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Αλέξανδρος Γ. Σφακιανάκης

Sunday, February 7, 2021

Planification virtuelle comparée à la conformation manuelle pour les reconstructions mandibulaires par lambeau libre de fibula : étude scannographique de la symétrie

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Publication date: February 2021

Source: Annales françaises d'Oto-rhino-laryngologie et de Pathologie Cervico-faciale, Volume 138, Issue 1

Author(s): S. Bartier, O. Mazzaschi, L. Benichou, E. Sauvaget

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Plasma Ablation assisted Endoscopic Endonasal Transpterygoid Approach to Sphenoid Lateral Recess Cerebrospinal Fluid Leaks : Technique and Outcome.

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Plasma Ablation assisted Endoscopic Endonasal Transpterygoid Approach to Sphenoid Lateral Recess Cerebrospinal Fluid Leaks : Technique and Outcome.

World Neurosurg. 2021 Feb 03;:

Authors: Rathod R, Virk RS, Nayak G

Abstract
BACKGROUND: Management of sphenoid lateral recess (SLR) cerebrospinal fluid (CSF) leaks present a challenge because of the location and requiring complete visualisation of the defect for a successful repair. Endoscopic endonasal transpterygoid approach (EETPA) is considered the gold standard in addressing these defects. We layout our experience in implementing this approach with plasma ablation.
METHODS: A case series of 11 diagnosed patients of SLR CSF leaks who underwent plasma ablation assisted EETPA repair by a single surgeon between 2011 and 2020 at our institution. Outcomes in terms of surgical field grade on Wormald 11-point grading scale, post-operative complications, healing on nasal endoscopy and imaging and surgical success rate were assessed.
RESULTS: The etiology was spontaneous leak in 10 (90.9%) patients and secondary to temporal lobe abscess and/or meningitis in one (9.09%). Three (27%) patients were previously operated elsewhere by the transsphenoid route which we re-operated by this technique. As per Wormald grading, Grade 1 field in 3 (27.27%), Grade 2 in 6 (54.5%) and Grade 3 in 2 cases (18.18%) was noted. Complications occurred in 3 patients (27%) in the form of dry eye (9%), meningitis (9%) and transient CSF rhinorrhoea in immediate post-operative period (9%). Repair sites were well healed on follow up nasal endoscopy and imaging. Surgical success rate was 100%.
CONCLUSIONS: Plasma ablation assisted EETPA allows for uni-nostril approach to the SLR, provides easy accessibility and better visualisation with a bloodless field which allows appropriate repair thus minimising complications and preventing recurrence.

PMID: 33548527 [PubMed - as supplied by publisher]

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Surgical approach to the facial recess influences the acceptable trajectory of cochlear implantation electrodes.

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Surgical approach to the facial recess influences the acceptable trajectory of cochlear implantation electrodes.

Eur Arch Otorhinolaryngol. 2021 Feb 05;:

Authors: Copson B, Wijewickrema S, Ma X, Zhou Y, Gerard JM, O'Leary S

Abstract
PURPOSE: To provide practical guidance to the operative surgeon by mapping the location, where acceptable straight-line virtual cochlear implant electrode trajectories intersect the facial recess. In addition, to investigate the influence of facial recess preparation, virtual electrode width and surgical approach to the cochlea on these available trajectories.
METHODS: The study was performed on imaging data from eight cadaveric temporal bones within the University of Melbourne Virtual Reality (VR) Temporal Bone Surgery Simulator. The facial recess was opened to varying degrees, and acceptable trajectory vectors with varying diameters were calculated for electrode insertions via cochleostomy or round window membrane (RWM). The percentage of acceptable insertion vectors through each location of the facial recess was visually represented using heatmaps.
RESULTS: Seven of the eight bones allowed for acceptable vector trajectories via both cochleostomy and RWM approaches. These acceptable trajectories were more likely to lie superiorly within the facial recess for insertion via the round window, and inferiorly for insertion via cochleostomy. Cochleostomy insertions required a greater degree of preparation and skeletonisation of the junction of the facial nerve and chorda tympani within the facial recess. The width of the virtual electrode had only marginal impact on the availability of acceptable trajectories. Heatmaps emphasised the intimate relationship the acceptable trajectories have with the facial nerve and chorda tympani.
CONCLUSION: These findings highlight the differences in the acceptable straight-line trajectories for electrodes when implanted via the round window or cochleostomy. There were notable exceptions to both surgical approaches, likely explained by the variation of hook region anatomy. The methodology used in this study holds promise for translation to patient specific surgical planning.

PMID: 33547488 [PubMed - as supplied by publisher]

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Benign recurrent vestibulopathy: MRI and vestibular tests results in a series of 128 cases.

