigate the prevalence of Birt–Hogg–Dubé (BHD) syndrome in patients with familial spontaneous pneumothorax (FSP) and the clinical characteristics of pneumothorax related to BHD syndrome compared with those of primary spontaneous pneumothorax. METHODS A total of 37 families diagnosed with FSP from 2007 to 2017 were enrolled in this study. The FLCN gene, which is responsible for BHD syndrome, was sequenced using the Sanger method in 25 probands. For the patients with confirmed BHD syndrome-related pneumothorax, clinical characteristics including the median onset age of pneumothorax, the male-to-female ratio, the mean height and body mass index (BMI) and the recurrence rate after different treatment modalities were obtained and compared with those of patients with primary spontaneous pneumothorax. RESULTS Of the 25 probands with FSP, 16 [64.0%, 95% confidence interval (CI) 43.8–84.2%] harboured FLCN germline mutations. In the patients with BHD syndrome-related pneumothorax, the median onset age of pneumothorax was 34 years; the male-to-female ratio was 1.3:1; and the mean height and BMI were 167.0 ± 8.6 cm and 23.6 ± 3.4 kg/m2, respectively. These characteristics were significantly different from those in patients with primary spontaneous pneumothorax from the same centre. The recurrence rate of BHD syndrome-related pneumothorax after conservative therapy was 53.1% (95% CI 38.6–67.5%) compared with 9.1% (95% CI 0–19.4%) after surgical treatment. CONCLUSIONS BHD syndrome is one of the most common causes of FSP. Patients with FSP should be recommended for mutation screening for the FLCN gene to facilitate early diagnosis and proper intervention.

scholarly journals Outcome of horizontal strabismus surgery and parents’ satisfaction

2014 ◽  
Vol 6 (2) ◽  
pp. 162-169 ◽  
Author(s):  
Ananda K Sharma ◽  
Madhu Thapa ◽  
Gulshan B Shrestha ◽  
Sanjeeta Sitaula ◽  
Gauri S Shrestha
Keyword(s):  
Standard Deviation ◽  
Strabismus Surgery ◽  
Cosmetic Outcome ◽  
Treatment Modalities ◽  
Female Ratio ◽  
Ocular Deviation ◽  
Cosmetic Outcomes ◽  
Binocular Single Vision ◽  
Male To Female

Introduction: A clinical audit of strabismus surgery in children in terms of functional and cosmetic outcomes helps improve the quality of services in pediatric ophthalmology.  Objective: To evaluate the outcome of strabismus surgery and assess the satisfaction of the patients’ parents with respect to the surgery outcome.Subjects and methods: A study of an interventional series of cases that included 60 strabismic subjects was carried out. The bilateral strabismus surgery under general anesthesia was performed on all subjects using the fornix approach. The parents’ understanding about strabismus and the cosmetic outcome was assessed through a set of interview questionnaires. The main outcome measures were the amount of deviation, the parents’ knowledge about strabismus and their satisfaction after the intervention. Results: Of the 60 subjects, 32 (53.3%) were esotropic and 28 (46.7%) exotropic. The male to female ratio was 1:1. The mean age with standard deviation was 16.6±8.5years,with a range of 3 to 35 years. The pre- operative mean esotropia with standard deviation was 48.2±14.8 pd, with a range of 22 to 114 pd). The pre-operative mean exotropia was 57.8±14.2 pd, with a range of 25 to 90 pd). In 93.47% of the subjects, the ocular deviation after surgery reduced significantly (p=<0.00). After the strabismus surgery, orthophoria was achieved in 15 (25%) subjects, and with excellent cosmetics. After surgery, gross binocular single vision was attained in 39.3% of the exotropes and in 17.9% of the esotropes. Only 30 % of the parents were aware about the strabismus and the treatment modalities. Nearly 90% of the parents were satisfied with the cosmetic outcome. Conclusion: Horizontal and bilateral strabismus has good surgical outcome with improved cosmetic acceptance.DOI: http://dx.doi.org/10.3126/nepjoph.v6i2.11704Nepal J Ophthalmol 2014; 6(12): 162-169 

scholarly journals Histomorphological and Immunohistochemical Study of Extra Nodal Lymphoma

