Surgical Management
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Author(s):  
A Cicilia Subbulakshmi ◽  
Saravana Bharathi ◽  
S Naveen

Accurate diagnosis with imaging and treatment planning are key in the execution of any surgical procedure.Panoramic radiography has been routinely used in dentistry to assist in clinical diagnosis, treatment procedure but it has limitations such as overlapping of anatomical areas which are of interest in the diagnosis. The invention of computed tomography (CT) had revolutionized the digital imaging though their limitations like 2-dimensional imaging features such as distortion, magnification, and superimposition were present. Cone beam computed tomography (CBCT) is rapidly gaining Interest in the medical fraternity. it was designed with the aim to offset some of the limitations of panoramic and CT imaging .CBCT ever since its inception, it had been routinely used in dentistry for its numerous advantages such as 3-dimensional and multi-planar views. Linear, Curved and angular measurements could be performed along with area and volume calculation and density. All with less radiation exposure compared to conventional computed tomography (CT) scans. In this case series three cases of jaw cysts have been presented with varied radiographic features and the role of CBCT in these cases flooding us with enormous radiographic informations which paved the way for precise surgical management.


2021 ◽  
Vol 259 (8) ◽  
pp. 909-913
Author(s):  
Pablo Jarrin Yepez ◽  
Jessica L. Klabnik ◽  
Joseph W. Lozier ◽  
Andrew J. Niehaus ◽  
Matt D. Miesner ◽  
...  

Author(s):  
A Cicilia Subbulakshmi ◽  
Saravana Bharathi ◽  
S Naveen

Accurate diagnosis with imaging and treatment planning are key in the execution of any surgical procedure.Panoramic radiography has been routinely used in dentistry to assist in clinical diagnosis, treatment procedure but it has limitations such as overlapping of anatomical areas which are of interest in the diagnosis. The invention of computed tomography (CT) had revolutionized the digital imaging though their limitations like 2-dimensional imaging features such as distortion, magnification, and superimposition were present. Cone beam computed tomography (CBCT) is rapidly gaining Interest in the medical fraternity. it was designed with the aim to offset some of the limitations of panoramic and CT imaging .CBCT ever since its inception, it had been routinely used in dentistry for its numerous advantages such as 3-dimensional and multi-planar views. Linear, Curved and angular measurements could be performed along with area and volume calculation and density. All with less radiation exposure compared to conventional computed tomography (CT) scans. In this case series three cases of jaw cysts have been presented with varied radiographic features and the role of CBCT in these cases flooding us with enormous radiographic informations which paved the way for precise surgical management.


Dysphagia ◽  
2021 ◽  
Author(s):  
Grainne Brady ◽  
Lauren Leigh-Doyle ◽  
Francesco Mattia Giovanni Riva ◽  
Cyrus Kerawala ◽  
Justin Roe

AbstractDespite recent advances in the radiation techniques used for the treatment of head and neck cancer (HNC) including intensity-modulated radiotherapy (IMRT), mandibular osteoradionecrosis (ORN) remains a significant complication. Advanced stage ORN is managed surgically with resection and immediate free tissue transfer reconstruction. An evaluation of the functional speech and swallowing outcomes was undertaken for patients undergoing surgical management of advanced ORN. We retrospectively reviewed consecutive patients, at a single, tertiary cancer centre, who underwent surgical resection for advanced Notani grade III ORN. Outcomes investigated included use and duration of tracheostomy and swallowing and speech status using Performance Status Scale for Head and Neck Cancer Normalcy of Diet (PSS-NOD) and Understandability of Speech (PSS-Speech) at baseline and 3 months following surgery. Ten patients underwent surgical resection with free tissue transfer reconstruction between January 2014 and December 2019. Two patients required supplemental nutrition via a gastrostomy at three months post surgery. As per the PSS-NOD data half of the patients’ (n = 5) diet remained stable (n = 2) or improved (n = 3) and half of the participants experienced a decline in diet (n = 5). The majority of patients had no speech difficulties at baseline (n = 8). The majority of patients’ speech remained stable (n = 8) with two patients experiencing a deterioration in speech clarity following surgery. Well-designed studies with robust, sensitive multidimensional dysphagia and communication assessments are required to fully understand the impact of surgical management of advanced ORN using resection with free tissue transfer reconstruction.


Author(s):  
Mayur Wanjari ◽  
Pratibha Wankhede ◽  
Deeplata Mendhe ◽  
Sagar Alwadkar ◽  
Hina Rodge

The testicles develop in the abdomen while a male baby is still in the uterus. Before birth, the testicles typically drop from inside the abdomen down into the scrotum. The scrotum is the sack of skin hanging behind the penis where the testicles are housed. Undescended testicles fail to drop into the scrotum before birth or in the first few months of life. The condition is also called cryptorchidism. Here we discussed, A 15 Years old male child was brought to Acharya Vinobha Bhave Rural Hospital with a complaint of undescended testis and is brought for surgical management. The history of previous illness as narrated by the father the child was born with an undescended testis on the right side.