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Benign recurrent vestibulopathy: MRI and vestibular tests results in a series of 128 cases.

Eur Arch Otorhinolaryngol. 2021 Feb 06;:

Authors: Ducroz C, Dumas G, Quatre R, Attyé A, Fabre C, Schmerber S

Abstract
PURPOSE: Benign recurrent vestibulopathy is a recent entity, close to probable Meniere's disease and vestibular-migraine. So far, no study has systematically investigated the presence of endolymphatic hydrops of the lateral semicircular canal in benign recurrent vestibulopathy using magnetic resonance imaging. The aim of this study was to determine magnetic resonance imaging data and vestibular test results in patients with benign recurrent vestibulopathy.
METHODS: 128 patients with benign recurrent vestibulopathy included since 2010 were retrospectively analyzed. Patients had magnetic resonance imaging with a delayed acquisition, audiogram, head shaking test, caloric-test, skull-vibration-induced-nystagmus-test, video-head- impulse-test, and vestibular evoked myogenic potential. Endolymphatic hydrops presence was classified into four categories: cochlear, saccular, lateral semicircular canal and association with saccule.
RESULTS: In benign reccurent vestibulopathy, 23% of cases showed an endolymphatic hydrops on magnetic resonance imaging, more frequently located in the lateral semicircular canal (59%) and related to the disease duration. The most often impaired tests were caloric-test (49%) with fluctuations of hypofunction in 67% and skull-vibration-induced-nystagmus-test (61%). No correlation between the caloric-test and the presence and location of the endolymphatic hydrops was observed.
CONCLUSION: In our series of benign reccurent vestibulopathy, a rare endolymphatic hydrops was most often observed for the lateral semicircular canal and correlated with the seniority of the pathology. Hydrops identified at the magnetic resonance imaging was not correlated with the caloric-test results. Skull-vibration-induced-nystagmus-test and caloric-test were the most often modified vestibular tests.

PMID: 33547924 [PubMed - as supplied by publisher]

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The use of periocular fillers in aesthetic medicine.

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The use of periocular fillers in aesthetic medicine.

J Plast Reconstr Aesthet Surg. 2021 Jan 09;:

Authors: Mandal P, Gama F

Abstract
The periocular area is the first to display signs of ageing. Dermal fillers are an increasingly popular, minimally invasive method for facial rejuvenation. The eye is anatomically delicate and complex. Therefore, special consideration must be taken if dermal fillers are employed. This article examines the literature to assess the efficacy and safety of dermal fillers around the eye as well as the management of complications secondary to dermal filler use, such as oedema, granuloma formation, filler migration, xanthelasma, skin necrosis and visual loss. Hyaluronic acid (HA) is the most popular and commonly employed dermal filler for periocular use. It is effective, with good observer improvement and patient satisfaction (p<0.0001). Ninety percent of adverse events are mild in nature and self-resolve within 1 month. Malar oedema is a delayed complication unique to the periocular area, occurring in 11% of patients. This can be managed with use of hyaluronidase if a HA filler has been employed. Other complications, such as granuloma formation, filler migration and xanthelasma, have also been reported with variable management outcomes. Vascular adverse events include skin necrosis and visual loss. No Level 1 evidence exists for the management of visual loss. Two cases of visual restoration have been identified in the literature; however, this is rare.

PMID: 33546985 [PubMed - as supplied by publisher]

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A sling of a normal right inferior vena cava around the abdominal aorta.

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A sling of a normal right inferior vena cava around the abdominal aorta.

Surg Radiol Anat. 2021 Feb 06;:

Authors: Karaosmanoglu AD, Ardali Duzgun S, Akata D, Ozmen MN, Karcaaltincaba M

Abstract
Variations in the anatomy of inferior vena cava (IVC) may have important clinical implications. In-depth knowledge of its embryology and variations are of fundamental importance to prevent any potential medical complications related to anatomic variations of the IVC. In this article, we described a previously unreported, to the best of our knowledge, a variation of IVC. In the case we presented, the IVC was seen almost completely encircling the abdominal aorta. We decided to call this anatomic variation as "a sling of a normal right IVC around the abdominal aorta". Cross-sectional imaging is a prompt and highly reliable method to evaluate IVC anatomy and may have significant clinical importance to prevent any potential complications related to IVC during surgery or interventional radiology procedures.

PMID: 33547916 [PubMed - as supplied by publisher]

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[New approval: Atezolizumab and bevacizumab for first line of unresecable hepatocellular carcinoma].

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[New approval: Atezolizumab and bevacizumab for first line of unresecable hepatocellular carcinoma].

Bull Cancer. 2021 Feb 02;:

Authors: Minot-This MS, Edeline J

PMID: 33546873 [PubMed - as supplied by publisher]

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