scholarly journals THE RECONSTRUCTION OF EXTERNAL NASAL FULL-THICKNESS DEFECTS WITH PLASTIC MATERIAL USING ALLOCARTILAGE

2016 ◽  
pp. 99-104
Author(s):  
S. A. Ivanov ◽  
I. D. Shlyaga
Keyword(s):  
Wound Healing ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Plastic Material ◽  
Full Thickness ◽  
Surgical Wound ◽  
Analog Scale ◽  
Cosmetic Results ◽  
Fascial Flap ◽  
Nasal Defects

The worked out technique of the reconstruction of full-thickness nasal defects consists in formation of three-layer plastic material based on skin-fascial flap, allogene cartilage and dermal transplantation. We have performed 13 operations, and all the patients have achieved acceptable clinical outcomes. The article presents the data on surgical wound healing, detection of the transplanted allocartilage, estimation of the cosmetic results by the visual analog scale.

Bioabsorbable instrumentation for single-level cervical degenerative disc disease: a radiological and clinical outcome study

2009 ◽  
Vol 11 (5) ◽  
pp. 529-537 ◽  
Author(s):  
Andre Tomasino ◽  
Harry Gebhard ◽  
Karishma Parikh ◽  
Christian Wess ◽  
Roger Härtl
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Neck Disability Index ◽  
Fusion Rate ◽  
Analog Scale ◽  
Single Level ◽  
Arm Pain ◽  
Neck Disability ◽  
Metallic Plates

Object The authors present the radiological and clinical outcome data obtained in patients who underwent single-level anterior cervical discectomy and fusion (ACDF) for cervical spondylosis and/or disc herniation; bioabsorbable plates were used for instrumentation. The use of metallic plates in ACDF has gained acceptance as a stabilizing part of the procedure to increase fusion rates, but when complications occur with these devices, the overall effectiveness of the procedure is compromised. As a possible solution, bioabsorbable implants for ACDF have been developed. This study investigates the feasibility and radiological and clinical outcomes of the bioabsorbable plates for ACDF. Methods The radiological and clinical outcomes of 30 patients were investigated retrospectively. All patients presented with cervical radiculopathy or myelopathy and underwent single-level ACDF in which a bioabsorbable anterior cervical plate and an allograft bone spacer were placed at a level between C-3 and C-7. Radiological outcome was assessed based on the fusion rate, subsidence, and Cobb angle of the surgical level. Clinical outcome was determined by using a visual analog scale, the Neck Disability Index, and the Odom criteria. Results There were no intraoperative complications, and no hardware failure was observed. No signs or symptoms of adverse tissue reaction caused by the implant were seen. Two reoperations were necessary due to postoperative blood collections. The overall complication rate was 16.7%. After 6 months, radiographic fusion was seen in 92.3% of patients. Subsidence at 11.3 ± 7.2 months was 3.1 ± 5.8 mm (an 8.2% change over the immediately postoperative results), and the change in the sagittal curvature was –2.7 ± 2.7°. The visual analog scale score for neck and arm pain and Neck Disability Index improved significantly after surgery (p < 0.001). Overall at 19.5 months postoperatively, 83% of the patients had favorable outcomes based on the Odom criteria. Conclusions Absorbable instrumentation provides better stability than the absence of a plate but graft subsidence and deformity rates may be higher than those associated with metal implants. There were no device-related complications, but adverse late effects cannot be excluded. The fusion rate and outcome are comparable to the results achieved with metallic plates. The authors were satisfied with the use of bioabsorbable plates as a reasonable alternative to metal, avoiding the need for lifelong metallic implants.

scholarly journals KOMPARASI ELECTROSURGERY, ABRASIVE BUR DAN SCALPEL TECHNIQUE PADA DEPIGMENTASI GUSI DENGAN TEKNIK SPLIT MOUTH (Case Series)

2018 ◽  
Vol 14 (1) ◽  
pp. 20
Author(s):  
RM Norman Tri Kusumo Indro
Keyword(s):  
Wound Healing ◽  
Visual Analog Scale ◽  
Gold Standard ◽  
Case Series ◽  
Analog Scale ◽  
Healing Index

