Wies procedure for correcting involutional entropion of the lower lid in geriatrics

Objective: To evaluate the anatomic outcome and recurrence rate of the Wies procedure for treating involutional entropion of the lower lid in geriatrics. Materials and methods: This retrospective case series was conducted in the Ophthalmology department of a tertiary care hospital from January 1, 2016 to December 31, 2017. Geriatric patients (≥ 65 years) who had undergone the Wies procedure, i.e., transverse lid split and everting sutures for correction of involutional entropion of the lower lid were included. All the surgeries were done under local anaesthesia by a single ophthalmologist. The follow-up period was 12 months. A successful outcome was defined as restoration of lid margin to its position with no lash touching the cornea and no recurrence within 12 months. Results: Eighteen eyes of 13 patients with a mean age of 67.6 ± 2.2 SD years were included. There were 11 males (61%) and 7 females (39%). Bilateral entropion correction was done in five patients. Nine right eyes and nine left eyes were included. Anatomical success was 94.4% at 12 months. Recurrence was seen in one (5.6%) patient at 12 months. Conclusion: The Wies procedure for correction of involutional entropion with horizontal lid laxity in the geriatric population provided good anatomic results in our study. The recurrence rate was minimal within 1 year. The recurrence rate can be reduced by an accurate initial entropion assessment.

Download Full-text

A 10-min novel technique for involutional entropion: Mini-incisional continuous ligation everting sutures

European Journal of Ophthalmology ◽

10.1177/11206721211050038 ◽

2021 ◽

pp. 112067212110500

Author(s):

Yong M Choi ◽

Namju Kim

Keyword(s):

Recurrence Rate ◽

Surgical Outcome ◽

Case Series ◽

Interquartile Range ◽

Retrospective Case ◽

Novel Technique ◽

Time To Recurrence ◽

Involutional Entropion ◽

Surgical Modality

Purpose To introduce a novel technique of mini-incisional continuous ligation everting sutures for correction of involutional entropion and report the surgical outcome. Methods A retrospective case series. Eighty-five eyelids of 77 patients who underwent correction of involutional lower lid entropion using mini-incisional continuous ligation everting sutures were included in this study. The medical records of patients with at least 24 months of follow-up after surgery were reviewed. We collected information on demographic and clinical characteristics, including sex, age at surgery, duration of follow-up, horizontal lid laxity, surgical outcomes, and complications. Main outcome measures were success of surgery, recurrence rate, time to recurrence, and risk factors for recurrence. Results The median (interquartile range) age at the time of surgery was 72.0 (65.5–78.0) years and the median (interquartile range) follow-up duration was 24.0 (24.0–42.5) months. Thirty-seven eyelids (43.5%) showed horizontal eyelid laxity on a lid distraction test The surgical outcome was successful in the majority of patients (94.1%) with a recurrence rate of 5.9% in the 2 years after surgery. Only female sex was significantly correlated with recurrence of entropion (odds ratio 9.466, 95% confidence interval 1.022 to 87.670, P = 0.048). Conclusion This novel technique is a promising surgical modality for correction of lower lid involutional entropion because of its ease of application, simplicity, compatibility with anticoagulants, and low recurrence rate.

Download Full-text

Is Video-Assited Thoracoscopic Surgery Superior to Limited Axillary Thoracotomy in the Management of Spontaneous Pneumothorax?

Canadian Respiratory Journal ◽

10.1155/2001/208537 ◽

2001 ◽

Vol 8 (5) ◽

pp. 339-343 ◽

Cited By ~ 19

Author(s):

Meaghen J Hyland ◽

Ahmad S Ashrafi ◽

André Crépeau ◽

Reza J Mehran

Keyword(s):