2021 ◽  
Vol 8 (2) ◽  
pp. A50-55
Author(s):  
B R Vani ◽  
Sandhyalakshmi B N ◽  
Netra M Sajjan ◽  
Panduranga C ◽  
Deepak Kumar B ◽  
...  
Keyword(s):  
Morphological Diversity ◽  
Treatment Modalities ◽  
Cell Phenotype ◽  
Anatomical Location ◽  
Anatomic Site ◽  
Female Ratio ◽  
Poorly Differentiated Carcinoma ◽  
Poorly Differentiated ◽  
Age Range ◽  
Male To Female

Background: NHL are heterogeneous group of hematolymphoid malignancy occurring in nodal and extra nodal sites. Extra nodal lymphoma (ENL) is distinct from nodal lymphomas due to varied anatomical location, morphological diversity. Methods: A retrospective observational study was conducted in the department of pathology from January 2011 till December 2019. Clinical details and other investigations were recorded. Gross morphological features were noted. Slides are reviewed microscopically and blocks were subjected to IHC for further typing cases were selected as per Dawson et al criteria. Result: During study period, ENL constituted 25 cases (29.4%) of the 85 cases of all NHL. Age range is 05 to 63 years with a mean age of 42.5 years. Male to female ratio is 2.2 :1.Head and neck is the most common site of ENHL constituting 19 cases(76%), next commonest location is in the GIT with 3 cases (12%). We had one each case of ENHL in testis, breast and spine (4% each). On IHC, 92% cases (23 cases) exhibited   B cell phenotype and the remaining 08 % (02 cases) were of T cell phenotype. Conclusion: Lymphomas in the extra nodal sites are rare but has the propensity to occur in any anatomic site. Hence a differential of lymphoma to be considered in extra nodal site. Histology with IHC enables to differentiate from poorly differentiated carcinoma as the treatment modalities and prognosis varies.

Retrospective Analysis of 91 Kaposi’s Sarcoma Cases: A Single-Center Experience and Review of the Literature

Dermatology ◽  
2018 ◽  
Vol 234 (5-6) ◽  
pp. 205-213
Author(s):  
Serkan Yazici ◽  
Ozge Zorlu ◽  
Emel Bulbul Baskan ◽  
Saduman Balaban Adim ◽  
Kenan Aydogan ◽  
...  
Keyword(s):  
Medical Records ◽  
Kaposi's Sarcoma ◽  
Kaposi’S Sarcoma ◽  
Demographic Characteristics ◽  
Treatment Modalities ◽  
Review Of The Literature ◽  
Female Ratio ◽  
Single Center Experience ◽  
Male To Female

Background: Kaposi’s sarcoma (KS) is a multifocal angioproliferative tumor involving primarily the skin. Objective: The aim of this study was to describe the clinical, demographic, histopathological characteristics, treatment modalities, and outcome of 91 KS patients, and compare them with other contemporary research. Methods: Medical records of 91 KS patients followed between January 2005 and September 2017 were evaluated retrospectively. Results: Most of our patients were male (male-to-female ratio was 4.05). The median age at diagnosis was 69 years (range, 6–93 years). The duration of the lesions varied between 3 and 25 years. The lower extremities were the most commonly involved area (51.6%). Of the 91 patients, classic type KS was seen in 75 patients. Radiotherapy was used successfully in approximately half of our patients. Recurrence was observed in approximately one third of the patients. All KS patients in this study except 1 were classic KS. Conclusion: The clinical and demographic characteristics of our patients were compatible with the previous literature suggesting that KS is a tumor that tends to be limited to the skin. Close follow-up of patients is important to monitor for recurrence. This is the largest report from Turkey to date.

scholarly journals Epistaxis in the University of Port Harcourt Teaching Hospital: Aetiological Profile and Management

2020 ◽  
pp. 90-96
Author(s):  
Ibekwe Matilda Uju ◽  
O. Ikenga Victor
Keyword(s):  
Social Sciences ◽  
Teaching Hospital ◽  
Favourable Outcome ◽  
Treatment Modalities ◽  
Female Ratio ◽  
Port Harcourt ◽  
The University ◽  
Age Range ◽  
Male To Female ◽  
Nose And Throat