Pendahuluan dan tujuan : pigmentasi gingiva merupakan keluhan estetik utama terutama orang Asia. Pigmentasi melanin disebabkan oleh berlebihnya granul melanin didalan lapisan epitelium gingiva. Senyum yang harmonis dipengaruhi tidak hanya dari bentuk, posisi ,warna dari gigi, akan tetapi gusi berpengaruh. Pigmentasi melanin bukan merupakan kelainan patologis dan tidak berbahaya, penanganan secara estetik dapat dilakukan dengan hasil yang sangat baik. Penatalaksanaan : kasus ini menjelaskan teknik split mouth  pada prosedur depigmentasi dengan tiga teknik yang berbeda. Prosedur dengan pisau bedah,dan dengan mata bur. kedua teknik ini dinilai efektif untuk menangani kasus depigmentasi gingiva. Pengukuran komparasi akan diukur dari wound healing index and visual analog scale. Kesimpulan : teknik dengan pisau bedah merupakan teknik yang paling umum dan memberikan hasil yang baik, kelemahan teknik pisau bedah adalah waktu operasi yang cukup lama. Prosedur dengan bur merupakan teknik yang mulai sering digunakan, teknik ini tidak memakan waktu serta hasil maksimal. Kelemahan teknik ini membutuhkan presisi. Kasus ini akan membahas mengenai kekurangan dan kelebihan dari ketiga teknik tersebut dengan mempertahankan prosedur pisau bedah sebagai terapi gold standard untuk depigmentasi.

scholarly journals Transforaminal Percutaneous Endoscopic Lumbar Decompression by Using Rigid Bendable Burr for Lumbar Lateral Recess Stenosis: Technique and Clinical Outcome

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Shuo Tang ◽  
Song Jin ◽  
Xiang Liao ◽  
Kun Huang ◽  
Jiaquan Luo ◽  
...  
Keyword(s):  
Back Pain ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Surgical Procedure ◽  
Leg Pain ◽  
Analog Scale ◽  
Lateral Recess ◽  
Lumbar Decompression ◽  
Lateral Recess Stenosis ◽  
The Mean

Background. Open laminectomy has been regarded as the standard surgical procedure for lumbar lateral recess stenosis during the last decades. Although percutaneous endoscopic lumbar decompression has led to successful results comparable with open decompression, its application in LSS with is still challenging and technically demanding. Here, we report the surgical procedure and preliminary clinical outcomes of transforaminal percutaneous endoscopic lumbar decompression (PELD) by using flexible burr for lumbar lateral recess stenosis. Method. A retrospective study was performed for the patients with lumbar lateral recess stenosis receiving PELD by using flexible burr. The indications of surgery were moderate to severe stenosis, persistent neurological symptoms, and failure of conservative treatment. The patients with mechanical back pain, more than grade I spondylolisthesis, or radiographic signs of instability were not included. Before the operation, the transforaminal epidural lidocaine injections were carried out to make the diagnosis more precise and accurate. Radiologic findings were investigated, and visual analog scale (VAS) for back and leg pain, Oswestry Disability Index, and modified Macnab criteria were analyzed at the different time of preoperation, postoperation, 3 months, 6 months, and 12 months. Results. The follow-up period was 12 months. The mean VAS scores for back and leg pain immediately improved from 7.9 ± 1.2 to 2.8± 1.3, 2.4 ± 1.0, and 2.3 ± 1.0, respectively. The mean visual analog scale scores (VAS) for back pain and leg pain were significantly improved after PELD. The preoperative ODI dropped from 69.1 ± 7.3 to 25.9 ± 8.7, 25.0± 6.9, and 24.7 ± 6.4, respectively. The final outcome was excellent in 39.6%, good in 47.9%, fair in 8.3%, and poor in 4.17%. 87.5% of excellent-to-good ratio was achieved on the basis of Macnab criteria at postoperative 12 months. The complications were limited to transient postoperative dysesthesia (one case), temporary pain aggravation (six cases), and neck pain during the operation (one case). Conclusion. This observation suggests that the clinical outcomes of PELD for lateral recess stenosis were excellent or showed good results. This minimally invasive technique would be helpful in choosing a surgical method for lateral recess stenosis.

