scholarly journals Five-year experience in surgical treatment of temporal bone paragangliomas

2021 ◽  
Vol 6 (2) ◽  
pp. 66-72
Author(s):  
Khassan Mokhamad Ali Diab ◽  
Nikolai A. Daikhes ◽  
Parviz U. Umarov ◽  
Olga A. Pashchinina ◽  
Dariya A. Zagorskaya
Keyword(s):  
Surgical Treatment ◽  
Temporal Bone ◽  
Study Data ◽  
Point Of View ◽  
Type B ◽  
Tumor Removal ◽  
Bone Pathology ◽  
Lateral Skull Base ◽  
Type C

Objectives to discuss a five-year experience in surgical treatment of temporal bone paragangliomas from the point of view of U. Fisch and D. Mattox classification modified by М. Sanna in 2013. Material and methods. In the period from February 2015 till December 2020, we performed 130 operations to remove temporal bone paraganglioma. The examined and operated patients included 34 men and 96 women aged from 2 to 82 years. The paraganglioma types A, B and C were distributed as follows: type A in 22 patients (A1 12 cases, A2 10 cases); type B in 73 patients (B1 25 cases, B2 16 cases, B3 32 cases); type C in 35 patients (С1 10 cases, С2 12 cases, С3 7 cases, С4 5 cases) Results. The evaluated results included the quality of tumor removal, the auditory function and the function of the facial nerve in relation to the size of the neoplasm, registered during the early and late postoperative periods. Based on the study data, we developed an algorithm of tactics of surgical treatment of patients with this type of temporal bone pathology aimed to avoid damage to the vital structures of the lateral skull base.

Optimising Epilepsy Therapy – Searching for the Evidence – Looking Beyond the Data

2015 ◽  
Vol 10 (2) ◽  
pp. 164
Author(s):  
Mar Carreño ◽  
Eugen Trinka ◽  
Martin Holtkamp ◽  
◽  
◽  
...  
Keyword(s):  
Refractory Epilepsy ◽  
Study Data ◽  
Type D ◽  
Epilepsy Therapy ◽  
Suitable Treatment ◽  
Type C ◽  
The Individual ◽  
The Devil

There is now an extensive range of anti-epileptic drugs (AEDs) available including older established treatments and a newer generation of medications. The choice of drugs and what constitutes optimal therapy, however, is unclear due to limitations in the data supporting their use, particularly among the newer treatments. In clinical trials of monotherapy, a treatment is required to show only non-inferiority to another benchmark treatment. In trials of polytherapy, comparisons are limited to placebo. It is therefore necessary to look beyond the study data and consider other parameters to ascertain the most suitable treatment for the individual patient. Available evidence suggests that efficacy is similar among most AEDs, but this does not mean they are all the same. Some show efficacy in early and refractory epilepsy and some improve depression and quality of life (QOL) in epilepsy. AEDs are associated with a range of adverse events (AEs) that can limit their usefulness. AE classifications include type A (augmented and dose related) including tiredness, fatigue, insomnia, dizziness, vertigo, imbalance, ataxia, tremor and cognitive impairment; type B (bizarre and idiosyncratic) including various hypersensitivity reactions; type C (chronic long-term toxicity) including hirsutism, alopecia, weight gain and obesity; and type D (teratogenesis and carcinogenesis). The newer AEDs have been more thoroughly assessed for AEs than older drugs and risks are better understood. In AED safety, it is not better to follow a policy of ‘better the devil you know’ but rather to carefully monitor AE incidence and be prepared to switch drugs to improve tolerability and avoid non-compliance and treatment failure.

scholarly journals Surgical treatment of glossopharyngeal nerve schwannomas: Results of two-center study (14 patients included) and literature review

2021 ◽  
Vol 27 (4) ◽  
pp. 23-29
Author(s):  
Andrii H. Sirko ◽  
Oleksandr M. Lisianyi ◽  
Оksana Y. Skobska ◽  
Rostislav R. Malyi ◽  
Iryna O. Popovych ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Facial Nerve ◽  
Hearing Impairment ◽  
Cranial Nerves ◽  
Type A ◽  
Jugular Foramen ◽  
Type B ◽  
Tumor Removal ◽  
Type D ◽  
Total Tumor Removal