Spontaneous Pneumothorax ◽

Thoracoscopic Surgery ◽

Tertiary Care ◽

Operating Time ◽

Case Series ◽

Length Of Hospital Stay ◽

Tube Length ◽

Care Hospital ◽

Retrospective Case

OBJECTIVE: To evaluate bullectomy and pleurectomy in the treatment of spontaneous pneumothorax (PNO) using video-assisted thoracoscopic surgery (VATS), and to compare the outcome with that of the same procedure performed using limited axillary thoracotomy (LAT).DESIGN: A retrospective case series with patient follow-up.SETTING: A Canadian tertiary care hospital.PATIENTS: The medical records of all patients with a spontaneous PNO treated by either VATS or LAT at the Ottawa Hospital - General Campus, Ottawa, Ontario, between April 1993 and August 1999 were reviewed, and the patients were subsequently interviewed.MAIN OUTCOME MEASURES: Operative details (length of operation, operative complications); postoperative details (duration of chest tube, length of hospital stay, duration of analgesia, pain, time missed from work, complications, recurrence rate); and cost (hospital and operative, socioeconomic [time missed from work]).RESULTS: Fifty patients were identified who had had surgical treatment of a spontaneous PNO. Twenty-eight patients were treated by LAT and 22 underwent VATS. The median length of follow-up was 44.6 months (range four to 81.5 months). Three patients developed a recurrent PNO - two patients after LAT and one patient after VATS. No difference was found between the two groups in the operating time or in the amount of pain experienced immediately after surgery. However, patients who underwent VATS had a shorter length of stay (P=0.002) and a shorter requirement for analgesics postoperatively (P=0.03). Overall, the total cost of VATS was no different than that for LAT; however, in terms of socioeconomic costs, patients in the VATS group missed significantly less time from work postoperatively (P=0.02).CONCLUSIONS: VATS offers a cost effective and better tolerated procedure for the management of spontaneous PNO than the time-honoured open technique.

Download Full-text

Clinical Outcomes of Percutaneous Plantar Fasciotomy Using Microdebrider Coblation Wand

Foot & Ankle International ◽

10.1177/1071100719883266 ◽

2019 ◽

Vol 41 (2) ◽

pp. 187-192

Author(s):

Ricardo E. Colberg ◽

Monte Ketchum ◽

Avani Javer ◽

Monika Drogosz ◽

Melissa Gomez ◽

...

Keyword(s):

Conservative Treatment ◽

Plantar Fasciitis ◽

Case Series ◽

Successful Outcome ◽

Oral Steroid ◽

Tarsal Tunnel ◽

Retrospective Case ◽

Level Of Evidence ◽

Plantar Fasciotomy

Background: Plantar fasciitis is the most common cause of heel pain in adults. Multiple conservative treatment plans exist; however, some cases do not obtain significant clinical improvement with conservative treatment and require further intervention. This retrospective case study evaluated the success rate of percutaneous plantar fasciotomy and confounding comorbidities that negatively affect outcomes. Methods: A series of 41 patients treated with percutaneous plantar fasciotomy using the Topaz EZ microdebrider coblation wand were invited to participate in this retrospective follow-up study, and 88% ( N = 36) participated. A limited chart review was completed and the patients answered a survey with the visual analog scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) questionnaire. Average outcomes were calculated and 45 variables were analyzed to determine if they were statistically significant confounders. Patients had symptoms for an average of 3 years before the procedure and were contacted for follow-up at an average of 14 months after the procedure. Results: The average VAS for pain score was 1.3 ± 1.8 and the average FAAM score was 92 ± 15. Eighty-nine percent of patients had a successful outcome, defined as FAAM greater than 75. In addition, patients at 18 months postprocedure reported complete or near-complete resolution of symptoms with an FAAM score greater than 97. Concurrent foot pathologies (eg, tarsal tunnel syndrome), oral steroid treatment prior to the procedure, and immobilization with a boot prior to the procedure were statistically significant negative confounders ( P < .05). Being an athlete was a positive confounder ( P = .02). Conclusion: Percutaneous plantar fasciotomy using a microdebrider coblation was an effective treatment for plantar fasciitis, particularly without concurrent foot pathology, with a low risk of complications. Level of Evidence: Level IV, retrospective case series.

Download Full-text

Tracheo-bronchial foreign bodies: our experience at a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20161848 ◽

2016 ◽

Author(s):

Shashidhar S. Suligavi ◽

Mallikarjun N. Patil ◽

S. S. Doddamani ◽

Chandrashekarayya S. Hiremath ◽

Afshan Fathima

Keyword(s):

Foreign Body ◽

Early Diagnosis ◽

Foreign Bodies ◽

Tertiary Care ◽

Case Series ◽

Team Work ◽

Care Hospital ◽

Retrospective Case ◽

Presenting Symptoms ◽

Case Series Study

Background:Tracheo- bronchial foreign bodies have always posed a challenge to the ENT surgeon as they present with varied symptomatology ranging from a simple cough and fever to more grave respiratory distress. It requires a strong suspicion, early diagnosis and timely intervention to reduce the overall morbidity and mortality .This study was undertaken to highlight our experiences in handling cases of tracheo- bronchial foreign bodies (FB) at our setup.Methods:It is a retrospective case series study conducted in S. Nijalingappa Medical College between January 2011 and January 2015. Results:Most commonly affected were children between 1year to 3years of age. Chronic cough and wheeze were the commonest presenting symptoms. Vegetative foreign body was found to be the commonest variety of foreign body. The mortality rate in our study was 4.7% (n=3).Conclusions:A good clinical acumen, team work, early diagnosis and timely intervention are all needed to reduce the overall mortality and morbidity associated with tracheo- bronchial foreign bodies.