Background: Bleeding from the nose is one of the commonest emergencies that could present in a typical ear, nose and throat clinic. It is often a frightful experience for both the patient and relations, especially in severe cases. Aim: To determine the aetiological profile, the management and outcome in patients that presented with epistaxis in University of Port Harcourt teaching hospital.  Patients and Methods: This was a retrospective study of patients with complaints of epistaxis that were managed within the period of January 2006 to January 2018 in the Ear, Nose and Throat (ENT) department, including referrals from the accident & emergency department and children emergency ward. Data on demographics, aetiology, associated clinical features, treatment modalities and outcome of such treatments were all collated. These were analyzed using IBM statistical package for social sciences SPSSversion 20and results presented in simple descriptive tables. Results: There were altogether 196 patients studied, 95 males and 101 females, giving a male to female ratio of 1:1.06.  The age range was from 1 to 81 years. Age group 30-39 was the most affected with 22.29% Aetiological factors were; hypertension in 9.2% trauma in 11.2%, idiopathic in most; 58.2%, chronic rhinosinusitis in 18.4%. Conservative medical therapy was the commonest treatment modality; 68.38%. Anterior nasal packing in 26.5% while 4.1% had posterior packing. Anterior aspect of the nose was the commonest site of bleed recorded in 160 cases. All the patients had a favourable outcome. Conclusion: Epistaxis in this environment still presents as a common emergency and in the majority of the case, the cause is not known, however, trauma appears to be one of the commonest cause implicated in our setting. The young adults appear to be the ones mainly affected.

scholarly journals Appropriate follow-up period for odontogenic keratocyst: a retrospective study

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Hwi-Dong Jung ◽  
Jung-Hwan Lim ◽  
Hyung Jun Kim ◽  
Woong Nam ◽  
In-Ho Cha
Keyword(s):  
Statistical Significance ◽  
Age Distribution ◽  
Odontogenic Keratocyst ◽  
Treatment Modalities ◽  
Mandibular Ramus ◽  
Radiographic Images ◽  
Female Ratio ◽  
Large Size ◽  
Male To Female

Abstract Purpose The aim of this study was to conduct epidemiologic investigations on the pattern of the lesion and differences between treatment modalities in terms of recurrence by reviewing follow-up records to form a basis for planning patient follow-up visits. Materials and methods In this retrospective, single-center cohort study, 266 patients diagnosed with odontogenic keratocyst between 1993 and 2013 were included. Medical records and radiographic images were analyzed for age distribution, occurrence site and size, treatment modalities, and recurrence. Results The average age at first diagnosis was 33.1 years, and the male to female ratio was 1.33:1.00. The highest rate of incidence was in the third decade followed by the fourth, second, and fifth decades. The incidence in the maxilla was 34%, and 66% in the mandible. Mandibular ramus was most commonly involved. Lesions between 3 and 6 crowns were the most common, and the rate of recurrence increased with size. Enucleation after decompression had higher rate of recurrence (35.8%) than enucleation (27.1%), but there was no statistical significance. Conclusion The recurrence of odontogenic kerotocyst (OKC) was significantly associated with large size, multilocular form, and surgical procedure. A 10-year follow-up period is recommended to determine any recurrence of OKC.

Endoscopic control of the sphenopalatine artery for epistaxis: long-term results

2007 ◽  
Vol 121 (8) ◽  
pp. 759-762 ◽  
Author(s):  
M Abdelkader ◽  
S C Leong ◽  
P S White
Keyword(s):  
Treatment Success ◽  
Effective Means ◽  
Late Recurrence ◽  
Long Term Results ◽  
Artery Ligation ◽  
Sphenopalatine Artery ◽  
Endoscopic Control ◽  
Long Term Follow Up ◽  
Endoscopic Ligation

AbstractThe aim of this study was to prospectively evaluate post-operative cessation of bleeding and late recurrence of epistaxis in a cohort of patients treated by endoscopic ligation of the sphenopalatine artery. Participants comprised patients undergoing sphenopalatine artery ligation for posterior epistaxis at three east Scotland hospitals. Main outcome measures were recurrence of epistaxis in the immediate post-operative period and at long-term follow up (minimum nine months). Forty-three patients (30 men and 13 women) underwent 45 procedures; two patients underwent bilateral ligation. Two patients suffered recurrence as in-patients. Two patients experienced subsequent epistaxis requiring medical treatment. Two further patients suffered minor late epistaxis not requiring treatment. Success in preventing significant recurrence was 93 per cent. All recurrences requiring intervention occurred within one month of surgery. None of the patients in this series reported nasal complications. We found sphenopalatine artery ligation to be an effective means of achieving long-term control of posterior epistaxis.

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