Midfacial Degloving Approach Facilitated with Endoscope for Nasal, Paranasal & Nasopharyngeal Pathologies

2021 ◽  
Vol 15 (6) ◽  
pp. 1262-1265
Author(s):  
T. Rashid ◽  
A. Ayoub ◽  
M. Ahmed ◽  
S. Qadir ◽  
M. Jan ◽  
...  
Keyword(s):  
Cosmetic Outcome ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Common Complication ◽  
Surgical Team ◽  
Inclusion Criteria ◽  
Male Patients ◽  
Period Data ◽  
Midfacial Degloving

Background: Endoscopic sinus surgery is mostly conducted for the removal of the inflammatory as well as infectious diseases of sinus and malignant or benign nasal, paranasal & nasopharyngeal pathologies. The various surgical approaches that have been used range from transpalatine to a lateral rhinotomy and to mid-facial degloving. Aim: To determine the outcome of mid-facial degloving approach facilitated with endoscope for nasal, paranasal and nasopharyngeal pathologies. Methods: Forty five patients that fulfilled the inclusion criteria were enrolled in the study. All the patients were then underwent surgery by the researcher along with a surgical team under general anesthesia by using Mid-facial degloving approach. The patients were followed - up on 3 & 6 months after the surgery and underwent clinical examination and endoscopic nasal examination to assess the complications, cosmetic outcome and recurrence after the procedure during the follow-up period. Data was entered & analyzed using SPSS v. 23. Results: Mean age of the patients in the sample was 25.47±10.52 years. There were 39(86.7%) male patients and 6(13.3%) female patients. Cosmetic outcome was excellent in 31(68.9%) cases, satisfactory in 12(26.7%) while 2(4.4%) variable comments about the cosmetic effects of the procedure. Bleeding was most common complication 3(6.7%), however recurrence occurred in 3(6.7%) cases. Conclusion: It is concluded that mid-facial degloving approach is a highly successful method for removal of nasal, paranasal or nasopharyngeal pathologies. Key words: Mid-facial degloving, endoscope, nasal, paranasal, nasopharyngeal, pathologies

EP.WE.1048Weight Regain After Sleeve Gastrectomy More Common in Male and Less Common in Super-Obese Patients - Results of an 18-Month Follow-up Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ahmed Salman Bodla ◽  
Jenny Abraham ◽  
Neha Shah ◽  
Vinod Menon
Keyword(s):  
Sleeve Gastrectomy ◽  
Revisional Surgery ◽  
Patient Specific ◽  
Obese Patients ◽  
Inclusion Criteria ◽  
Super Obese ◽  
Burn Out ◽  
Single Centre Study ◽  
Male Patients

Abstract Aims Long-term success of Sleeve Gastrectomy (SG) is undermined by weight regain (WR). Several procedure- and patient-specific factors have been proposed in previous studies. Here we look at 18-month follow-up post-SG to investigate WR and patient-specific variables influencing this. Methods A single-centre study involving retrospective analysis of a prospectively-maintained database. Inclusion criteria: Primary non-revisional SG patients with adequate follow-up data to assess WL/WR trends. Patients were divided into two subgroups based on their %EWL between 6-to-12 and 12-to-18 months: weight regainers (WR) and weight losers/maintainers (WL/M). Results Out of 338 SG cases between 2012-2017, 180 met inclusion criteria of which 18.3% were men and 45% were super-obese. All patients lost weight during first 6 months (mean %EWL 52.3%, P < 0.0001). Between 6-to-12 months, 87.6% patients continued WL with a further mean %EWL of 10.35% (P < 0.0001). Between 12-to-18 months, a drastic deceleration/reversal of WL progress was observed with an average of only 0.76% EWL (P = 0.84), with 42% of patients regaining weight in this period (mean EWG 6.8%). Male patients encountered significantly higher WR rate (OR 3.27, P = 0.003), whereas it was much less frequent in pre-operatively super-obese patients (OR 0.48, P = 0.036). Moreover, there was no difference in the 6-month %EWL between WR and WL/M subgroups (P = 0.62), thus negating the possibility of WL burn-out phenomenon. Conclusions Different rates of WR in men and super-obese patients may indicate underlying behavioural and biological differences. More research is needed to investigate them in detail, having implications for revisional surgery and follow-up support.