Objective: This study is aimed to analyze the outcomes of surgical treatment of glossopharyngeal schwannomas based on pre- and postoperative neurological status assessment. Materials and methods: This paper is a retrospective analysis of examination and surgical treatment of 14 patients who were operated on in two large clinics from 2018 to 2021 inclusive. When analyzing the collected data, gender, age, disease symptoms, tumor size and location, surgical approach, tumor to cranial nerves (CN) ratio, jugular foramen (JF) condition, and tumor removal volume were taken into account. All tumors were divided into groups depending on tumor location relative to the JF. Particular attention was paid to assessing cranial nerves functions. Facial nerve function was assessed as per House-Brackmann Scale (HBS), hearing function as per Gardner-Robertson Scale (GRS). Results: 3 (21.4%) patients had total tumor removal: 2 patients had type A tumors and one had type B tumor. Subtotal resection took place in 7 (50%) cases. In 4 cases, a tumor was partially removed: 3 patients had type D tumors and one had type B tumor. 3 (21.4%) patients had preoperative FN deficit (HBS Grade II) and mild dysfunction. 5 (35.7%) patients had postoperative facial nerve deficit: HBS ІІ, 2; ІІІ, 1; V, 2. Preoperative sensorineural type hearing impairment on the affected side was diagnosed in 13 (92.6%) patients. Before surgery, 6 patients had non-serviceable hearing, which remained at the same level after surgery. None of the patients with grade I or II hearing before surgery had any hearing impairment postoperatively. In 2 (14.3%) cases, hearing improved from grade V to grade III after surgery. 6 (42.9%) patients developed new neurological deficit in the caudal group CN. Postoperative deficit of the caudal group CN occurred in type D tumors in 3 patients, type A tumors 2 patients, and type B tumors one patient. Conclusions: Applying a retrosigmoid approach only makes it possible to achieve total tumor removal in case of type A tumors. To remove other tumor types, it is necessary to select approaches that enable access to the jugular foramen and infratemporal fossa. Intraoperative neurophysiological monitoring is an extremely important tool in glossopharyngeal schwannoma surgery. The most common postoperative complication is a developed or increased deficit of the caudal CN group, which can lead to persistent impairments in the patients’ quality of life. Preservation of the CN VII and VIII function in most cases is a feasible task and shall be ensured as a standard for this pathology.

scholarly journals Endoscopic Anatomy of Hypotympanum Surgical Implications

2018 ◽  
Vol 01 (02) ◽  
pp. 058-067
Author(s):  
Rajesh Boddepalli ◽  
Sreerama Boddepalli
Keyword(s):  
Temporal Bone ◽  
Local Anesthesia ◽  
Type A ◽  
Jugular Foramen ◽  
Type B ◽  
Cadaveric Dissection ◽  
Endoscopic Anatomy ◽  
Type C ◽  
Four Levels ◽  
Temporal Bones

Abstract Objective To assess the endomeatal endoscopic morphological anatomy of hypotympanum under local anesthesia and further cadaveric dissection of temporal bone to know complete anatomical details of hypotympanum. Materials and Methods Two hundred six cases of live operations were studied, these included 160 cases of simple dry perforations for myringoplasty and 46 cases of stapedectomy operations. All operations were performed under local anesthesia using a 0-degree, 4-mm endoscope. The hypotympanum was visualized. Twenty wet temporal bones were dissected endoscopically and complete hypotympanic details were studied. Results Out of 206 cases, 94 cases (45%) were found to be type A; 51 cases (25%) were type B and 60 cases (30%) were type C hypotympanum. Wet cadaveric bones were dissected to visualize the transmeatal endoscopic jugular foramen in four levels (levels 1, 2, 3, and 4).

Surgical Treatment for Recurrent Dislocation of the Extensor Carpi Ulnaris Tendon

2001 ◽  
Vol 26 (6) ◽  
pp. 556-559 ◽  
Author(s):  
G. INOUE ◽  
Y. TAMURA
Keyword(s):  
Surgical Treatment ◽  
Satisfactory Result ◽  
Type A ◽  
Recurrent Dislocation ◽  
Tendon Sheath ◽  
Type B ◽  
Extensor Retinaculum ◽  
Ulnar Side ◽  
Extensor Carpi Ulnaris ◽  
Type C

Twelve patients with recurrent dislocation of the extensor carpi ulnaris tendon were treated with repair or reconstruction of its tendon sheath, and each had a satisfactory result. We found three types of disruption of the fibro-osseous sheath. Type A: the fibro-osseous sheath ruptured ulnarly and the torn sheath lay superficial to the tendon ( n = 5). These were treated by reconstruction of the sheath using a piece of the extensor retinaculum. Type B: the fibro-osseous sheath ruptured radially and the torn sheath lay in the ulnar groove beneath the tendon ( n = 3). These were treated by direct suture of the sheath over the tendon. Type C: detachment of the periosteum from the ulnar side of the ulna in continuity with the fibro-osseous sheath formed a false pouch into which the tendon easily dislocated ( n = 4). These were treated by reattachment of the periosteum.

