scholarly journals Cryotherapy: An Alternative to Surgical Adjunct

2020 ◽  
Keyword(s):  
Surgical Adjunct

scholarly journals Autologous Platelet-Rich Fibrin (PRF) as an Adjunct in the Management of Osteoradionecrosis and Medication-Related Osteonecrosis of Jaws. Case Series in A Single Centre

2021 ◽  
Vol 11 (8) ◽  
pp. 3365
Author(s):  
Benjie Law ◽  
Hui Yuh Soh ◽  
Syed Nabil ◽  
Rama Krsna Rajandram ◽  
Abd Jabar Nazimi ◽  
...  
Keyword(s):  
Case Series ◽  
Cost Effective ◽  
Control Group ◽  
Platelet Rich Fibrin ◽  
Tissue Healing ◽  
Number Of Patients ◽  
Short Period ◽  
Oral And Maxillofacial Region ◽  
Surgical Adjunct ◽  
Autologous Platelet

Osteoradionecrosis (ORN) of the jaws and medication-related osteonecrosis of the jaws (MRONJ) are uncommon but serious diseases affecting the oral and maxillofacial region with clinically similar appearance but distinct pathophysiology. Management of ORN and MRONJ is inherently challenging and the treatment outcomes are unpredictable. The use of autologous platelet concentrates (APCs) to promote hard and soft tissue healing is well described in the literature, and the efficacy of leucocyte and platelet-rich fibrin (L-PRF) has been well documented in a number of clinical studies. The aim of this study was to present our treatment strategy and the outcomes of incorporating L-PRF as a surgical adjunct in management of ORN and MRONJ in our centre. Methods: eight cases of ORN and MRONJ were treated with a combination of sequestrectomy and L-PRF as a surgical adjunct. Results: the overall success was 87.5%. Using L-PRF as an adjunct, we were able to predictably manage ORN and MRONJ without causing significant morbidity. Conclusion: our experience shows that L-PRF may be used as a valuable and cost-effective adjunct to surgical management of ORN and MRONJ. However, due to a limited number of patients, and a short period of review, the true effectiveness of the method is yet to be demonstrated in a longer follow-up study including a greater number of patients, besides the inclusion of a control group.

Intradural spinal endoscopy in children

2011 ◽  
Vol 8 (1) ◽  
pp. 107-111 ◽  
Author(s):  
Joshua J. Chern ◽  
Amber S. Gordon ◽  
Robert P. Naftel ◽  
R. Shane Tubbs ◽  
W. Jerry Oakes ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Brain Tumors ◽  
Arachnoid Cyst ◽  
Spinal Cord Tumor ◽  
Split Cord Malformation ◽  
Type Ii ◽  
Pediatric Spine ◽  
Spinal Cord Malformation ◽  
Wide Acceptance ◽  
Surgical Adjunct

Intracranial endoscopy in the treatment of hydrocephalus, arachnoid cysts, or brain tumors has gained wide acceptance, but the use of endoscopy for intradural navigation in the pediatric spine has received much less attention. The aim of the authors' present study was to analyze their experience in using spinal endoscopy to treat various pathologies of the spinal canal. The authors performed a retrospective review of intradural spinal endoscopic cases at their institution. They describe 4 representative cases, including an arachnoid cyst, intrinsic spinal cord tumor, holocord syrinx, and split cord malformation. Intradural spinal endoscopy was useful in treating the aforementioned lesions. It resulted in a more limited laminectomy and myelotomy, and it assisted in identifying a residual spinal cord tumor. It was also useful in the fenestration of a multilevel arachnoid cyst and in confirming communication of fluid spaces in the setting of a complex holocord syrinx. Endoscopy aided in the visualization of the spinal cord to ensure the absence of tethering in the case of a long-length Type II split spinal cord malformation. Conclusions Based on their experience, the authors found intradural endoscopy to be a useful surgical adjunct and one that helped to decrease morbidity through reduced laminectomy and myelotomy. With advances in technology, the authors believe that intradural endoscopy will begin to be used by more neurosurgeons for treating diseases of this anatomical region.

Vasoconstrictor activity in cerebrospinal fluid from patients subjected to early surgery for ruptured intracranial aneurysms

1981 ◽  
Vol 55 (2) ◽  
pp. 237-245 ◽  
Author(s):  
David J. Boullin ◽  
Lennart Brandt ◽  
Bengt Ljunggren ◽  
Philip Tagari
Keyword(s):  
Cerebrospinal Fluid ◽  
Content Type ◽  
Vasoactive Substances ◽  
Angiographic Vasospasm ◽  
Close Relationship ◽  
Surgical Adjunct ◽  
Serial Samples ◽  
Subarachnoid Blood ◽  
Ruptured Intracranial Aneurysms ◽  
Isolated Tissues

✓ Vasoconstrictor activity was examined in serial samples of cerebrospinal fluid (CSF) obtained from 10 patients undergoing aneurysm clipping within 48 hours after subarachnoid hemorrhage (SAH). There was no close relationship between vasoconstrictor activity in postoperative CSF samples and the patient's clinical condition or angiographic vasospasm. The identity of the vasoconstrictor substance(s) in CSF was not established, but serotonin, histamine, norepinephrine, epinephrine, acetylcholine, or angiotensinII were eliminated as prime vasoconstrictor agents inducing cerebral vasospasm. Differences in the temporal profile of the responses of isolated tissues to CSF from patients with early and late surgery suggested that differing substances were involved in the production of spasm. A correlation between CSF potassium concentrations and vasoactive substances was found, but potassium could not account for vasoconstrictor activity of CSF. A log:linear correlation between total vasoconstrictor activity and total CSF collected could not be explained. Also, because of possible differences in the identity of vasoactive substances in CSF in this study compared to earlier studies, clinical comparisons based on apparent differences in pharmacological potency of CSF were not warranted. Nevertheless, removal of subarachnoid blood by cisternal rinsing seemed to be a useful surgical adjunct.