Download Full-text

Transcanal Endoscopic Antrostomy Hole : Its Utility in Restoring Ventilation Pathway to Epitympanum and Mastoid Antrum During Tympanoplasty

Bangladesh Journal of Endosurgery ◽

10.3329/bje.v2i1.19588 ◽

2014 ◽

Vol 2 (1) ◽

pp. 9-14

Author(s):

Sheikh Shawkat Kamal

Keyword(s):

Middle Ear ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Retrospective Case ◽

Middle Ear Mucosa ◽

Case Series Study ◽

Temporal Bones ◽

Mastoid Antrum

Aim: To evaluate the role of newly created transcanal endoscopic antrostomy hole as a passage in restoring the aeration of epitympanum and mastoid antrum.Materials & Methods: Study design: Retrospective case series study. Study duration: From January 2013 to January 2014. Study place: Private tertiary care hospital. Patients: 27 ears of 23 adult patients (age ranging from 15years to 54years) underwent transcanal endoscopic tympanoplasty for their chronic middle ear diseases in presence of inflamed middle ear mucosa along with radiological shadows of stagnant fluid in their epitympanum and mastoid antrum. Structured three months follow-up was ensured in every case. Intervention: A hole was created at a selected site of posterior meatal wall purely through transcanal endoscopic approach that established direct communication between mastoid antrum and external auditory canal. Thereafter this newly created passage was used for three purposes- assessment of the condition of mastoid antrum, performing the water test for checking epitympanic patency and in few cases placement of temporary tube for postoperative ventilation and drainage of middle ear. Main out come measures: The feasibility, performance and management of transcanal endoscopic antrostomy hole as passage for reestablishing the aeration of epitympanum and mastoid antrum.Results: The chosen site for antrostomy hole was found effective and safe in providing convenient entrance into the mastoid antrum in every case in this study with out facing technical complexity and failure. Postoperative healing of skin over antrostomy hole was found complete in all ears without any inward growth of skin in to mastoid antrum. Available post operative CT scan imaging of temporal bones showed improved aeration in their epitympanum and mastoid antrum.Conclusions: The role of transcanal antrostomy hole has been proved worthy in restoring ventilation pathway to epitympanum and mastoid antrum during tympanoplasty. This antrostomy hole has the potentiality to be considered in future for placement of long term mastoid ventilation tube in order to treat persistent atelectatic middle ear.

Download Full-text

Laser Therapy for Refractory Myringitis in Children

Otolaryngology ◽

10.1067/mhn.2002.127628 ◽

2002 ◽

Vol 127 (3) ◽

pp. 163-168 ◽

Cited By ~ 9

Author(s):

Frank P. Fechner ◽

Michael J. Cunningham ◽

Roland D. Eavey

Keyword(s):

Laser Treatment ◽

Tertiary Care ◽

Case Series ◽

Laser Technique ◽

Retrospective Case ◽

Tympanic Membrane Perforations ◽

Specialty Hospital ◽

Associated Symptoms ◽

Initial Results

OBJECTIVE: We present the application and initial results of a CO2 laser technique for the treatment of medically refractory chronic granular myringitis (CGM). STUDY DESIGN AND SETTING: Retrospective case series of 15 treated ears in 13 consecutive patients between the ages of 6 and 14 years (median age, 9.0 years) cared for in a tertiary care specialty hospital. RESULTS: Eleven of 15 treated ears had total resolution of CGM and associated symptoms; median follow-up time was 10 months. Three ears were improved, and 1 ear remained unchanged. Three of 5 preoperative tympanic membrane perforations healed after laser treatment; 1 patient developed a postoperative, dry perforation. Hearing was not impaired in any patient tested. CONCLUSION: Preliminary results suggest that CGM, when refractory to medical treatment, can often be treated effectively by a single laser treatment.

