Endoscopic surgery for intraconal orbital tumors

xlomafota13 shared this article with you from Inoreader Endoscopic surgery for intraconal orbital tumors Via hno HNO. 2022 Mar 17. doi: 10.1007/s00106-022-01156-y. Online ahead of print. ABSTRACT Traditionally, external craniofacial approaches have been used for orbital tumor resection. Over the last 30 years, endoscopic sinonasal and skull base techniques have become widely used throughout the world. These experiences paved the way for the extension of transnasal endoscopic techniques to the intraconal orbit. Transnasal endoscopic intraconal surgery has several advantages regarding mo rbidity and outcome as compared with purely external approaches. However, the anatomical knowledge and experience of the surgeon is crucial for the success of the surgery. Endoscopic approaches for intraconal tumor removal are feasible for medial and inferior lesions as well as for lesions lateral to the optic nerve provided they remain inferior to the "plane of resectability" and no optic nerve retraction is required. As intraorbital tumors are rare, new international staging systems including CHEER (Cavernous Hemangioma Exclusively Endonasal Resection) and ORBIT (Orbital Resection by Intranasal Technique) help to standardize safety, efficacy, and outcome. PMID:35298667 | DOI:10.1007/s00106-022-01156-y 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.

Evaluation of thermal plasma process for treatment disposal of solid radioactive waste

xlomafota13 shared this article with you from Inoreader Evaluation of thermal plasma process for treatment disposal of solid radioactive waste Via radioactive iodine J Environ Manage. 2022 Mar 14;311:114895. doi: 10.1016/j.jenvman.2022.114895. Online ahead of print. ABSTRACT The management of radioactive waste is a worldwide activity based on the guidelines of the International Atomic Energy Agency (IAEA), and all stages of management require scientifically proven methods for possible deployment. The management of radioactive waste is a huge challenge due to the high risk in the collection, gathering, transport, handling, and storage. In this s tudy, a thermal plasma treatment process was evaluated for its efficiency to process solid radioactive waste. Experiments were carried out with the application of stable isotopes of Lead, Iodine, Cobalt, and Cesium. After the thermal plasma treatments, the slag and the residual gas were analyzed to verify the influence of process time and discharge power on the efficiency of the process. The treatment for 25 min and 10 kW was sufficient to reduce the mass by 50% of the slag. When the applied power was increased to 15 kW, an expressive reduction in the treatment time (10 min) was able to promote the same mass reduction. The results indicated that the treatment of radioactive waste by thermal plasma is a promising method to manage and reduce the mass and volume for the final disposal. PMID:35299134 | DOI:10.1016/j.jenvman.2022.114895 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.

Acupuncture and its effect on cytokine and chemokine profiles in seasonal allergic rhinitis: a preliminary three-armed, randomized, controlled trial

xlomafota13 shared this article with you from Inoreader Acupuncture and its effect on cytokine and chemokine profiles in seasonal allergic rhinitis: a preliminary three-armed, randomized, controlled trial 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 17. doi: 10.1007/s00405-022-07335-5. Online ahead of print. ABSTRACT PURPOSE: Numerous studies have demonstrated effectiveness for acupuncture in the treatment of seasonal allergic rhinitis (SAR). However, the underlying mechanism remains still unclear. METHODS: 29 SAR patients were recruited from a large randomized, controlled trial investigating the efficacy of acupuncture in SAR. 16 patients were treated by acupuncture plus rescue medication (RM, cetirizine), 6 patients received sham acupuncture plus RM and 8 patients RM alone over 8 weeks. Patients were blinded to the allocation to real or sham acupuncture. At baseline and different time-points during intervention, plasma and nasal concentration of mediators of various biological functions were determined in addition to validated disease-specific questionnaires. RESULTS: The concentration of biomarkers related to the Th1-, Th2-, and T reg-cluster was not changed in patients who received acupuncture, in neither plasma nor nasal fluid. However, with respect to eotaxin and some unspecific pro-inflammatory cytokines (IL-1b, IL-8, IP-10, MIP-1b, MCP-1), acupuncture led to a, partially significantly, lower nasal concentration than sham acupuncture or RM. Furthermore, the nasal symptom score was significantly reduced in patients only after real acupuncture. CONCLUSION: In SAR, acupuncture reduces the intranasal unspecific inflammation, but does not seem to act immunologically on the Th1-Th2-imbalance. PMID:35301577 | DOI:10.1007/s00405-022-07335-5< /a> View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Readmission Rates Following Major Head and Neck Surgery With Concurrent Tracheostomy

