Efficacy and safety of non-penetrating glaucoma surgery with phacoemulsification versus non-penetrating glaucoma surgery: a Meta-analysis

AIM: To compare the clinical efficacy and safety of non-penetrating glaucoma surgery (NPGS) plus phacoemulsification (Phaco-NPGS) and NPGS-alone. METHODS: We systematically searched various databases and reviewed studies that had evaluated the effects of Phaco-NPGS or NPGS-alone for patients with glaucoma. Primary outcomes included postoperative intraocular pressure (IOP) and the number of postoperative antiglaucoma medications. Secondary outcomes were the prevalence of complications, incidence of needling or goniopuncture, and surgical success rate. RESULTS: In total, 380 and 424 eyes in NPGS-alone and Phaco-NPGS groups respectively were included. Both postoperative IOP and number of medications were significantly lowered in the Phaco-NPGS group than that in the NPDS-alone group [weighted mean difference (WMD)=-1.12, 95% confidence interval (CI): -2.11 to -0.12, P=0.03; WMD= -0.31, 95%CI: -0.53 to -0.09, P=0.006]. Moreover, Phaco-NPGS had a significantly lower prevalence of complications and postoperative procedures compared to NPGS-alone, while no significant difference existed for surgical success. CONCLUSION: Phaco-NPGS superior to NPGS-alone in the reduction of IOP and medications. Phaco-NPGS can be recommended for glaucoma patients with coexisting cataracts owing to its superior efficacy, fewer complications, and postoperative procedures.

An update about neck rejuvenation and complications

The submental-cervical angle is an important anatomical landmark in neck beauty. Considered attractive and a sign of youthful when between 105° and 120°, greater values are considered a “heavy” neck or double chin and are related to the aging process and/or weight gain. The submandibular gland can also contribute to the alteration of the submental-cervical angle, increasing the area’s bulging. Neck-lifting techniques have the potential to produce important changes in the lateral view of the face, making it look more youthful, and that is more noticeable in the frontal aspect. This review focuses on the treatment of the neck, including all modifications that occur during the aging process, and postoperative procedures used to decrease the risk of complications.

Rehabilitation of a voice function in patients with benign laryngeal lesions after surgical treatment

Usually benign laryngeal lesions like cysts, polyps and fibrous masses occurs in result of phonotrauma as reactive changes of the mucous of vocal cords. Presence of organic pathology of larynx is a reason of functional voice disorders. 45 patients in age of 18-70 y.o. with benign laryngeal lesions were investigated. All patients underwent microlaryngoscopy with excision of the lesion in inpatient mode. This article describes complex of pre- and postoperative procedures performed to assess the vocal function in patients. For the surgical excision of lesions «cold-steel» instruments, radiofrequently ablation and laser surgery were used. Authors analysed the correlation between complaints, acoustic voice parameters and the process of mucous recovery. Laser technique is recommended for surgical treatment of benign lesions of larynx. Fibrolaryngoscopy, laryngostroboscopy and computer acoustic assessment of vocal parameters are required before voice normalization. Phonotherapy is indicated n case of persistence of dysphonia.

Contemporary Management of Osteoporotic Fractures

With aging of the population, osteoporotic fractures are becoming an increasing medical problem world­wide. It has been estimated that 2,700,000 patients experienced a low energy fracture in the Polish population in 2010. On the basis of contemporary world standards and publications in the field of orthopaedics and trau­matic surgery, a summary of the principles of management of osteoporotic fractures is presented. Both general problems of fracture treatment in elderly patients as well as difficulties in surgical and conservative treatment resulting from osteoporotic bone abnormalities are discussed. Special attention is paid to preoperative and postoperative procedures in patients with proximal femur fractures. Also presented is a contemporary strategy for the treatment of fractures of the distal forearm, proximal humerus and vertebrae. General principles of diagnosis and treatment of osteoporosis are discussed.

Flapless Dental Implant Placement

Flapless dental implant placement is possible in selected patients but limited to those sites with adequate or augmentable attached gingiva and available bone volume and density. Inadequate attached gingiva, available bone, and bone density may be augmented by pre-, intra-, or postoperative procedures. Bone ridge contour can be approximated by using a described fast set polyvinyl siloxane site evaluation technique. Assuming adequate length and height, a bone width of 5 mm is usually acceptable for standard diameter implants (3.5–4.2 mm). However, implant placement in sites with parabolic shaped ridges may need to be placed deeper to avoid vertical bone loss and implant thread exposure. Inadequate bone volume, less than 5 mm of bone width, may be developed by ridge expansion (split ridge) techniques. With ridge expansion, complications may arise such as malposition and labyrinthine concussion. Malposition may be corrected intraoperatively or grafted for a later implant placement. Labyrinthine concussion is usually of short duration but may be treated with head maneuvers. Sites with 2 mm or less width of available bone may not be treated flaplessly and may be more appropriately treated with extracortical augmentation grafting.