ROBOTIC REPAIR OF ATRIAL SEPTAL DEFECT WITH PARTIAL PULMONARY VENOUS RETURN ANOMALY: OUR 5‐YEAR EXPERIENCE

xlomafota13 shared this article with you from Inoreader ROBOTIC REPAIR OF ATRIAL SEPTAL DEFECT WITH PARTIAL PULMONARY VENOUS RETURN ANOMALY: OUR 5‐YEAR EXPERIENCE Via The International Journal of Medical Robotics and Computer Assisted Surgery ABSTRACT Introduction Partial pulmonary venous return anomalies (PPVRA) were not considered as a good candidate for robotic surgery in early time of robotic cardiac surgery. In this study, we present our experience in patients undergoing robotic atrial septal defect (ASD) and PPVRA surgery. Methods Between November 2014-January 2020, data of 21 patients underwent robotic ASD with PPVRA was collected. Inclusion criterion was presence of right-sided PPVRA with ASD. All operations were performed robotically. Results The mean age of patients was 26.7±10.3 years. 17 patients (81 %) had superior-caval ASD with supracardiac PPVRA and double-patch technique was used. Four patients had inferior-caval ASD with intracardiac PPVRA and single-patch technique was preferred. Cross-clamp time and cardiopulmonary bypass time were 92.8±29.6 and 127.8±38.1, respectively. There was no mortality. One patient had atrioventricular-block and required pacemaker. Conclusion Robotic repair of ASD with PPVRA is feasible and effective method as an alternative to conventional surgery. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The effectiveness of topical 1% lidocaine with systemic oral analgesics for ear pain with acute otitis media

xlomafota13 shared this article with you from Inoreader The effectiveness of topical 1% lidocaine with systemic oral analgesics for ear pain with acute otitis media Via International Journal of Pediatric Otorhinolaryngology Publication date: May 2022 Source: International Journal of Pediatric Otorhinolaryngology, Volume 156 Author(s): Ateş Kara, Ayşe Büyükcam, Murat Sütçü, Enes Sali, Şefika Elmas Bozdemir, Manolya Kara, Eda Çullas İlarslan, Cemil Kaya, Sabahat Karakaşlılar, Gülsüm Sönmez, Soner Sertan Kara, Tuğba Bedir, Eda Albayrak, Tuğçe Tural Kara, Solmaz Çelebi, Fatma Nur Öz, Adem Karbuz, Ayper Somer, Derya Alabaz, Hasan Tezer View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Comparison of Video Head Impulse Test Findings in Individuals Aged between 20–39 and 40–60 Years

xlomafota13 shared this article with you from Inoreader Comparison of Video Head Impulse Test Findings in Individuals Aged between 20–39 and 40–60 Years Via Indian Journal of Otology Özge Gedik, Nilüfer Bal, Sümeyye Özdemir, Berna Özge Mutlu, Elifnur Taşdemir, Burcu Kaya, Eda Kurt, Nur Sema Kaya, Zeynep Durukan Indian Journal of Otology 2021 27(4):225-229 Objective: The aim of this study was to investigate the normal gain values specific to each semicircular canals by using the goggle-less model of video head impulse test (vHIT) between ages of 20–39 and 40–60, gender and age-related gain values changes. Materials and Methods: The present study was performed in 99 participants aged 20–39 years and 100 participants aged 40–60 years. Each semicircular canal gain values were interpreted by comparing for both the age group of 20–39 and 40–60 years and gender. Results: The mean right lateral, right posterior, left lateral, and left posterior canal gain of 20–39 age group was significantly higher than the 40–60 age group. Regardless of age, while the mean left lateral canal gain in females was significantly higher than males, the mean right anterior and right posterior canal gain was significantly higher in males. The mean right lateral and the left lateral canal gains were significantly higher in females in the 20–39 year s' age group; however, the mean right anterior, right posterior, and left posterior canals gains were significantly higher in males than in females. The mean right lateral canal gain in males was significantly higher in the 40–60 age group than that of females. Conclusions: The vHIT as a standard test for vestibular assessment provides clinical benefits, in addition the comparing for different age groups for goggle-less vHIT model will provide more beneficial results in the evaluation of patients. In the literature, there are not many studies on the goggle-less vHIT device, so we believe our study will be a pioneer in this field. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Otogenic Cerebral Venous Sinus Thrombosis: A Case Report and Literature Review