xlomafota13 shared this article with you from Inoreader Readmission Rates Following Major Head and Neck Surgery With Concurrent Tracheostomy Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Mar 18:34894221083778. doi: 10.1177/00034894221083778. Online ahead of print. ABSTRACT OBJECTIVES: To determine the influence of major head and neck procedures on readmission and complication rates following tracheostomy. METHODS: A retrospective cohort study using the 2005 to 2017 National Surgical Quality Improvement Program (NSQIP) database. Current Procedural Terminology codes were used to identify tracheostomy patients and to define the underlying head and neck procedure. Patients under the age of 18 and with unknown pre-operative variables were excluded. Univariate and multivariable analyses were performed. RESULTS: A total of 3240 tracheostomy patients undergoing major head and neck surgery were identified in NSQIP. The 30-day mortality rate was 104 (3.2%) and 258 (9.0%) patients were readmitted. 637 (19.7%) patients had an unplanned return to the operating room. There were 1606 (49.6%) non-tracheostomy specific complications, which included 850 (26.2%) medical and 1142 (35.2%) surgical complications. On multivariable analysis, we found that the underlying procedures did not impact the risk of readmission (P > .05 for all). The underlying procedure was also not associated with unplanned return to the operating room except for thyroidectomies, which had a lower risk than free tissue graft reconstruction (OR = 0.53 (95%CI 0.31, 0.88), P = .018). CONCLUSION: While almost 1 in every 2 patients had a complication following major head and neck surgery that included creation of a tracheostomy, the rate of readmission is comparatively low and is not associated with the underlying procedure. These findings should reassure head and neck surgeons that properly managed tracheostomies do not constitute a disproportionate risk of readmission. PMID:35301871 | DOI:10.1177/00034894221083778 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Analysis of Different Techniques of Tonsillectomy: An Insight

xlomafota13 shared this article with you from Inoreader Analysis of Different Techniques of Tonsillectomy: An Insight Via Otolaryngology Indian Abstract Tonsillectomy is one of the most commonly performed surgical procedure in otolaryngology especially in children. This is an age old procedure which has seen continuous changes in the surgical technique from guillotine method to snare technique to coblation tonsillectomy, and is still evolving day by day. But there are no consensus as to which technique is the best or most appropriate for tonsillectomy. The objective of this study is to compare three different surgical techniques of tonsillectomy namely the Cold dissection snare technique (CDST), Bipolar electro-dissection technique (BEDT) and Harmonic scalpel technique (HST) and to identify the method which is safe, with less operative time, which offers decreased intra-operative blood loss and with lowest post-operative morbidity and complications. This prospective and comparative study was conducted over a time duration of 1 year 6 months from January 2018 to July 2019 after the approval from ethical committee. Total 150 cases of tonsillectomy were done by dividing into three groups of 50 cases each. The study showed maximum cases of tonsillitis in the age group less than 10 years and the most common indication for tonsillectomy being chronic recurrent tonsillitis. Harmonic scalpel technique (HST) had least operative time, least intra-operative blood loss, took minimum time for resumption of normal diet and normal activity and also had least pain score on post-operative day 1st, 5th, 10th and 15th. STATISTICS: Kruskall-Wallis and the non-parametric Analysis of variance (ANOVA) tests were applied to determine statistically significant variances. All the differences are found to be significant P < 0.05. Harmonic Scalpel Technique (HST) is the latest technique as it is associated with quicker procedure, less intraoperative blood loss and less post-operative pain. 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.

Resection of Lumbar Spinal Facet Joint Cysts and Cerebrospinal Fluid Leakage: Incidence, Prognostic Parameters, and Outcome in a Single-center Series