scholarly journals Clinical Outcomes of Treating Cervical Adjacent Segment Disease by Anterior Cervical Discectomy and Fusion Versus Total Disc Replacement: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 9 (5) ◽  
pp. 559-567 ◽  
Author(s):  
Victor M. Lu ◽  
Ralph J. Mobbs ◽  
Kevin Phan
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Total Disc Replacement ◽  
Anterior Cervical Discectomy ◽  
Adjacent Segment ◽  
Analog Scale ◽  
Cervical Discectomy

Study Design: Systematic review and meta-analysis. Objective: To compare clinical outcomes of all available adjacent segment disease (ASD) cohorts being treated by either anterior cervical discectomy and fusion (ACDF) or total disc replacement (TDR). Methods: We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines for systematic reviews. Searches of electronic databases from inception to August 2017 identified 349 articles for screening. Data was extracted and analyzed using meta-analysis of proportions. Results: The search identified 1 double-armed study and 8 single-armed studies from which data of 5 TDR and 5 ACDF cohorts treating ASD were extracted. Between the 2 pooled TDR (n = 103) and ACDF (n = 258) groups, baseline characteristics were predominantly similar. Compared with ACDF, TDR demonstrated superior operation duration (107 vs 188 minutes, P = .011) and range of motion of C2-C7 at final follow-up at least 1 year after surgery (40.2° vs 35.1°, P = .001). Other surgical and performance parameters including estimated blood loss, complications, and Japanese Orthopedic Association score, Neck Disability Index, Visual Analog Scale neck, and Visual Analog Scale upper limb measures were comparable between cohorts. Conclusion: TDR confers similar surgical and postoperative outcomes to the treatment of ASD as ACDF. Both procedures lead to improvement in all performance outcomes. Larger, prospective, randomized studies will validate the findings of this meta-analysis. Longer term studies are required to ascertain the recurrence rates of ASD following either surgical treatment of primary ASD.

Clinical Outcomes of Cervical Laminoplasty: Results at Two Years

Neurosurgery ◽  
2016 ◽  
Vol 80 (6) ◽  
pp. 934-941 ◽  
Author(s):  
Melissa M. Stamates ◽  
Michael X. Cui ◽  
Ben Z. Roitberg
Keyword(s):  
Ct Scan ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Cervical Myelopathy ◽  
Neck Disability Index ◽  
Cervical Laminoplasty ◽  
Medium Term ◽  
Analog Scale ◽  
Sf 36

Abstract BACKGROUND: Laminoplasty is an established treatment for cervical myelopathy. Multiple variations have emerged, many advocating the use of allograft, but controversy persists. OBJECTIVE: To assess medium-term clinical outcomes in patients who underwent laminoplasty with autograft at our institution. METHODS: Thirty-two consecutive patients (19 male, 13 female, average age 66 yr) from our prospective outcome registry that underwent cervical laminoplasty between 2009 and 2013 were reviewed. Computed tomography (CT) scan was performed immediately postoperatively and at 6-mo follow-up. Parameters included patient perception of outcome, Nurick score, Neck Disability Index (NDI), visual analog scale for neck pain, and SF-36. RESULTS: On retrospective analysis, all patients felt improved at 3 mo postoperatively; at 2 yr, this rate was 91%. Improvements were seen in Nurick scores, from 3.16 ± 0.9 preoperatively to 1.94 ± 0.8 at 2 yr; NDI score from 28.7% ± 9% preoperatively to 20.8% ± 9.6% at 2 yr; visual analog scale from 2.8 ± 1.2 preoperatively to 1.7 ± 0.9 at 2 yr; and SF-36 physical component summary from 27.9 ± 10 preoperatively to 37.8 ± 11.9 at 2 yr. All values reached significance at all follow-up points (P &lt; .05) with the exception of 6-mo NDI values (P = .062). No C5 palsy, graft complications, or reclosure was observed in any patient during the follow-up period. CONCLUSION: Laminoplasty with autograft is a safe and effective method to treat cervical myelopathy, with good medium-term clinical outcome. No reclosures were observed. Bony fusion was seen in all cases on CT scan. Our study found good outcomes in the performance of open-door laminoplasty without hardware, in the treatment of cervical stenosis.