scholarly journals Mechanical Thrombectomy for M2 Occlusions: A Single-Centre Experience

2017 ◽  
Vol 6 (3-4) ◽  
pp. 117-125 ◽  
Author(s):  
Pervinder Bhogal ◽  
Philipp Bücke ◽  
Marta Aguilar Pérez ◽  
Oliver Ganslandt ◽  
Hansjörg Bäzner ◽  
...  
Keyword(s):  
Mechanical Thrombectomy ◽  
Outcome Data ◽  
National Institutes Of Health ◽  
Inclusion Criteria ◽  
Recent Success ◽  
Single Centre Experience ◽  
Male Patients ◽  
The Mean ◽  
High Degree

Background: The recent success of several mechanical thrombectomy trials has resulted in a significant change in the management of patients presenting with stroke. However, questions still remain as to whether certain groups will benefit from mechanical thrombectomy. In particular, it is still uncertain whether mechanical thrombectomy should be performed in the M2 branches and, more generally, in the distal vasculature. Methods: We retrospectively analysed our prospectively maintained database of all patients undergoing mechanical thrombectomy between January 2008 and August 2016. We collected demographic, radiological, procedural and outcome data. Results: We identified 106 patients that met our inclusion criteria. The mean age of the patients was 68 ± 13.8 years, and there were 58 (54.7%) male patients. Associated medical conditions were common with hypertension seen in 71% of the patients. The average Alberta Stroke Program Early CT (ASPECT) score on admission was 8.5 ± 1.7. The mean National Institutes of Health Stroke Scale score was 11.8 ± 7.02. The mean duration of the procedure was 103 ± 3.4 min, and the average number of thrombectomy attempts required was 1.8 (range 1-8). Angiographically, Thrombolysis in Cerebral Infarction Scale (TICI) ≥2b was obtained in 90.5% of the patients. Five patients (4.7%) had symptomatic intracranial haemorrhage on follow-up. At 90-day follow-up, 54.6% of the patients had a modified Rankin Scale (mRS) score 0-2, and 71.5% had an mRS score ≤3. There were 15 deaths at 90 days (14.1%). Conclusion: Mechanical thrombectomy in patients with solitary M2 clots is technically possible and carries a high degree of success with a good safety profile. Patients with confirmed M2 occlusion should be considered for mechanical thrombectomy.

scholarly journals The Management of Foreign Body Displacement into the Maxillary Sinus as a Complication of Maxillofacial Interventions: Systematic Review

2020 ◽  
Author(s):  
Bartosz Wojtera ◽  
Angelika Woźna ◽  
Oskar Komisarek
Keyword(s):  
Systematic Review ◽  
Foreign Body ◽  
Maxillary Sinus ◽  
Randomized Trials ◽  
Foreign Bodies ◽  
Late Complications ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Inclusion Criteria

Abstract Displacement of foreign bodies into the maxillary sinus shows an increasing tendency, especially in regard to raising amount of dental implant installation procedures. The purpose of our study was to compare the efficiency and the rate of late complications among the methods of removal of foreign bodies from maxillary sinus. We performed a systematic review following PRISMA Checklist, searching Pubmed and Google Scholar databases for studies investigating the methods of removal of foreign bodies from maxillary sinus. The inclusion criteria embraced the examined group of at least 10 cases and the follow up period of minimum 3 months. We qualified 7 papers from 531 identified in primary search. Among qualified studies functional endoscopic sinus surgery used in order to remove foreign body from maxillary sinus had no late complications, whereas they occurred in 0–5% cases of using replaceable or pedicled bone approaches and in 15–18% cases of Caldwell-Luc approach. FESS probably should become a gold standard in retrieving foreign bodies from maxillary sinus, however poor evidence requires further investigation, especially in prospective, randomized trials.