xlomafota13 shared this article with you from Inoreader Otogenic Cerebral Venous Sinus Thrombosis: A Case Report and Literature Review Via Indian Journal of Otology Mostafa Meshref, Ahmed Taher Masoud, Amira Yasmine Benmelouka Indian Journal of Otology 2021 27(4):238-240 Cerebral venous sinus occlusion is an exceptional presentation in the emergency department. Otitis and mastoiditis are rarely associated with cerebral venous sinus occlusion. It is considered as a redoubtable complication with potentially severe outcomes. Symptoms that may indicate this thrombosis are variable and include progressive headache, intracranial hypertension, seizures, focal neurological deficits, and ophthalmologic symptoms. In this article, we report a case of a young female patient presenting with otitis and mastoiditis complicated with intracranial thrombosis. She was successfully treated with antibiotics, anticoagulants, and analgesics. Furthermore, we provide a brief review on cerebral venous sinus thrombosis with a focus on its risk factors and its management. Finally, we emphasize the need for better awareness about this potential intracranial complication. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The Endonasal Endoscopic Approach to Different Sinonasal Fungal Balls

xlomafota13 shared this article with you from Inoreader The Endonasal Endoscopic Approach to Different Sinonasal Fungal Balls Via International Journal of Otolaryngology Background. Fungal ball sinusitis is a sinonasal fungus ball that usually affects immunocompetent adults with female predominance. The most affected sinus is the maxillary sinus. Aspergillus species is the most typically found fungus. Computed tomography (CT) scan is the gold standard tool in order to diagnose fungal ball sinusitis. The ultimate method for a fungal ball is functional endoscopic sinus surgery (FESS), which has a high success rate and a low morbidity rate. Objective. This study aims to demonstrate the various clinical presentations of fungal ball sinusitis including isolated maxillary sinus, sphenoid sinus, simultaneous occurrence of maxillary and sphenoid fungal ball, and post endonasal endoscopic pituitary surgery fungal ball with various age groups. Also, this study aims t o emphasize the importance of early diagnosis and treatment in such cases. Patients and Methods. A retrospective study that was carried in the otorhinolaryngology department of two hospitals: King Fahad Specialist Hospital and Qatif Central Hospital, Eastern Region, Saudi Arabia. The study was conducted on a total of 16 patients who were diagnosed with paranasal sinuses fungal ball in an 11-year period from January 2008 and November 2019. Results. Out of 16 patients with paranasal sinuses fungal ball, 11 cases were female and 5 males, with age ranging between 16 and 46 years. Results showed eight isolated sphenoid (50%), six isolated maxillary fungal ball (38%), one simultaneous occurrence of the sphenoid and maxillary fungal ball (6%), and one post endonasal endoscopic pituitary surgery for pituitary adenoma (6%). CT scan was performed for all 16 cases which is the standard tool for the diagnosis of the fungal ball. Conclusion. Fungal ball may present with variety of symptoms but m ost commonly with postnasal discharge (PND), headache, and facial pain. CT sinuses is the diagnostic radiological modality to confirm the diagnosis. The FESS functional endoscopic sinus surgery is the gold safe approach for patients with fungal ball to manage their symptoms, confirm the diagnosis, and removal of disease with no morbidities. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evolution of midface microvascular reconstruction: three decades of experience from a single institution

xlomafota13 shared this article with you from Inoreader Evolution of midface microvascular reconstruction: three decades of experience from a single institution Via http://link.springer.com/journal/405,European archives of oto-rhino-laryngology,The European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino Eur Arch Otorhinolaryngol. 2022 Mar 22. doi: 10.1007/s00405-022-07321-x. Online ahead of print. ABSTRACT PURPOSE: Midface reconstruction poses a complex set of challenges for reconstructive surgeons. The optimal midface reconstruction must possess a durable underlying bone construct capable of integrating dental implants. Facial contour is restored by the overlying microvascular soft tissue reconstruction with reestablishment of the oral cavity. A plethora of microvascular flaps used in clinical practice have been described including those harvested from the iliac crest, scapula, fibula, forearm and back (latissimus dorsi). The objective was to share our experiences with each of these treatment options that have continued to evolve over time for the benefit of patients. METHODS: Our institution has over three decades of experience in reconstructing complex midface defects and this article summarizes midface reconstruction from an evolutionary perspective (for type II, III and IV defect; Browns classification, Supplementary Table I). We broadly divide this into (i) flaps supplied by the subscapular system (ii) autologous reconstruction with titanium mesh and (iii) fibula microvascular flaps using 3D planning. RESULTS: The advantages and disadvantages for each approach are discussed (Supplementary Table II). CONCLUSION: In the future, it is expected that 3D planning coupled with rapid prototyping, intraoperative navigation and CT imaging will become standard procedural practice. PMID:35316380 | DOI:10.1007/s00405-022-07321-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Common exacerbation-prone phenotypes across asthma and chronic obstructive pulmonary disease (COPD)

