Hypochlorous Acid Solution Is Safe for Intracavitary Lavage: Examination in a Rodent Model

xlomafota13 shared this article with you from Inoreader Hypochlorous Acid Solution Is Safe for Intracavitary Lavage: Examination in a Rodent Model Via Eplasty Eplasty. 2021 Jan 9;21:e1. eCollection 2021. ABSTRACT BACKGROUND: Intracavitary irrigation is a routine component of many surgical procedures, especially in those involving a contaminated field. Normal saline remains the irrigant of choice for most surgeons. Hypochlorous acid is a weak acid that produces hypochlorite ions with antimicrobial properties. Reducing microbial concentration during intracavitary irrigation is a potential benefit of using hypochlorous acid solution over normal saline. In this study, the safety of hypochlorous acid solution for intracavitary lavage was compared with normal saline in a rat model of 3 surgical procedures-laminectomy, thoracotomy, and laparotomy. METHODS: The intracavitary space was lavaged with either normal saline or hypochlorous acid. The procedures were also completed using Dakin's solution (sodium hypochlorite) as a comparator, given its known cytotoxicity. On postoperative day 5, necropsies of all animals were performed and relevant organs and blood samples obtained. Histology (hematoxylin and eosin staining) was used to examine biopsies of the collected organs for signs of inflammation, blood vessel integrity, and necrosis. Immunohistochemistry staining for caspase-3 was used to identify apoptotic cells. RESULTS: There were no differences in outcomes (survival, pain, and time to recovery) or histology between animals lavaged with hypochlorous acid and normal saline. Intact organ-specific archite cture was observed in both groups. In comparison, rats treated with Dakin's solution demonstrated significant capsular fibrosis and hemorrhage. Furthermore, significant apoptosis was noted within the bowel mesentery of the group treated with Dakin's solution when stained for caspase-3. CONCLUSION: Hypochlorous acid is safe for lavage of intraperitoneal, intrathecal, and intrathoracic cavities. Further studies should be conducted to demonstrate efficacy of hypochlorous acid in an infected field. PMID:33488909 | PMC:PMC7802432 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy of the laser at low intensity on primary burning oral syndrome: a systematic review

xlomafota13 shared this article with you from Inoreader Efficacy of the laser at low intensity on primary burning oral syndrome: a systematic review Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2021 Feb 20:24144. doi: 10.4317/medoral.24144. Online ahead of print. ABSTRACT BACKGROUND: Primary burning mouth syndrome (BMS) is a chronic clinical condition of idiopathic mainly characterized by pain and a burning sensation in the oral cavity. The application of laser at low intensity therapy is a treatment option. This systematic review evaluated the efficacy of laser therapy in treating symptoms of burning mouth syndrome. MATERIAL AND METHODS: The study was formulated according to the PRISMA and Cochrane guidelines. Seven databases were used as primary sources of research. Only randomized controlled clinical trials were included. The efficacy of the therapy was estimated comparing the values of the visual and numerical scales of pain before and after laser treatment, through qualitative analysis. RESULTS: The search resulted in 348 records and only eight filled the eligibility criteria an d were included. All studies evaluated pain and / or a burning sensation considering a time interval of two to ten weeks. The total sample consisted of 314 patients submitted to treatment: 123 from the control group, who participated with laser off or with the tip blocked, and 191 from the intervention group, treated with low-level laser therapy. The female gender stood out and the average age of the participants was 60.89 years. The main symptoms reported were pain and a burning sensation in the oral mucosa and tongue. The parameters adopted by the authors for laser treatment were diverse and the variables were not fully described in the published studies. Visual analog and numerical scales were used to assess symptoms and only three studies showed statistical significance. CONCLUSIONS: It is suggested that laser therapy may be an effective alternative in the treatment of BMS. New randomized clinical trials should consider well-established protocols to better understand the e fficacy of laser therapy without confounding the effects. PMID:33609024 | DOI:10.4317/medoral.24144 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Application of propolis extract, nanovitamin C and nanovitamin E to prevent alveolar osteitis after impacted lower third molar surgery. A randomized, double-blind, split-mouth, pilot study