A New Ceramic Interspinous Process Spacer for Lumbar Spinal Canal Stenosis

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONS108-ONS114 ◽  
Author(s):  
Shunsuke Yano ◽  
Kazutoshi Hida ◽  
Toshitaka Seki ◽  
Takeshi Aoyama ◽  
Minoru Akino ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Operation Time ◽  
Magnetic Resonance Images ◽  
Disc Height ◽  
Analog Scale ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis

Abstract Objective: Because surgery in elderly patients should be minimally invasive, interspinous process distraction has been widely used in this group to treat lumbar canal stenosis. We developed a new interspinous process distraction spacer composed of hydroxyapatite ceramic. In this work, we demonstrate the usefulness of this novel device. Methods: Since 2003, we operated on 19 elderly patients with lumbar canal stenosis, including 14 men and five women. Their mean age was 70.1 years. We compared the intervertebral angle, posterior disc height, and interspinous process distance on midsagittal magnetic resonance images obtained before and after the surgery. We also assessed clinical outcomes by using the Visual Analog Scale and the Zurich Claudication Questionnaire. Results: The average operation time per level was 44.7 minutes. Postoperatively, there were significant changes in the angle (from 12.5 to 8.6 degrees, P &lt; 0.0001), the posterior disc height (from 10.6 to 13.1 mm, P &lt; 0.0001), and the interspinous process distance (from 9.7 to 14.1 mm, P &lt; 0.0001). The clinical outcomes, which we assessed by using the Visual Analog Scale and the Zurich Claudication Questionnaire, were considered satisfactory. (Visual Analog Scale, from 6.88 to 3.00; Zurich Claudication Questionnaire, symptom severity domain from 2.94 to 1.92, physical function from 2.51 to 1.73.) Conclusion: Our ceramic spacer is useful in the treatment of elderly patients with lumbar canal stenosis. Treatment comprises an easy surgical procedure and produces no metal artifact on radiological evaluations, such as magnetic resonance imaging and computed tomographic scans.

scholarly journals Effect of Preoperative Frozen Shoulder on Clinical Outcomes After Arthroscopic Rotator Cuff Repair

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712093444
Author(s):  
Jeung Yeol Jeong ◽  
Seung Bo Shim ◽  
Jin Ho Hong ◽  
Wooyoung Im ◽  
Sang Min Lee ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Visual Analog Scale ◽  
Functional Outcomes ◽  
Constant Score ◽  
Preoperative Evaluation ◽  
Frozen Shoulder ◽  
Analog Scale ◽  
Active Motion ◽  
Significant Difference

Background: A concomitant rotator cuff tear (RCT) with frozen shoulder is a common but challenging clinical scenario. The effect of frozen shoulder on clinical outcomes is open to discussion. Purpose/Hypothesis: This study aimed to evaluate the effect of preoperative frozen shoulder on postoperative clinical outcomes of an RCT. We hypothesized that the treatment results of an RCT concomitant with preoperative frozen shoulder would be comparable with those of an isolated RCT. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 212 patients were divided into 2 groups: 154 in the non–frozen shoulder (NFS) group and 58 in the preoperative frozen shoulder (FS) group. All patients underwent a thorough preoperative evaluation that included range of motion (ROM) and the pain visual analog scale, functional visual analog scale, Constant score, and American Shoulder and Elbow Surgeons (ASES) score. The same evaluation was performed at 6 months and 1 and 2 years postoperatively. The healing status of the repaired RCT of all patients was evaluated by postoperative magnetic resonance imaging. Results: The FS group showed statistically significantly worse functional outcomes than the NFS group at 6 months and 1 year postoperatively ( P < .05). At 2 years postoperatively, active assisted ROM was equivalent between the groups, although the ASES and Constant scores were significantly lower for the FS group ( P < .033 and P < .001, respectively). The retear rates were 5.3% and 12.3% for the FS and NFS groups, respectively ( P = .013). Conclusion: Preoperative frozen shoulder positively affected rotator cuff healing but negatively affected most functional outcomes, including ROM, at 6 months and 1 year postoperatively. At 2 years after surgery, there was no significant difference in active motion, but outcome scores remained lower in the FS group. For patients with preoperative frozen shoulder, a delay in surgery for additional physical therapy might not be necessary. The retear rate for the NFS group was more than double that for the FS group in the current study, which indicates that surgery for an RCT combined with frozen shoulder might provide better results in the long term because of an intact, healed rotator cuff.