xlomafota13 shared this article with you from Inoreader Common exacerbation-prone phenotypes across asthma and chronic obstructive pulmonary disease (COPD) Via Rhinitis by Kentaro Hyodo, Hironori Masuko, Hisayuki Oshima, Rie Shigemasa, Haruna Kitazawa, Jun Kanazawa, Hiroaki Iijima, Hiroichi Ishikawa, Takahide Kodama, Akihiro Nomura, Katsunori Kagohashi, Hiroaki Satoh, Takefumi Saito, Tohru Sakamoto, Nobuyuki Hizawa Background and objectives Chronic inflammatory airway diseases, including asthma and chronic obstructive pulmonary disease (COPD), are complex syndromes with diverse clinical symptoms due to multiple pathophysiological conditions. In this study, using common and shared risk factors for the exacerbation of asthma and COPD, we sought to clarify the exacerbation-prone phenotypes beyond disease labels, and to specifically investigate the role of the IL4RA gene polymorphism, which is related to type 2 inflammation, in these exacerbation-prone phenotypes. Methods The study population comprised patients with asthma (n = 117), asthma-COPD overlap (ACO; n = 37) or COPD (n = 48) and a history of exacerbation within the previous year. Cluster analyses were performed using factors associated with both asthma and COPD exacerbation. The association of the IL4RA gene polymorphism rs8832 with each exacerbation-prone phenotype was evaluated by multinomial logistic analyses usi ng non-asthma non-COPD healthy adults as controls (n = 1,529). In addition, the genetic influence of rs8832 was also examined in asthma patients with allergic rhinitis and no history of exacerbation (n = 130). Results Two-step cluster analyses identified five clusters that did not necessarily correspond to the diagnostic disease labels. Cluster 1 was characterized by high eosinophil counts, cluster 2 was characterized by smokers with impaired lung function, cluster 3 was characterized by the presence of gastroesophageal reflux, cluster 4 was characterized by non-allergic females, and cluster 5 was characterized by allergic rhinitis and elevated total immunoglobulin E levels. A significant association with rs8832 was observed for cluster 5 (odds ratio, 3.88 (1.34–11.26), p = 0.013) and also for the type 2 exacerbation-prone phenotypes (clusters 1 and 5: odds ratio, 2.73 (1.45–5.15), p = 1.9 × 10−3). Discussion Our results indicated that t he clinical heterogeneity of disease exacerbation may reflect the presence of common exacerbation-prone endotypes across asthma and COPD, and may support the use of the treatable traits approach for the prevention of exacerbations in patients with chronic inflammatory airway diseases. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Laboratory and imaging findings of necrotizing otitis externa are associated with pathogen type and disease outcome: A retrospective analysis

xlomafota13 shared this article with you from Inoreader Laboratory and imaging findings of necrotizing otitis externa are associated with pathogen type and disease outcome: A retrospective analysis Via ear nose throat Ear Nose Throat J. 2022 Mar 19:1455613221080973. doi: 10.1177/01455613221080973. Online ahead of print. ABSTRACT OBJECTIVE: To examine associations of laboratory and imaging data with diagnostic parameters of necrotizing otitis externa (NOE) and its severity, and to compare between bacterial and fungal infections. METHODS: Records of patients diagnosed with NOE during 2010-2018 at the Department of Otolaryngology, Head and Neck Surgery were reviewed retrospectively for demographics; disease characteristics; and laboratory, scintigraphy, and imaging results. RESULTS: Of 48 patients with NOE, the mean age is 73±11.6 years; 32 (67%) were males; 83% had diabetes mellitus. Common pathogens were pseudomonas (49%) and fungi (33%). Sensitivities of the technetium-scan (SPECT ratio ≥1.5), temporal bone computed tomography (CT), and gallium-scan (SPECT ratio ≥1.3) were: 78.7%, 48.8%, and 31.4%, respectively. Gallium-scan results correlated positively with CT bone involvement (p=0.002) and hospital length of stay (p=0.0014). C-reactive protein (CRP) level correlated with hospital length of stay (p=0.028) and positive technetium-scan results (p=0.012). Fungal infection had a higher technetium SPECT ratio (2.16 vs. 1.77, p=0.04), gallium SPECT ratio (1.4 vs. 1.2, p=0.02), longer duration of systemic treatment (87.4 vs. 37.9 days, p=0.014), and longer hospital length of stay (31.6 vs. 15.2 days, p=0.004) compared to non-fungal infection. Eight (17%) patients had responded poorly to treatment. Fungal pathogens, facial nerve paresis, extra-auricular, and bilateral disease were more prevalent among the non-responders. CONCLUSION: The technetium scan has higher sensitivity than temporal bone CT for diagnosing NOE. The gallium scan and CRP correlated well with hospital length of stay. A high rate of fungal infection was found, with significantly higher technetium and gallium SPECT ratios and worse outcome compared to bacterial infection. Fungal NOE remains therapeutically challenging. PMID:35311376 | DOI:10.1177/01455613221080973 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