xlomafota13 shared this article with you from Inoreader Application of propolis extract, nanovitamin C and nanovitamin E to prevent alveolar osteitis after impacted lower third molar surgery. A randomized, double-blind, split-mouth, pilot study Via pubmed: "med oral patol oral... Med Oral Patol Oral Cir Bucal. 2021 Feb 20:23915. doi: 10.4317/medoral.23915. Online ahead of print. ABSTRACT BACKGROUND: Propolis has anti-inflammatory, analgesic and healing properties. The purpose of this study was to determine whether a gel containing 2% of propolis extract, 0.2% of ascorbic acid and 0.2% of tocopherol acetate is effective in preventing surgical complications related to impacted lower third molar extractions. MATERIAL AND METHODS: A randomized, double-blind, split-mouth study was performed. Fifteen patients were recruited who needed bilateral impacted lower third molar extractions with a similar surgical difficulty. A test or placebo gel was administered randomly inside post-extraction sockets. Each patient was instructed to apply the gel 3 times/day in the surgical wound for a week. After a month, the contralateral third molar was extracted, and the opposite gel applied. The following parameters were diagnos ed/evaluated and then recorded: alveolar osteitis following Blum's criteria, swelling and trismus at day one, two, three and seven post-intervention, wound healing at day 7 post-intervention, and postoperative pain using a visual analog scale, as well as, the number of analgesic pill intake. RESULTS: A total of twenty-six surgical procedures were performed in 13 patients (mean age 20.67±2 years). Alveolar osteitis was reported in 3 patients from the placebo group (23.1%) and none in the test group (0%) (p=0.25). No statistically significant differences were reported in swelling, trismus, wound healing or analgesic pill consumption between two groups. But statistically lower postoperative pain during the 7 days after surgical extractions was found according to visual analog scale in test group compared to the placebo group (p=0.007). No side effects were reported. CONCLUSIONS: The application of this gel may be effective in preventing alveolitis and thus reducing postope rative pain after impacted third molar extractions. More randomized clinical trials with larger sample are needed to confirm these results. PMID:33609021 | DOI:10.4317/medoral.23915 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cryosurgical Ablation for Treatment of Rhinitis: Two‐Year Results of a Prospective Multicenter Study

xlomafota13 shared this article with you from Inoreader Cryosurgical Ablation for Treatment of Rhinitis: Two‐Year Results of a Prospective Multicenter Study Via The Laryngoscope Objectives/Hypothesis To assess the long‐term (12–24 months) safety and effectiveness of cryoablation of the posterior nasal nerve as treatment for chronic rhinitis. Study Design A multicenter, prospective, single‐arm clinical study. Methods The study was conducted from February 2017 to April 2020. Study endpoints included change from baseline in the reflective Total Nasal Symptom Score (rTNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), physician assessment of improvement using the Clinical Global Impression–Improvement (CGI–I), and the incidence of treatment‐related adverse events. Results Ninety‐one participants completed the study through the initial 12‐month study period. Sixty‐two participants consented to the long‐term follow‐up with 57 completing the 24‐month follow‐up. Significant improvements in the total rTNSS were reflected in a median change from baseline of −3.0 or −4.0 at all timepoints (P < .001). Greater than 80.0% of participants achieved the minimum clinically important difference (MCID) of improvement by ≥1 point on the rTNSS at all follow‐ups. Total RQLQ scores indicated significant improvement (P < .0001) in quality of life. Over 77% of participants achieved the MCID (≥0.5 points) for the total RQLQ score. According to the CGI–I, ≥83.0% experienced improvement at all but the 12‐month visit (61.9%). One participant experienced two treatment‐related serious adverse events (epistaxis and retained pledget). A total of 29 nonserious treatment‐related AEs were reported in 23 participants; mo st events were transient and resolved with little to no intervention. Conclusions Cryotherapy significantly and clinically improves rhinitis symptoms and quality of life with outcomes that are durable through 24 months after treatment. Level of Evidence 4 Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Endoscopy‐Assisted Transoral Approach to Resect Parapharyngeal Space Tumors: A Systematic Review and Meta‐Analysis

xlomafota13 shared this article with you from Inoreader Endoscopy‐Assisted Transoral Approach to Resect Parapharyngeal Space Tumors: A Systematic Review and Meta‐Analysis Via The Laryngoscope Abstract Objectives By comparing the endoscopy‐assisted transoral approach (EATA) with external approaches (EAs) for the resection of parapharyngeal space tumors (PPSTs), we determined whether the EATA has advantages in terms of operation time, intraoperative bleeding volume, postoperative hospitalization, drainage volume, and complications. At the same time, we summarized the surgical indications for the EATA. Methods Systematic literature retrieval was performed in the PubMed, Web of Science, Embase, CNKI, Wanfang, and CQVIP databases up to February 2020. We calculated the mean difference (MD) with a 95% confidence interval (CI) for continuous outcomes and pooled odds ratio (OR) with 95% CI for dichotomous outcomes. The measured outcomes were operative time, bleeding volume, postoperative hospitalization, drainage volume, and complications. Results Seven studies involving 318 patients were eligible. Of these patients, 145 patients underwent EATA and 173 patients underwent EA surgery. All the former tumors were benign and located medial or anteromedial to the carotid sheath except for the unrecorded tumors. Compared with EAs, the EATA significantly shortened the operation time (MD = −5.56 min, 95% CI: −9.58 to −1.55), shrank the bleeding volume (MD = −89.02 ml, 95% CI: −126.16 to −51.88), shortened the postoperative hospitalization (MD = −2.44 days, 95% CI: −3.37 to −1.51), reduced the drainage volume (MD = −32.97 ml, 95% CI: −36.24 to −29.70), and lowered the incidence of complications (OR = 0.30, 95% CI: 0.16 to 0.59). Conclusion As for PPSTs, with an appropriate and precise patient selection, the EATA is a safe, effective, minimally invasive, and aesthetic surgical modality. Laryngoscope, 2021 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cone-beam computed tomography cinematic rendering: clinical, teaching and research applications