2021 ◽  
Vol 12 ◽  
pp. 514
Author(s):  
Kashif Majeed ◽  
Samuel Z. Hanz ◽  
Michelle Roytman ◽  
J. Levi Chazen ◽  
Jeffrey P. Greenfield

Background: CSF-venous fistulas (CVF) may cause incapacitating positional headaches resulting from spontaneous intracranial hypotension/hypovolemia (SIH). Their etiology remains unknown, although unrecognized local trauma may precipitate SIH. In addition, they are diagnostically challenging despite various imaging tools available. Here, we present CVF identification using magnetic resonance myelography (MRM) and elaborate on their surgical management techniques. Methods: Retrospective charts of confirmed and treated CVF patients with attention to their diagnostic imaging modalities and management techniques were further reviewed. Results: Six cases were identified of which three are presented here. There were two females and one male patient. All had fistulas on the left side. Two were at T7-T8 while the third was at T9-T10 level. Two underwent hemilaminotomies at the T7-T8 while the third underwent a foraminotomy at T9 level to access the fistula site. All CVF were closed with a combination of an aneurysm clip and a silk tie. On follow-up, all had complete resolution of symptoms with no evidence of recurrence. Conclusion: Of the various imaging modalities available, MRM is particularly sensitive in localizing CVF spinal nerve level and their laterality. In addition, the technique of aneurysm clip ligation and placement of a silk tie is curative for these lesions.


Author(s):  
Aditya Rali ◽  
Lucy T. Xu ◽  
Caroline Craven ◽  
Jonathon B. Cohen ◽  
Steven Yeh ◽  
...  

Abstract Background Intraocular lymphoma accounts for fewer than 1% of intraocular tumors. When the posterior segment is involved, it can be further classified as vitreoretinal or choroidal lymphoma. Vitreoretinal lymphoma (VRL) can rarely masquerade as an infectious retinitis making diagnosis and management challenging. Results A 73-year-old woman with a history of non-central nervous system (CNS) involving diffuse large B-cell lymphoma (DLBCL) was referred for worsening blurry vision—visual acuity of count figures at 2 ft—in her right eye for 8 months. Dilated fundus examination of the right eye was significant for retinal whitening and dot-blot hemorrhages, which was concerning for a viral retinitis and guided initial management. Secondary intraocular lymphoma was also considered. The retinal disease continued to progress despite intravitreal and systemic antiviral therapy, and a diagnostic vitrectomy was inconclusive. A retinal biopsy was then performed, which showed DLBCL, confirming a diagnosis of secondary VRL. Three subsequent treatments with intravitreal methotrexate led to regression of the VRL. Conclusions Our case highlights the utility of a retinal biopsy after an inconclusive diagnostic vitrectomy in a challenging scenario of VRL to establish a diagnosis and initiate successful treatment. A multidisciplinary team of providers was essential for diagnosis, comprehensive workup, medical and surgical management of the patient.


Animals ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 2920
Author(s):  
Rachel Turner ◽  
Bonnie Gatson ◽  
Jorge Hernandez ◽  
Amy Alexander ◽  
Copper Aitken-Palmer ◽  
...  

Tortoises belong to the taxonomic family Testudinidae, which is considered one of the most imperiled families of the order Testudines. Anesthesia is often required for the medical and surgical management of large tortoises. The objectives of this retrospective study were to review drug regimens used to successfully anesthetize Galapagos (Chelonoidis nigra), Aldabra (Aldabrachelys gigantea) and African spurred (Centrochelys sulcata) tortoises, and to compare the times to effect and to extubation in tortoises administered different premedication protocols. Anesthetic records of giant tortoises admitted to the University of Florida College of Veterinary Medicine between January 2009 and December 2019 were reviewed. A total of 34 tortoises (six Aldabra, 23 Galapagos, and five African spurred) were included, resulting in 64 anesthetic events. Frequently used premedication protocols included an α-adrenergic agonist and ketamine combined with either midazolam (group αadrenergic agonist, midazolam, ketamine, AMK; n = 34), a μ-opioid receptor agonist (group αadrenergic agonist, μ-opioid receptor agonist, ketamine, AOK; n = 13), or a μopioid receptor agonist and midazolam (group αadrenergic agonist, midazolam, μ-opioid receptor agonist, ketamine, AMOK; n = 10). Inhalant anesthetics (isoflurane, n = 21; sevoflurane, n = 23) were frequently used for maintenance of anesthesia following premedication. Out of the 34 total tortoises, 22 had only one anesthetic event, five had two anesthetic events, three had three anesthetic events, and four had four or more anesthetic events. Few adverse effects were observed and there was no mortality reported during the peri-anesthetic period. Sedation and general anesthesia of giant tortoises can be successfully performed with a combination of an α-adrenergic agonist and ketamine in combination with midazolam and/or a μopioid receptor agonist.


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