Download Full-text

Rhino Orbital Cerebral Mucormycosis in settings of Covid-19 infection: A Case Series of Thirteen Patients

10.21203/rs.3.rs-1240669/v1 ◽

2022 ◽

Author(s):

Rajesh Verma ◽

Rajarshi Chakraborty ◽

Keerthiraj DB ◽

Kingzang Wangda ◽

Veerendra Verma ◽

...

Keyword(s):

Amphotericin B ◽

Public Awareness ◽

Tertiary Care ◽

Case Series ◽

Care Hospital ◽

Imaging Features ◽

Initial State ◽

Northern India ◽

History Of

Abstract Background Rhino-Orbital-Cerebral Mucormycosis (ROCM) is an important infectious disease encountered in huge number in this recent post-covid 19 era. An alteration in defence immune system during covid-19 illness, in the presence of uncontrolled hyperglycaemia has led to the new epidemic of ROCM especially in developing nations like India. Method This case series of thirteen patients illustrates the various clinical presentation, laboratorical parameters, imaging features and outcome of patients of ROCM admitted in a tertiary care hospital in Northern India. Result In our case series, a total of 13 newly diagnosed cases of Rhino-Orbital-Cerebral Mucormycosis were studied. History of covid-19 illness was observed in 7 cases (53.8%), use of steroid during Covid-19 illness was seen in 5 cases (38.5%), oxygen therapy was given in 4 cases (30.8%). Co-morbid state in the form of diabetes mellitus was present in 12 cases (92.3%) with mean duration 16.69 months with an important finding of 6 cases (46.2%) having new-onset diabetes; hypertension in present in 3 cases (23.1%). Magnetic resonance imaging of paranasal sinuses showed involvement of multiple sinuses in all the 13 cases(100%), including maxillary and ethmoidal sinuses, with frontal in 12 cases (92.3%), sphenoidal in 11 cases (84.6%), symmetric in 9 cases (69.2%), mastoiditis in 4 cases (30.8%), maxillary space involvement in 4 cases (30.8%), palatal involvement in 1 case (7.7%). Multi-speciality approach treatment was given in the liposomal amphotericin B therapy in all the patients along with thorough endo-nasal debridement done in all cases, transcutaneous retrobulbar amphotericin B in 6 cases (46.2%) with exenteration done in 7 patients (53.9%). At 3 months of follow-up, there was substantial clinical improvement in all the cases. Conclusion There should be definite emphasis on high suspicion of mucor clinically for early diagnosis and aggressive management at initial state of diagnosis for better outcome. The need for sustained proper glycemic control during covid 19 era along with judicious use of steroid and public awareness for early symptoms and manifestations of mucor can curb the magnitude of such potentially opportunistic epidemic to a substantial rate. The longer the infection remains undetected, the greater the devastation ROCM can impose, of which blindness is an important hazard.

Download Full-text

Outcome of Ahmed Glaucoma Valve in Refractory Glaucoma – Our Population Analysis

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v37i3.1206 ◽

2021 ◽

Vol 37 (3) ◽

Author(s):

Momina Faisal ◽

Saadia Farooq ◽

Hajra Farooq

Keyword(s):

Population Analysis ◽

Tertiary Care ◽

Case Series ◽

Cyst Formation ◽

Safe Procedure ◽

Care Hospital ◽

Ahmed Glaucoma Valve ◽

Refractory Glaucoma ◽

Retrospective Case ◽

Retrospective Case Series

Purpose: To find out the outcomes of Ahmed Glaucoma Valve (AGV) implantation in a tertiary care hospital. Study Design: Retrospective case series. Place and Duration of Study: Shifa International Hospital Islamabad from January 2018 to July 2020. Methods: This retrospective case series of 19 eyes of 17 patients with refractory glaucoma included patients who underwent AGV implantation with a follow-up period of 6 months to 01 year. AGV was done as a primary procedure in 3 patients and secondary procedure in 17 patients after a previously failed trabeculectomy. All patients underwent complete eye examination, before surgery and then at 1 month, 2months, 6 months and 1 year. Goldman tonometer was used to check IOP. Complications, interventions and the number of anti-glaucoma medications (in post-operative period) needed to achieve the target pressure were noted. Success was defined as an IOP of less than 18 mm Hg, with or without a single anti-glaucoma medication. Results: Complete success was achieved in 57.9% and conditional success in 42.2%. The most common complication was encapsulated cyst formation in 31.6% and post-operative interventions were bleb deroofing in 10.5%, tube readjustment and tube wash in 10.5% and YAG vitreolysis in 5.3%. Conclusion: AGV is an effective and relatively safe procedure in refractory glaucoma irrespective of initial diagnosis and age of the patient. Encapsulated bleb was the commonest complication. Key Words: Ahmad Glaucoma valve, Glaucoma, Intra Ocular Pressure.