xlomafota13 shared this article with you from Inoreader Cone-beam computed tomography cinematic rendering: clinical, teaching and research applications Via Brazilian Oral Research Abstract Cone-beam computed tomography (CBCT) is an essential imaging method that increases the accuracy of diagnoses, planning and follow-up of endodontic complex cases. Image postprocessing and subsequent visualization relies on software for three-dimensional navigation, and application of indexation tools to provide clinically useful information according to a set of volumetric data. Image postprocessing has a crucial impact on diagnostic quality and various techniques have been employed on computed tomography (CT) and magnetic resonance imaging (MRI) data sets. These include: multiplanar reformations (MPR), maximum intensity projection (MIP) and volume rendering (VR). A recent advance in 3D data visualization is the new cinematic rendering reconstruction method, a technique that generates photorealistic 3D images from conventional CT and MRI data. This review discusses the importance of CBCT cinematic rendering for clinical decision-making, teaching, and research in Endodon tics, and a presents series of cases that illustrate the diagnostic value of 3D cinematic rendering in clinical care. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Zervikofaziale Aktinomykose

xlomafota13 shared this article with you from Inoreader Zervikofaziale Aktinomykose Via Laryngo-Rhino-Otologie Laryngorhinootologie DOI: 10.1055/a-1381-8406 Die Aktinomykose ist eine durch grampositive, fakultativ anaerobe Bakterien verursachte Infektionskrankheit, die sich in den meisten Fällen im zervikofazialen Bereich manifestiert und oft einen dentogenen Fokus aufweist. Das klinische Bild reicht vom akuten Abszessgeschehen bis zu chronisch fistulierenden Gewebeprozessen. Eine frühzeitige Diagnose und ein angemessenes therapeutisches Vorgehen mit einer Kombination aus ausgedehnter antibiotischer Behandlung und ggf. chirurgischer Sanierung sind für einen günstigen Krankheitsverlauf entscheidend. In diesem Artikel werden 5 Fälle von Aktinomyzeteninfektionen dargestellt, welche die Vielfalt der klinischen Erscheinungsbilder, die Pro blematik auf dem Weg zur richtigen Diagnose und mögliche Therapieverläufe illustrieren sollen. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Putting the Pieces Back Together Optimizing Function and Appearance after Orbital Surgery

xlomafota13 shared this article with you from Inoreader Putting the Pieces Back Together Optimizing Function and Appearance after Orbital Surgery Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722631 Objectives To describe medical and surgical options and techniques for functional and aesthetic abnormalities after orbital surgery and multidisciplinary approaches that include the orbit. Design A review of current management options in outpatient clinics and ambulatory surgery centers with selected illustrative cases. The rationale for choosing specific medical and surgical interventions will be discussed with a focus on eyelid malposition and double vision. Setting Outpatient clinics and ambulatory surgery centers. Participants Patients with eyelid, orbital, eye muscle, and scalp contour abnormalities as a result of medical and surgical interventions for brain and/or orbital tumors. Main Outcome Measures Descriptive outcomes. Results A variety of medical and surgical options are available to optimize eyelid, orbit, extraocular muscle, and scalp structure and function. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full t ext View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cerebellopontine Angle Epidermoids: Comparative Results of Microscopic and Endoscopic Excision Using the Retromastoid Approach”