Concept «quality of life» and method of its assessment in patients after surgical treatment of the aortal valve faults

2019 ◽  
pp. 46-50
Author(s):  
A. N. Molchanov
Keyword(s):  
Quality Of Life ◽  
Heart Disease ◽  
Surgical Treatment ◽  
The Elderly ◽  
Underlying Disease ◽  
Point Of View ◽  
Optimal Method ◽  
Surgical Interventions ◽  
Age Related

The review of the literature examines the study of the quality of life of patients in the older age group after cardiac surgery for heart disease. In recent years, the number of elderly people has increased significantly in many countries. As a result of this phenomenon, cardiologists and cardiac surgeons are increasingly confronted in their practice with elderly patients. There are features of the management of cardiac and cardiac surgical patients of advanced age, caused both by the specifics of the underlying disease and by concomitant diseases. With the emergence of new options for evaluating the effectiveness of various methods of surgical correction of heart disease in age patients, new questions arise that require evidentiary consideration and an optimal answer. Opinions of experts about the feasibility of surgical interventions in the elderly are often different. The urgency of the problem is due to the recent increase in the number of heart operations in the group of age-related patients. The study of the quality of life of patients in the postoperative period helps to determine the most rational and optimal method of surgical treatment, not only from the point of view of the cardiac surgeon, but also from the standpoint of assessing the patient himself. In addition, frequent postoperative complications and recurrences of diseases force specialists to focus on the quality of life of patients after surgery, which makes the problem extremely urgent.

scholarly journals Endometriosis in urology - an update

2021 ◽  
Vol 28 (1) ◽  
pp. 41-47
Author(s):  
Dan SPINU ◽  
◽  
Dragos Radu MARCU ◽  
Ovidiu BRATU ◽  
Lucian IORGA ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Differential Diagnosis ◽  
Urinary Tract ◽  
Surgical Treatment ◽  
Robotic Surgery ◽  
Point Of View ◽  
Relative Safety ◽  
Asymptomatic Patients ◽  
Gynecological Diseases

Introduction: Endometriosis represents the aberrant implantation of endometrial tissue, respectively outside the uterus. It is one of the gynecological diseases with a great impact on the patient’s quality of life and especially on the fertility aspects. Due to the aberrant implantation, this disease can theoretically affect any organ in the abdominal and retroperitoneal cavity. Thus, cases involving the organs of the urinary tract are not a surprise. Material and methods: The present paper focuses on the urological impairment of endometriosis, etiology according to various hypotheses and an update of existing treatment methods. The possible proposals of therapeutic guides found in the literature are also taken into account.Results: The urological condition of this disease seems to increase in frequency in recent years. If in the case of asymptomatic patients an expectant attitude can be approached in relative safety, the local invasive nature of the disease, which can lead to the loss of the function of the various organs of the urinary tract, must not be omitted. In the case of symptomatic patients, the treatment is either hormonal or surgical, lately there is a tendency to combine the two types of treatment. Being a condition with relatively rare urological involvement, the differential diagnosis often omits endometriosis. There are currently several plausible guide proposals, but it takes time and richer casuistry to be able to standardize them. From the point of view of surgical treatment, there is a tendency to introduce robotic surgery in the therapeutic arsenal of this disease, both in the case of classical endometriosis and in the case of urological involvement.

scholarly journals Analysis of Factors Dimensions of Quality Service and Customer Satisfaction Effect on Housi in Makassar, in South Sulawesi, Indonesia

2019 ◽  
Author(s):  
Muklis Kanto ◽  
Patta Rapanna
Keyword(s):  
Customer Satisfaction ◽  
Service Quality ◽  
Urban Areas ◽  
Marketing Mix ◽  
Type B ◽  
South Sulawesi ◽  
Quality Dimension ◽  
Customer Type ◽  
Type C

Housing and settlement are one of human basic requirements and that is the important factor in increasing their level and status.The increasing of society interest of having a house in urban areas be the main tringger of developer companies appear that compete with service quality. In this case, marketing management be an important think to give attention. The aim of this research is to know that how far thew quality of marketing mix, quality of vicinity, and quality of interaction as service quality dimension which generally perceive by housing customer influenced positively and significantly to the customer satisfaction.This research used sampiling from housing customer in Makassar City in three stratums that are housing customer type A (simpledents by using healthyhouse), type B (middle house) and type C (luxurioushouse). The sampling used randomly and based onstratum (stratified random sampling) the sampiling ofthis research consisted of 125 respondents by usingquestionnaire which used likerd scale and the dataanalysis used AMOS program.The result of theresearch which used hirerachical opproach in measurethe service quality shows that the service quality havepositive influential and significant for customersatisfaction, marketing mix have positive influential andsignificant for customer satisfaction, vicinity havepositive influential and does not significant for customersatisfaction.