How I do it: endonasal transcribriform approach for resection of esthesioneuroblastoma

xlomafota13 shared this article with you from Inoreader How I do it: endonasal transcribriform approach for resection of esthesioneuroblastoma Via leak of cerebrospinal fluid Acta Neurochir (Wien). 2022 Mar 16. doi: 10.1007/s00701-022-05178-x. Online ahead of print. ABSTRACT BACKGROUND: Olfactory neuroblastoma, also known as esthesioneuroblastoma, accounts for only 3-6% of sinonasal malignancies but confers a 40% 5-year overall survival. METHOD: The authors describe techniques for the endonasal, minimally invasive resection of an esthesioneuroblastoma in a 69-year-old man who presented with headaches and anosmia and describe surgical nuances and their effect on adjuvant therapy planning. CONCLUSION: This approach, along with microsurgical techniques, helped increase tumor visualization, improved marginal resection, and reduced surgical risk, which may improve patient outcomes. Multilayered reconstruction with a synthetic dural substitute and creation of a nasoseptal flap were performed to reduce postoperative cerebrospinal fluid leak. PMID:35292841 | DOI:10.1007/s00701-022-05178-x View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anatomic evaluation of the triceps tendon insertion at the proximal olecranon regarding placement of fracture fixation devices

xlomafota13 shared this article with you from Inoreader Anatomic evaluation of the triceps tendon insertion at the proximal olecranon regarding placement of fracture fixation devices Via radiol anat Surg Radiol Anat. 2022 Mar 17. doi: 10.1007/s00276-022-02921-y. Online ahead of print. ABSTRACT PURPOSE: Olecranon fractures, especially with a small proximal fragment, remain a surgical challenge. Soft tissue irritation and affection of the triceps muscle bear a risk of complications. In order to find an area for a soft-tissue sparing placement of implants in the treatment of olecranon fractures, we aimed to define and measure the segments of the proximal olecranon and eval uate them regarding possible plate placement. METHODS: We investigated 82 elbow joints. Ethical approval was obtained from the local ethics committee, After positioning in an arm holder and a posterior approach we described the morphology of the triceps footprint, evaluated and measured the surface area of the triceps and posterior capsule and correlated the results to easily measurable anatomical landmarks. RESULTS: We found a bipartite insertional footprint with a superficial tendinous triceps insertion of 218.2 mm2 (± 41.2, range 124.7-343.2), a capsular insertion of 159.3 mm2 (± 30.2, range 99.0-232.1) and a deep, muscular triceps insertion area of 138.1 mm2 (± 30.2, range 79.9-227.5). Olecranon height was 26.7 mm (± 2.3, range 20.5-32.2), and olecranon width was 25.3 mm (± 2.4, range 20.9-30.4). Average correlation between the size of the deep insertion and ulnar (r = 0.314) and radial length (r = 0.298) was obtained. CONC LUSIONS: We demonstrated the bipartite morphology of the distal triceps footprint and that the deep muscular triceps insertion area by its measured size could be a possible site for the placement of fracture fixations devices. The size correlates with ulnar and radial length. PMID:35301578 | DOI:10.1007/s00276-022-02921-y View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Radiological score of computed tomography scans predicts revision surgery for chronic rhinosinusitis

xlomafota13 shared this article with you from Inoreader Radiological score of computed tomography scans predicts revision surgery for chronic rhinosinusitis Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2022 Feb;42(1):63-74. doi: 10.14639/0392-100X-N1561. ABSTRACT OBJECTIVE: Evaluate computed tomography (CT) signs that predict need for revision endoscopic sinus surgery (ESS) of chronic rhinosinusitis (CRS). METHODS: CRS patients (n = 48) underwent routine sinus CT scans and baseline ESS in 2006-2011. Lund-Mackay (LM) scores and 43 other CT signs were analysed blinded from both sides. Patients filled in a questionnaire during the day of CT s canning. Follow-up data were collected from hospital records until January 2018. Associations were analysed by Fisher's exact, Mann Whitney U, Kaplan-Meier method with logrank test and Cox's proportional hazard model. RESULTS: Total LM score was not significantly associated with the need for revision ESS. The best predictive model was a sum of CT signs of non-detectable anatomy of inferior/middle turbinates, obstructed frontal recess, and previous sinus surgery. Using these CT findings, we formed a Radiological Score (RS) (min-max, 0-3 points). Having at least one RS point was significantly associated with the need for revision ESS during the average follow-up of 10.7 years (p = 0.008, Logrank test). CONCLUSION: We identified a radiologic score that was able to predict the need for revision ESS, which is probably useful in predicting CRS outcomes. PMID:35292788 | DOI:10.14639/0392-100X-N1561 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.