Endonasal Sinus Surgery: Extended versus Limited Approach

2002 ◽  
Vol 16 (4) ◽  
pp. 187-192 ◽  
Author(s):  
Matthias Kuehnemund ◽  
Andrej Lopatin ◽  
Ronald G. Amedee ◽  
Wolf J. Mann
Keyword(s):  
Chronic Rhinosinusitis ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Postoperative Results ◽  
Transport Time ◽  
Endonasal Sinus Surgery ◽  
Extended Approach ◽  
Long Term Follow Up

Background This study was designed to investigate whether two different surgical approaches in endonasal sinus surgery lead to different postoperative results in patients with chronic rhinosinusitis. Methods Sixty-five patients suffering from chronic rhinosinusitis were operated on with either a limited approach or an extended approach. They were examined preoperatively and reassessed during 3 months, 6 months, and long-term follow-up visits that included endoscopy, saccharin transport time, and the assessment of symptoms. Results The concept of this study was prospective, randomized, and multicenter (Mainz, Germany, and Moscow, Russia). The results of the two different surgical approaches were compared with each other. Conclusion Surgical results and symptomatology were similar in both groups of patients, suggesting that a conservative approach may be sufficient in most patients.

scholarly journals Surgical Management of Fungal Rhinosinusitis

2009 ◽  
Vol 1 (1) ◽  
pp. 69-75
Keyword(s):  
Surgical Management ◽  
Current Treatment ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Treatment Protocols ◽  
Fungal Rhinosinusitis ◽  
Intracranial Involvement ◽  
Invasive Fungal Rhinosinusitis ◽  
Orbital Soft Tissue

Abstract Fungal rhinosinusitis is on the rise. Most current treatment protocols for fungal rhinosinusitis include surgery combined with medical therapy. Endoscopic sinus surgery has revolutionized the management of this disease limiting the use of the open surgical approaches to very extensive cases with orbital, soft tissue or intracranial involvement by invasive fungal rhinosinusitis. A regular and thorough follow-up is mandatory in all cases to check for recurrences. This article discusses the various forms of fungal rhinosinusitis and their surgical management.

scholarly journals Maxillary Sinusitis as a Complication of Zygomatic Implants Placement: A Narrative Review

2022 ◽  
Vol 12 (2) ◽  
pp. 789
Author(s):  
Riccardo Nocini ◽  
Giorgio Panozzo ◽  
Alessandro Trotolo ◽  
Luca Sacchetto
Keyword(s):  
Search Strategy ◽  
Maxillary Sinusitis ◽  
Sinus Surgery ◽  
Inclusion Criteria ◽  
Field Methods ◽  
Post Operative Period ◽  
Zygomatic Implants ◽  
Selection Of ◽  
Better Than

Aims: The aim of this review is to consider maxillary sinusitis as a complication of zygomatic implants placements. Maxillary sinusitis a common complication but in the literature there are no reviews that focus only on this condition and its possible treatment. This review was carried out with to highlight the main findings of the literature on this topic and to improve knowledge in this field. Methods: The search strategy resulted in 155 papers. After selection of the inclusion criteria only 11 papers were examined. From the papers these, 12.3% patients presented maxillary sinusitis but only four studies evaluated sinusitis (both clinical and radiological evaluation). The most common treatment used by the authors were antibiotics alone or combined with functional endoscopic sinus surgery (FESS). Results: The literature shows an absence of precise and shared guidelines diagnosis and post-operative follow-up, and of the treatment of maxillary sinusitis following zygomatic implantology. It has not been determined if the surgical placement of ZIs is better than the other techniques for treatment of the onset of maxillary sinusitis in the post-operative period. Conclusion: To date there are no shared protocols for maxillary sinusitis treatment. In our experience, and according to the literature in the presence of risk factors such as age, comorbidities, smoking, nasal septal deviation or other anatomical variants, we suggested that FESS is performed at the same time as placement of zygomatic implants.