Comparison of the Quality of Two Types of Milk at Two Sources in the Belo Horizonte, Brazil Market

1978 ◽  
Vol 41 (9) ◽  
pp. 739-742
Author(s):  
MANUEL S. BORGES ◽  
RONON RODRIGUES ◽  
JORGE RUBINICH ◽  
CELSO MEDINA FAGUNDES
Keyword(s):  
Processing Plant ◽  
Type B ◽  
Sharp Decline ◽  
Milk Samples ◽  
Standard Plate ◽  
Plate Counts ◽  
Type C ◽  
Belo Horizonte ◽  
Milk Market

Type B and type C milk samples were collected at the processing plant and at random points of retail sales. Coliform counts (MPN) were significantly higher in comparable milk sampled at retail than when sampled at the processing plant. Standard plate counts were higher at retail than at the processing plant. Thirty one of 53 samples of type C milk contained in excess of the 150,000/ml maximum for bacteria specified by code when tested at retail compared to 14 of 63 when tested at the creamery. Tests to predict shelf life by incubating specially prepared samples at 20 C indicated a sharp decline in quality between the industry and consumption. This sharp decline in quality between industry and consumption appeared to be a major problem that must be resolved in the present milk market. Type B milk was found to be a much superior product when examined by quality tests of this study. Flavor scores for the type B milk were consistently higher than the comparable type C samples. Type B milk was more commonly criticized for feed flavor while type C milk was more commonly critized as coarse/high acid.

scholarly journals Assessment of Bacteriological Quality of Fast Foods and Soft Drinks in Relation to Safety and Hygiene

1970 ◽  
Vol 25 (1) ◽  
pp. 73-75 ◽  
Author(s):  
Jafor Ahmed ◽  
M Lokman Hossain ◽  
M Abdul Malek ◽  
Fauzia Begum
Keyword(s):  
Type A ◽  
Soft Drinks ◽  
Coliform Bacteria ◽  
Plate Count ◽  
Type B ◽  
Fast Foods ◽  
Bacteriological Quality ◽  
Type D ◽  
Type C

Bacteriological quality assessment of fast foods and soft drinks of different establishments of Dhaka City was carried out. For systematic study of varieties of such foods consumed by different class of people, the food samples were divided into four major categories: Type A (upper class), Type B (middle class), Type C (moderate class) and Type D (lower class). The quality of samples was assessed by determining standard plate count (SPC). The SPC showed that about 15% of Type A, 23% of Type B, 43% of Type C and 57% of Type D samples were unsafe for human consumption. Coliform bacteria were detected in about 13-48% of various food varieties. Psychrophilic bacteria were present in about 19-42% samples, indicating not suitable for longterm preservation in refrigeration condition. One sample of Type A and two samples each of Type B, Type C and Type D yielded growth of Salmonella and a considerable number of the samples contained Escherichia coli. In this study it was found that the condition of most of the Type C and Type D food and drinks were unsafe for consumption. The safely and hygienic status of Type A and Type B were comparatively better than those of Type C and Type D. Keywords: Bacteriological quality; Fast food; Soft drink; Safety; HygieneDOI: http://dx.doi.org/10.3329/bjm.v25i1.4863 Bangladesh J Microbiol, Volume 25, Number 1, June 2008, pp 73-75

Concept «quality of life» and method of its assessment in patients after surgical treatment of the aortal valve faults

2019 ◽  
pp. 46-50
Author(s):  
A. N. Molchanov
Keyword(s):  
Quality Of Life ◽  
Heart Disease ◽  
Surgical Treatment ◽  
The Elderly ◽  
Underlying Disease ◽  
Point Of View ◽  
Optimal Method ◽  
Surgical Interventions ◽  
Age Related

The review of the literature examines the study of the quality of life of patients in the older age group after cardiac surgery for heart disease. In recent years, the number of elderly people has increased significantly in many countries. As a result of this phenomenon, cardiologists and cardiac surgeons are increasingly confronted in their practice with elderly patients. There are features of the management of cardiac and cardiac surgical patients of advanced age, caused both by the specifics of the underlying disease and by concomitant diseases. With the emergence of new options for evaluating the effectiveness of various methods of surgical correction of heart disease in age patients, new questions arise that require evidentiary consideration and an optimal answer. Opinions of experts about the feasibility of surgical interventions in the elderly are often different. The urgency of the problem is due to the recent increase in the number of heart operations in the group of age-related patients. The study of the quality of life of patients in the postoperative period helps to determine the most rational and optimal method of surgical treatment, not only from the point of view of the cardiac surgeon, but also from the standpoint of assessing the patient himself. In addition, frequent postoperative complications and recurrences of diseases force specialists to focus on the quality of life of patients after surgery, which makes the problem extremely urgent.

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