Safety Profile of 5-Aminolevulinic Acid as a Surgical Adjunct in Clinical Practice

2015 ◽  
Vol 27 (4) ◽  
pp. 304-309 ◽  
Author(s):  
Cristina Honorato-Cia ◽  
Antonio Martinez-Simón ◽  
Elena Cacho-Asenjo ◽  
Francisco Guillén-Grima ◽  
Sonia Tejada-Solís ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Safety Profile ◽  
Aminolevulinic Acid ◽  
Surgical Adjunct

Utility and cost–effectiveness of 3D-printed materials for clinical use

2019 ◽  
Vol 3 (4) ◽  
pp. 209-218 ◽  
Author(s):  
Julian Vitali ◽  
Matthew Cheng ◽  
Michael Wagels
Keyword(s):  
Cost Effectiveness ◽  
3D Printing ◽  
Relevant Literature ◽  
Clinical Use ◽  
Surgical Guides ◽  
Rigorous Testing ◽  
Clinical Benefits ◽  
3D Printed ◽  
Surgical Adjunct ◽  
Printed Materials

This review summarizes the utility of 3D-printing as a surgical adjunct, reviewing the cost–effectiveness. The relevant literature was analyzed outlining the utility and/or cost–effectiveness of 3D-printing for clinical use. Compared with existing methods, the evidence suggests an advantage of using 3D-printing as a technology in the treatment of complex clinical cases. However, in high frequency cases, the additional preoperative expenses are not justified. Considerable evidence of its clinical benefits exists for the application of 3D-printed anatomical models and teaching tools. However, the evidence supporting 3D-printing’s use as surgical guides or implantable devices is less clear. Furthermore, caution must exist when using these devices in the clinical setting due to a paucity of rigorous testing, global regulation and long-term data.

Perioperative Sonography

1989 ◽  
Vol 4 (1_suppl) ◽  
pp. S91-S100 ◽  
Author(s):  
William M. Chadduck
Keyword(s):  
Real Time ◽  
Ventricular Catheter ◽  
Neurosurgical Procedures ◽  
Intramedullary Spinal Cord ◽  
Intraoperative Sonography ◽  
Pediatric Age Group ◽  
Dural Closure ◽  
Catheter Tip ◽  
Surgical Adjunct ◽  
Time Of Operation

Experience using intraoperative real-time sonographic examinations for over a thousand patients has delineated the advantages of this surgical adjunct for a number of cranial and spinal pediatric neurosurgical procedures. Unusual and unfamiliar angles of insonation call for careful attention to anatomy. The advantages of intraoperative sonography in localizing intracerebral tumors, brain abscesses, and foreign bodies are demonstrated. In addition, adequacy of tumor removal can be assessed better at the time of operation and the operative area can be inspected for bleeding even after dural closure. In the pediatric age group, intraoperative real-time sonography is used most commonly for placement of shunts, allowing positioning of the ventricular catheter tip away from the choroid plexus. The use of air as a contrast agent in conjunction with intraoperative sonography allows better identification of catheter tips and can demonstrate the intercommunication of potentially isolated cavities within the brain. Intraoperative sonography has been extremely helpful, especially for identifying cysts within and the extent of intramedullary spinal cord tumors. Visualization of a syrinx is exquisite. Some of the cases presented also serve to identify limitations of intraoperative sonography as a surgical adjunct. (J Child Neurol 1989;4:S91-S100).

Clinical profile, risk factors and outcome of medical, surgical and adjunct interventions in patients with Pythiuminsidiosum keratitis

2018 ◽  
Vol 103 (3) ◽  
pp. 296-300 ◽  
Author(s):  
Shweta Agarwal ◽  
Geetha Iyer ◽  
Bhaskar Srinivasan ◽  
Saket Benurwar ◽  
Mamta Agarwal ◽  
...  
Keyword(s):  
Primary Treatment ◽  
Routine Care ◽  
Additional Benefit ◽  
Clinical Profile ◽  
Interventional Study ◽  
Management Options ◽  
Recommended Treatment ◽  
Surgical Adjunct ◽  
Oral Azithromycin ◽  
Therapeutic Penetrating Keratoplasty

PurposeTo report clinical profile and compare management options for Pythium keratitis.MethodRetrospective interventional study of 46 patients diagnosed as Pythium keratitis by PCR DNA sequencing from January 2014 to July 2017. Interventions were categorised into medical management (MM) (topical azithromycin and linezolid with oral azithromycin at presentation), surgery (S) (therapeutic penetrating keratoplasty, TPK), surgical adjunct (SA) (cryotherapy±alcohol with TPK) and medical adjunct (MA) (MM after TPK).ResultsPrimary treatment included MM (1 eye), SA (3 eyes) and S (42 eyes). Recurrence occurred in 27/43 eyes (MM+S group). Second surgery (S) was required in 11 eyes (TPK-2), with additional procedures (SA) in 10 eyes and evisceration in five eyes. 8/43 eyes received MA after TPK-1. One eye required TPK-3. Recurrence occured in all eyes that received MA (100%) and in 28 of 54 TPKs (51.8%) (TPK 1+2+3) in 42 eyes. Recurrence was noted in 1/14 (7.1%) that underwent SA.ConclusionThe currently available and recommended treatment for Pythium keratitis is surgical by means of a TPK and in worse cases evisceration. In our study, MM/MA measures showed no benefit with recurrence or worsening of infection requiring resurgery. Almost 50% of TPKs had a recurrence requiring resurgery. However, adjunctive procedures during TPK appear to have additional benefit with low risk of recurrence and could be included as routine care.

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