Download Full-text

Endovascular Embolization in the Treatment of Epistaxis

Otolaryngology ◽

10.1177/0194599819829743 ◽

2019 ◽

Vol 160 (5) ◽

pp. 822-828 ◽

Cited By ~ 2

Author(s):

Phillip Huyett ◽

Brian T. Jankowitz ◽

Eric W. Wang ◽

Carl H. Snyderman

Keyword(s):

Tertiary Care ◽

Surgical Techniques ◽

Case Series ◽

Major Complication ◽

Endovascular Embolization ◽

High Risk Group ◽

Care Hospital ◽

Retrospective Case ◽

Increased Risk ◽

Operative Control

Objective The cost-effectiveness of endovascular embolization (EE) for intractable epistaxis has been questioned, especially as endoscopic surgical techniques have become standard of care at many institutions. Our objectives were to review the safety profile and effectiveness of EE for epistaxis. Study Design Retrospective case series. Setting Tertiary care hospital. Subjects There were 54 patients and 64 unique encounters. Patients were 66.7% male, with a mean age of 64.5 years. Bleeding disorders were present in 18.8%, hypertension was present in 71.7%, and 61.1% were on anticoagulant/platelet drugs. Methods Charts of patients undergoing EE for epistaxis between 2005 and 2015 were retrospectively reviewed. Results The immediate bleeding control rate was 92.6%. Three patients died within 1 week of EE and were excluded from further analysis. Overall, 64.7% of the remaining patients had no further episodes of epistaxis. Thirteen patients (25.4%) rebled within 1 week, 11 of whom required repeat EE or operative control. Five patients (9.8%) rebled more than 1 week following the procedure with 4 requiring repeat EE or operative control. The major complication rate was 7.4% and included transient stroke, diplopia, facial skin necrosis, and extraperitoneal hemorrhage. Conclusion While the immediate success rate of EE for epistaxis was comparable to the literature, the overall short- and long-term rebleed rate was high in this selected population. The results suggest that patients who are referred for EE represent a high-risk group with increased risk of repeat hemorrhage and morbidity. Patients who undergo EE for epistaxis should be carefully monitored for complications, including repeat hemorrhage.

Download Full-text

Neurocysticercosis – A Window to Intraocular Involvement

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i2.14963 ◽

2016 ◽

Vol 7 (2) ◽

pp. 135-141

Author(s):

BN Kalpana ◽

HR Samhitha ◽

Kailash P Chhabria ◽

Sonali Muralidhar ◽

Kirti Raj

Keyword(s):

Retinal Detachment ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Case Series ◽

Positive Association ◽

Care Hospital ◽

Retrospective Case ◽

Tractional Retinal Detachment ◽

Number Of Patients

Objective : To analyse the clinical characteristics of intraocular cysticercosis and the association of neurocysticercosis with intraocular involvement in these patientsMaterials and methods: Retrospective case series of records of patients managed at a Tertiary Care Hospital in South India. Case records of patients managed at a Tertiary Care Hospital in South India over two years (October 2012 – October 2014) were reviewed and cases reported with intraocular cysticercosis were included in the study and results analyzed.Results: Five (5) patients of intraocular cysticercosis were diagnosed in a two year period at our centre, 60% being bilateral. Eight (8) eyes of five (5) patients had intraocular cysts documented by clinical examination and B mode ultrasonography (75% eyes with active cysts, 25% eyes inactive) .Visual acuity at presentation of eyes with active cysts ranged from perception of light to counting finger 4m. The 75% eyes had tractional retinal detachment at presentation. Neurocysticercosis was documented in 80% of the cases oncomputed tomography / magnetic resonance imaging . Six (6) eyes with active cysts underwent parsplanavitrectomy with cyst removal using vitreous cutter with concurrent management of tractional retinal detachment in five (5) eyes. Postoperative visual recovery was poor in eyes with associated tractional retinal detachment while good anatomical outcome was achieved in all six (6) cases.Conclusion: Intraocular cysticercosis can be associated with cysts in other areas. High number of patients with neurocysticercosis (80%) in those with intraocular cysticercosis in our study may indicate positive association between the two which needs further investigation.

Download Full-text