xlomafota13 shared this article with you from Inoreader Resection of Lumbar Spinal Facet Joint Cysts and Cerebrospinal Fluid Leakage: Incidence, Prognostic Parameters, and Outcome in a Single-center Series Via leak of cerebrospinal fluid Clin Spine Surg. 2022 Mar 10. doi: 10.1097/BSD.0000000000001309. Online ahead of print. ABSTRACT STUDY DESIGN: Single-center series. OBJECTIVE: Intraspinal facet joint cysts can lead to nerve root compression symptoms with severe discomfort and disability. Permanent improvement can be achieved by surgical resection of the cyst. However, cerebrospinal fluid (CSF) leakage is a common problem in resection of facet joint cyst.The aim of the study was to investigate the frequency of CSF leak after resection of a joint cyst and to determine predictive factors. METHODS: A total of 176 consecutive patients underwent surgery for lumbar spinal facet joint cyst in our institution between 1997 and 2018. Patients with a CSF leak were compared with patients without a CSF leak (control group). RESULTS: CSF leakage occurred in 14 patients (8.0%) In 2 of the cases (14.3%), the CSF leak was recognized only postoperatively, in 12 cases (85.7%) , the CSF leak was detected intraoperatively. Despite intraoperative dura repair, 4 of these 12 patients (33.3%) presented with CSF leakage postoperatively. Altogether 6 patients had postoperative CSF leakage. Compared with patients without CSF leak, there were no differences in preoperative symptoms, surgical technique, complications, or postoperative findings. Adhesion of the cyst to the dura mater was present in all 14 patients with CSF leakage (100%), but only 61.7% of the control group (P<0.005). All patients in the CSF leak group showed an improvement of their preoperative symptoms. CONCLUSIONS: The rate of CSF leakage in resection of spinal facet joint cyst was 8% in the present study. The occurrence of a CSF leakage was independent of clinical factors, level, or side of the cyst, but significantly correlated to dural adhesion of the cyst.Since neither clinical recovery nor recurrence rates do depend on complete removal of the cyst, aggressive resection of dural adhe rend parts of the cyst wall should be avoided to prevent CSF leakage. PMID:35276717 | DOI:10.1097/BSD.0000000000001309 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-dimensional analysis of mandible ramus morphology and transverse stability after intraoral vertical ramus osteotomy

xlomafota13 shared this article with you from Inoreader Three-dimensional analysis of mandible ramus morphology and transverse stability after intraoral vertical ramus osteotomy Via radiol anat Surg Radiol Anat. 2022 Mar 18. doi: 10.1007/s00276-022-02912-z. Online ahead of print. ABSTRACT OBJECTIVES: The purpose of this study was to investigate short- and long-term postoperative changes of both morphology and transverse stability in mandibular ramus after intraoral vertical ramus osteotomy (IVRO) in patients with jaw deformity using three-dimensional (3D) orthognathic surgery planning treatment software for measurement of distances and angles. STUDY DESIGN: T his retrospective study included consecutive patients with skeletal Class III malocclusion who had undergone intraoral vertical ramus osteotomy and computed tomography images before (T0), immediately after (T1), and 1 year after (T2) surgery. Reference points, reference lines and evaluation items were designated on the reconstructed 3D surface models to measure distances, angles and volume. The average values at T0, T1, T2 and time-dependent changes in variables were obtained. RESULTS: After surgery, the condylar length, ramal height, mandibular body length and mandibular ramus volume were significantly decreased (P < 0.01), while clinically insignificant change was observed from T1 to T2. The angular length was increased immediately after surgery (P < 0.05), but it was decreased 1 year after surgery (P < 0.05). Lateral ramal inclination showed significant increase after surgery (P < 0.05) and maintained at T2. CONCLUSION: Changes in the morphology of the man dibular ramus caused by IVRO do not obviously bring negative effect on facial appearance. Furthermore, despite position and angle of mandibular ramus changed after IVRO, good transverse stability was observed postoperatively. Therefore, IVRO technique can be safely used without compromising esthetic results. PMID:35303119 | DOI:10.1007/s00276-022-02912-z View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Relationship of PPARG overexpression with prognostic parameters in papillary thyroid carcinoma

xlomafota13 shared this article with you from Inoreader Relationship of <em>PPARG</em> overexpression with prognostic parameters in papillary thyroid carcinoma Via Acta Otorhinolaryngol Ital Acta Otorhinolaryngol Ital. 2022 Feb;42(1):34-40. doi: 10.14639/0392-100X-N1034. ABSTRACT OBJECTIVES: PAX8/PPARG chromosomal rearrangement is frequently seen in thyroid cancer, and PPARG overexpression has been shown in the follicular variant of papillary thyroid carcinoma, but not in papillary thyroid carcinoma other than the follicular variant. The main aim of this study was to investigate the frequency of PPARG overexpression among papillary thyroid ca rcinoma and if there were any variants of papillary thyroid carcinoma with PPARG overexpression other than the follicular variant. METHODS: Immunohistochemical analysis of PPARG overexpression was performed using a PPARG monoclonal antibody in a series of 111 paraffin-embedded blocks of thyroid tumours. Of the patients in our study, 100 were diagnosed with papillary thyroid carcinoma, 9 with follicular adenoma and 2 with follicular carcinoma. RESULTS: PPARG staining was detected in 19 of the 111 cases. Sixteen patients with PPARG overexpression had papillary thyroid carcinoma and 3 had follicular adenoma. CONCLUSION: PPARG overexpression was detected mainly in follicular-variant papillary thyroid carcinoma. Vascular invasion, lymphatic invasion, thyroid capsule invasion and lymph node positivity were lower in patients with PPARG overexpression. PMID:35292786 | DOI:10.14639/0392-100X-N1034 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.