xlomafota13 shared this article with you from Inoreader Cerebellopontine Angle Epidermoids: Comparative Results of Microscopic and Endoscopic Excision Using the Retromastoid Approach" Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722713 Background Densely packed neurovascular structures, often times inseparable capsular adhesions and sometimes a multicompartmental tumor extension, make surgical excision of cerebellopontine angle epidermoids (CPEs) a challenging task. A simultaneous or an exclusive endoscopic visualization has added a new dimension to the classical microscopic approaches to these tumors recently. Method Eighty-six patients (age: 31.6 ± 11.7 years, M:F = 1:1) were included. Nineteen patients (22.1%) had a multicompartmental tumor. Tumor extension was classified into five subtypes. Sixty-two patients underwent a pure microscopic approach (72%) out of which 10 patients (16%) underwent an endoscope-assisted surgery (11.6%) and 24 patients (28%) underwent an endoscope-controlled excision. Surgical outcomes were retrospectively analyzed. Results Headache (53.4%), hearing loss (46.5%), and trigeminal neuralgia (41.8%) were the leading symptoms. Interestingly, 21% of the patients had at least one preexisting cranial nerve deficit. Endoscopic assistance helped in removing an unseen tumor lobule in 3 of 10 patients (30%). Pure endoscopic approach significantly reduced the hospital stay from 9.2 to 7.3 days (p = 0.012), and had a statistically insignificant yet a clearly noticeable lesser incidence of subtotal tumor excision (0 vs. 10%, p = 0.18) with comparable cranial nerve deficits but with a higher postoperative cerebrospinal fluid (CSF) leak rate (29% vs. 4.8%, p = 0.004). Conclusion Endoscope assistance in CPE surgery is a useful addition to conventional microscopic retromastoid approach. Pure endoscopic excision in CPE is feasible, associated with a lesser duration of hospital stay, better extent of excision in selected cases, and it has a comparable cranial nerve morbidity profile albeit with a higher rate of CSF leak. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstructive Outcomes of Multilayered Closure of Large Skull Base Dural Defects Following Open Anterior Craniofacial Resection

xlomafota13 shared this article with you from Inoreader Reconstructive Outcomes of Multilayered Closure of Large Skull Base Dural Defects Following Open Anterior Craniofacial Resection Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0041-1722899 Background Standardized reconstruction protocols for large open anterior skull base defects with dural resection are not well described. Here we report the outcomes and technique of a multilayered reconstructive algorithm utilizing local tissue, dural graft matrix, and microvascular free tissue transfer (MVFTT) for reconstruction of these deformities. Design This study is a retrospective review. Results Eleven patients (82% males) met inclusion criteria, with five (45%) having concurrent orbital exenteration and eight (73%) requiring maxillectomy. All patients required dural resection with or without intracranial tumor resection, with the average dural defect being 36.0 ± 25.9 cm2. Dural graft matrices and pericranial flaps were used for primary reconstruction of the dural defects, which were then reinforced with free fascia or muscle overlay by means of MVFTT. Eight (73%) patients underwent anterolateral thigh MVFTT, with the radial forearm, fibula, and vastus lateralis comprising the remainder. Average total surgical time of tumor resection and reconstruction was 14.9 ± 3.8 hours, with median length of hospitalization being 10 days (IQR: 9.5, 14). Continuous cerebrospinal fluid drainage through a lumber drain was utilized in 10 (91%) patients perioperatively, with an average length of indwelling drain of 5 days. Postoperative complications occurre d in two (18%) patients who developed asymptomatic pneumocephalus that resolved with high-flow oxygen therapy. Conclusion A standardized multilayered closure technique of dural graft matrix, pericranial flap, and MVFTT overlay in the reconstruction of large open anterior craniofacial dural defects can assist the reconstructive team in approaching these complex deformities and may help prevent postoperative complications. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  | &nb sp;Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Pathological Spectrum of Dura-Based Nonmeningothelial Lesions: 5 Years' Experience from a Tertiary Care Centre

xlomafota13 shared this article with you from Inoreader Pathological Spectrum of Dura-Based Nonmeningothelial Lesions: 5 Years' Experience from a Tertiary Care Centre Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1721817 Introduction Nonmeningothelial lesions arising from the dura comprise a wide spectrum of pathologies ranging from neoplastic to infective etiologies. They have overlapping clinical and radiologic findings necessitating histopathological evaluation for the final diagnosis which in turn dictates management and prognosis. Therapeutic strategies are different for each of the lesion. There is scarcity of large case series detailing clinicopathological spectrum of dura-based nonmeningothelial lesions. Materials and Methods In this study, we analyzed the neuropathological spectrum of dura-based nonmeningothelial lesions diagnosed over a period of 5 years in our tertiary care center. Results There were 79 cases of dura-based nonmeningothelial lesions constituting 7.3% of all dura-based lesions (age range: 2–75 years; M:F = 2:3). Basal region was more frequently involved than the convexities. On histopathology, neoplastic lesions predominated (92.4%) and included in order of frequency solitary fibrous tumor/hemangiopericytoma (35.6%), gliomas (27.4%), metastasis (27.4%), mesenchymal tumors (4%), primitive neuroectodermal tumor (2.73%), and medulloblastoma (2.73%). Infective lesions were less frequent (7.6%), included fungal infections and Rosai-Dorfman disease. Conclusion Awareness of the spectrum of nonmeningothelial dural lesions is useful for pathologists as well as the treating surgeon. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.