Endoscopic Findings after Functional and Radical Sinus Surgery: A Prospective Randomized Study

1994 ◽  
Vol 8 (2) ◽  
pp. 71-76 ◽  
Author(s):  
Matti A. Penttilä
Keyword(s):  
Maxillary Sinusitis ◽  
Randomized Study ◽  
Endoscopic Examination ◽  
Sinus Surgery ◽  
Surgical Approaches ◽  
Subjective Symptoms ◽  
Endoscopic Findings ◽  
Mucosal Thickness ◽  
Chronic Maxillary Sinusitis

Functional endoscopic (FES) and radical Caldwell-Luc (C-L) surgical approaches were compared in a prospective randomized trial of 150 consecutive patients (aged 14–88 years) suffering from chronic maxillary sinusitis over 3 months’ duration refractory to medical and repeated antral irrigation therapy. A total of 143 patients with 109 operated antra in the C-L group and 127 antra in the FES group were available for the follow-up nasal and antral endoscopic examination median 12 months postoperatively. Both modalities proved effective in relieving subjective symptoms. Postoperatively, FES antra contained markedly fewer secretions, although the endoscopically enlarged natural antral ostium was closed in 18.6% of the sinuses. The inferior meatal antrostomies of the C-L operation were markedly stenosed or closed in 31.4% of the sinuses. Antral mucosal thickness and antral polyps diminished significantly after both operations, but large polyps were found more often after FES.

Outcome of Buccal Mucosal Graft Urethroplasty in Long Segment Anterior Urethral Stricture

2020 ◽  
Vol 19 (2) ◽  
pp. 64-68
Author(s):  
Mrinmoy Biswas ◽  
Sudip Das Gupta ◽  
Mohammed Mizanur Rahman ◽  
Sharif Mohammad Wasimuddin
Keyword(s):  
Urethral Stricture ◽  
Flow Rate ◽  
Surgical Outcome ◽  
Simple Technique ◽  
Anterior Segment ◽  
Maximum Flow ◽  
Anastomotic Site ◽  
Buccal Mucosal Graft ◽  
Male Patients

Objective: To assess the success of BMG urethroplasty in long segment anterior urethral stricture. Method: From January 2014 to December 2015, twenty male patients with long anterior segment urethral stricture were managed by BMG urethroplasty. After voiding trial they were followed up at 3 month with Uroflowmetry, RGU & MCU and PVR measurement by USG. Patients were further followed up with Uroflowmetry and PVR at 6 months interval.Successful outcome was defined as normal voiding with a maximum flow rate >15ml /sec and PVR<50 ml with consideration of maximum one attempt of OIU after catheter removal. Results: Mean stricture length was 5.2 cm (range 3-9 cm) and mean follow-up was 15.55 months (range 6-23 months). Only two patients developed stricture at proximal anastomotic site during follow-up. One of them voided normally after single attempt of OIU. Other one required second attempt of OIU and was considered as failure (5%). Conclusion: BMG urethroplasty is a simple technique with good surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.64-68

Obesity may be associated with adjacent-segment degeneration after single-level transforaminal lumbar interbody fusion in spinopelvic-mismatched patients with a minimum 2-year follow-up

2021 ◽  
Vol 34 (1) ◽  
pp. 83-88
Author(s):  
Ping-Guo Duan ◽  
Praveen V. Mummaneni ◽  
Minghao Wang ◽  
Andrew K. Chan ◽  
Bo Li ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Adjacent Segment Degeneration ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Inclusion Criteria ◽  
Single Level ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Surgery Rates

