Role of MRI in Pre-Operative Assessment of Patients with Advanced Ovarian Cancer Candidate for Cytoreductive Surgery, A Brief Review

When it comes to gynecologic cancer, ovarian cancer with no doubt is the deadliest and most challenging. The reason often falls into the late presentation, in fact the clinical symptoms are not prominent until the disease is disseminated In patients with advanced ovarian cancer cytoreductive surgery procedure is the key element in treatment plan. One of the best tools to predict successful and complete cytoreductive surgery is using prior imaging. Magnetic resonance imaging is one of the newly described imaging modality for advanced ovarian cancer patients selected for cytoreductive surgery. Here we discussed the application of MRI in advanced ovarian cancer underwent cytoreductive surgery.

Role of Radiologic Imaging in Otosclerosis

Purpose of Review To review the role of imaging in otosclerosis with an emphasis on pre- and post-operative imaging evaluation. Recent Findings Pre-operative CT imaging can help define the extent of bone involvement in otosclerosis and may help avoid surgical complications due to variant anatomy or unsuspected alternative causes of conductive hearing loss. In patients with recurrent hearing loss after surgery, CT imaging can clarify prosthesis position and re-assess anatomy. Summary CT imaging complements otologic exam and audiometry findings in patients with suspected otosclerosis, for pre-operative planning, and post-operative assessment for patients with recurrent symptoms.

Hydration Matters - Role of body Hydration in pain control during Endodontic Therapy

Aim: To assess the relationship of body hydration levels and its impact on pain control during endodontic therapy. Methods: 500 patients were included who required endodontic therapy for irreversible pulpitis. Patient’s body weight was measured in kilograms, while their hydration was calculated the number of glasses of water consumed daily. The pain was measured using the numeric pain for the level of pain perceived during endodontic treatment. Data collection and analysis was done using SPSS version 23. Results: A significant correlations exist between patient’s pain perception during endodontic therapy and their body hydration levels. Our findings suggest that pain levels during endodontic procedures can be reduced with adequate body hydration. Conclusion: Pre-operative assessment of patient’s hydration can help reduce pain during endodontic treatment. Hence, it is important to consider adequately water intake to reduce pain during the endodontic treatment. Keywords: Water intake, body hydration, endodontic treatment, pain.

Evaluation and Comparison of Functional and Aesthetic Outcomes of McGregor and Stepped Lower Lip-Split Incisions for Extirpation of Primary Tumor in Cases of Squamous Cell Carcinoma of Oral Cavity (SCCOC)

Background: Clear surgical margins are of utmost importance in surgical oncological procedures. Secondary consideration includes the functional and aesthetic outcomes of the patients after the procedure. The recognised surgical approach to the posteriorly located oral cavity and oropharyngeal tumors involves the splitting of the lower lip with or without mandibulectomy. In order to perk up postoperative function and aesthetics, quite a lot of modifications of the unique midline lower lip-splitting incision have been projected by various authors till date. A stepped ladder lower lip split incision (LLSI) helps in improved functional and aesthetic outcomes. Objectives: The prime accent of the study is to compare the McGregor LLSI and the stepped LLSI with respect to functional and aesthetic outcomes in tumors ablation for SCCOC. Methodology: The study population (n=22) is assigned randomly in two equal groups as a subject in the ratio of 1:1. Systemically healthy histologically diagnosed patients of SCCOC requiring LLSI for the tumours ablation will be included. In Group A- McGregor LLSI will be performed and in Group B- a Stepped LLSI would performed. Post-operative assessment of functional and aesthetic outcomes will be done. Expected Results: A stepped ladder LLSI used for tumours ablation will be effective in preserving post-operative lip movement, lip competency and cosmesis. Conclusion: Utility of a Stepped ladder LLSI for accessibility and ablation of posterior oral and oropharyngealtumors would be undoubtfully beneficial for improving post-operative functional and aesthetic outcomes and could be executed in routine oncologic surgery.

Pre-operative assessment of difficult laparoscopic cholecystectomy: a scoring method

Background: Laparoscopic cholecystectomy (LC) has become the gold standard procedure for management of symptomatic gallstone disease. At times, it is difficult and takes longer time or has to be converted to an open procedure. The study was undertaken to determine the factors which predict difficult LC. The aim of the study was to evaluate a pre-operative scoring method to predict difficult LC.Methods: This was a prospective study conducted in the department of general surgery, MVJ Medical College, Bangalore from December 2020 to August 2021. There were 100 cases operated by experienced surgeons. Scoring method which included parameters from history, clinical and sonological findings with maximum score up to 15. Score up to 5 predicted easy, 6-10 difficult and 11-15 is very difficult.Results: Pre-operative scoring system correlated with 85.7% for easy, 83.3% in difficult cases and 100% in very difficult cases. The factors like previous history of hospitalization (p=0.004), clinically palpable gallbladder (GB) (p=0.009), impacted GB stone (p=0.001), pericholecystic collection (p=0.04), and abdominal scar due to previous abdominal surgery (p=0.009) were found statistically significant in predicting difficult LC.Conclusions: Pre-operative prediction of risk factors to assess the operative difficulty is an important point for planning the surgery and the high-risk patients may be informed accordingly.

Blepharoplasty and Eyelid Reconstruction

A mastery of facial and eyelid anatomy is paramount to perform oculoplastic surgery safely and successfully. An understanding of periocular structures, vasculature, and innervation highlights the delicate relationship between form and function, which establishes the foundation for cosmetic and reconstructive procedures. This knowledge, coupled with an appreciation for the patient’s goals – both functional and aesthetic – and expectations for the outcome of surgery allows one to complete an effective, multidimensional pre-operative assessment encompassing patient selection, history, physical examination, and ancillary testing. Ultimately, the synthesis of these principles guides the selection and execution of appropriate and efficacious surgical technique for blepharoplasty and eyelid reconstruction. This review contains 15 figures and 28 references Keywords: Eyelid anatomy, Eyelid crease, Eyelid margin, Canthal tendons, Lacrimal system, Blepharoplasty, Tenzel flap, Hughes flap, Cutler-Beard procedure, Canthotomy and cantholysis

Blepharoplasty and Eyelid Reconstruction

A mastery of facial and eyelid anatomy is paramount to perform oculoplastic surgery safely and successfully. An understanding of periocular structures, vasculature, and innervation highlights the delicate relationship between form and function, which establishes the foundation for cosmetic and reconstructive procedures. This knowledge, coupled with an appreciation for the patient’s goals – both functional and aesthetic – and expectations for the outcome of surgery allows one to complete an effective, multidimensional pre-operative assessment encompassing patient selection, history, physical examination, and ancillary testing. Ultimately, the synthesis of these principles guides the selection and execution of appropriate and efficacious surgical technique for blepharoplasty and eyelid reconstruction. This review contains 15 figures and 28 references Keywords: Eyelid anatomy, Eyelid crease, Eyelid margin, Canthal tendons, Lacrimal system, Blepharoplasty, Tenzel flap, Hughes flap, Cutler-Beard procedure, Canthotomy and cantholysis