Dreierkombination (Thomapyrin®) ist wirksamer bei Kopfschmerzen als Monosubstanzen und Zweierkombination

2005 ◽  
Vol 24 (07) ◽  
pp. 626-639 ◽  
Author(s):  
V. Pfaffenrath ◽  
L. Pageler ◽  
H. Peil ◽  
B. Aicher ◽  
H. C. Diener
Keyword(s):  
Pain Intensity ◽  
Visual Analog Scale ◽  
A Priori ◽  
Intensity Difference ◽  
Visuelle Analogskala ◽  
Analog Scale ◽  
Pain Intensity Difference

ZusammenfassungDie Wirksamkeit, Sicherheit und Verträglichkeit einer Einzelgabe von zwei Tabletten der fixen Dreierkombination mit 250 mg Azetylsalizylsäure (ASS) plus 200 mg Paracetamol plus 50 mg Koffein (Thomapyrin®) gegenüber zwei Tabletten mit 500 mg ASS, oder zwei Tabletten mit 500 mg Paracetamol, oder zwei Tabletten mit 50 mg Koffein beziehungsweise Plazebo wurde in einer klinischen Studie an 1 743 Patienten geprüft, die ihre episodischen Kopfschmerzen vom Spannungstyp oder ihre Migräne mit und ohne Aura üblicherweise erfolgreich mit verschreibungsfreien Analgetika behandeln. Die Dreierkombination war im a priori definierten primären Endpunkt “Zeit bis zu 50% Schmerzreduktion” sowohl der Zweierkombination aus ASS plus Paracetamol (p = 0,0181), als auch den Monoanalgetika ASS (p = 0,0398) und Paracetamol (p = 0,0016), sowie auch der Monotherapie mit Koffein (p < 0,0001) und Plazebo (p < 0,0001) überlegen. Alle Behandlungen außer der Koffein-Monotherapie waren der Plazebobehandlung überlegen (p < 0,0001). Die überlegene Wirksamkeit der Dreierkombination gilt auch für alle sekundären Endpunkte wie beispielsweise der “Verringerung der Kopfschmerzen auf 10 mm VAS (visual analog scale = visuelle Analogskala zur Schmerzmessung), dem gewichteten % SPID (sum of pain intensity difference = aufsummierte Schmerzintensitätsdifferenz gegenüber dem Ausgangsschmerz in Prozent), dem Ausmaß der Beeinträchtigung der alltäglichen Aktivitäten und der globalen Beurteilung der Wirksamkeit durch die Patienten. Alle Behandlungen waren gut verträglich, die Inzidenz von unerwünschten Begleiterscheinungen war gering.

Perceived Tension, Movement, and Pleasantness in Harmonic Musical Intervals and Noises

2020 ◽  
Vol 37 (4) ◽  
pp. 298-322 ◽  
Author(s):  
Marco Costa ◽  
Mattia Nese
Keyword(s):  
Visual Analog Scale ◽  
Energy Content ◽  
High Pitch ◽  
Analog Scale ◽  
Psychophysical Procedure ◽  
Preliminary Study

Perceived valence, tension, and movement of harmonic musical intervals (from the unison to the octave presented in a low- and high-register) and standard noises (brown, pink, white, blue, purple) were assessed in two studies that differed in the crossmodal procedure by which tension and movement were rated: proprioceptive device or visual analog scale. Valence was evaluated in both studies with the visual analog scale. In a preliminary study, the proprioceptive device was calibrated with a psychophysical procedure. Roughness of the stimuli was included as covariate. Tension was perceived higher in dissonant intervals and in intervals presented in the high register. The higher the high-pitch energy content in the standard noise, the higher the perceived tension. The visual analog scale resulted in higher tension ratings than the proprioceptive device. Perception of movement was higher in dissonant intervals, in intervals in the high register, and in standard noises than in musical intervals. High-pitch spectrum noises were associated with more sense of movement than low-pitch spectrum noises. Consonant intervals and low-register intervals were evaluated as more pleasant than dissonant and high-register intervals. High-pitch spectrum purple and blue noises were evaluated as more unpleasant than low-pitch spectrum noises.

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