OBJECTIVEIn this study, the authors’ aim was to investigate whether obesity affects surgery rates for adjacent-segment degeneration (ASD) after transforaminal lumbar interbody fusion (TLIF) for spondylolisthesis.METHODSPatients who underwent single-level TLIF for spondylolisthesis at the University of California, San Francisco, from 2006 to 2016 were retrospectively analyzed. Inclusion criteria were a minimum 2-year follow-up, single-level TLIF, and degenerative lumbar spondylolisthesis. Exclusion criteria were trauma, tumor, infection, multilevel fusions, non-TLIF fusions, or less than a 2-year follow-up. Patient demographic data were collected, and an analysis of spinopelvic parameters was performed. The patients were divided into two groups: mismatched, or pelvic incidence (PI) minus lumbar lordosis (LL) ≥ 10°; and balanced, or PI-LL < 10°. Within the two groups, the patients were further classified by BMI (< 30 and ≥ 30 kg/m2). Patients were then evaluated for surgery for ASD, matched by BMI and PI-LL parameters.RESULTSA total of 190 patients met inclusion criteria (72 males and 118 females, mean age 59.57 ± 12.39 years). The average follow-up was 40.21 ± 20.42 months (range 24–135 months). In total, 24 patients (12.63% of 190) underwent surgery for ASD. Within the entire cohort, 82 patients were in the mismatched group, and 108 patients were in the balanced group. Within the mismatched group, adjacent-segment surgeries occurred at the following rates: BMI < 30 kg/m2, 2.1% (1/48); and BMI ≥ 30 kg/m2, 17.6% (6/34). Significant differences were seen between patients with BMI ≥ 30 and BMI < 30 (p = 0.018). A receiver operating characteristic curve for BMI as a predictor for ASD was established, with an AUC of 0.69 (95% CI 0.49–0.90). The optimal BMI cutoff value determined by the Youden index is 29.95 (sensitivity 0.857; specificity 0.627). However, in the balanced PI-LL group (108/190 patients), there was no difference in surgery rates for ASD among the patients with different BMIs (p > 0.05).CONCLUSIONSIn patients who have a PI-LL mismatch, obesity may be associated with an increased risk of surgery for ASD after TLIF, but in obese patients without PI-LL mismatch, this association was not observed.

Implant Complications in 20 Triple Pelvic Osteotomies

1993 ◽  
Vol 06 (04) ◽  
pp. 202-207 ◽  
Author(s):  
Cindy Fries ◽  
Audrey Remedios
Keyword(s):  
Postoperative Complication ◽  
Hip Dysplasia ◽  
Pelvic Osteotomy ◽  
Implant Failure ◽  
Screw Loosening ◽  
Common Complication ◽  
Implant Complications ◽  
Gait Abnormalities

SummaryIn 12 dogs with hip dysplasia, 20 triple pelvic osteotomies (eight bilateral and four unilateral) were performed. Screw loosening, occurring in six of 12 dogs (seven of 20 osteotomies), was the most common complication after surgery. Implants loosened from the cranial ilium in six hemipelvises (30%) and from both fragments in one hemipelvis, two to six weeks (mean — three) after the operation. Medial acetabular displace-ment caused pelvic narrowing (6 to 9%, mean = 8%) in three of four dogs. Medial ischial displacement decreased pelvic diameter (11 to 21%, mean = 17%) in four of seven osteotomies. All of the dogs with implant failure were treated conservatively with cage rest and in two cases Ehmer slings were used. Although none were lame, gait abnormalities were evident in three of seven dogs on follow-up examinations four to 12 months (mean = six) later.Screw loosening, occurring in seven of 20 hemipelvises, was the most common postoperative complication associated with triple pelvic osteotomy. Fixation failures were managed conservatively. Despite decreased pelvic diameter in four of seven animals, none were lame or showed signs of pelvic obstruction at follow-up examinations four to 12 months later.

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