scholarly journals Transforaminal Endoscopic Decompression for a Giant Epidural Gas-Containing Pseudocyst: A Case Report and Literature Review

2017 ◽  
Vol 3 (20;3) ◽  
pp. E445-E449
Author(s):  
Xiao Guang Liu
Keyword(s):  
Endoscopic Surgery ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Rare Condition ◽  
Radicular Pain ◽  
Recurrence Rates ◽  
Endoscopic Techniques ◽  
First Case ◽  
The Right ◽  
Epidural Gas

The isolated epidural gas-containing pseudocyst is an uncommon pathogenic factor for severe pain of the lower limb as a result of nerve root compression. After reviewing these rare cases reported in the literature, we found that the name, pathogenesis, and treatment strategy of this pathology remained controversial. The most common treatment is conservative treatment or percutaneous aspiration which might result in poor pain relief and high recurrence rates. Moreover, the patient who received open surgery had good clinical outcome; however, he or she might experience a significant soft tissue injury. In this study, we report the first case of a patient who had a giant epidural gas-containing pseudocyst and received percutaneous endoscopic surgery. This 57-year-old man had been complaining of severe radicular pain in his right ankle for one year. According to computed tomography (CT) and magnetic resonance imaging (MRI) prior to the surgery, the results showed an isolated epidural gas-containing pseudocyst was located in the right lateral recess of S1. At the last follow-up period, postoperative CT scan showed the gas-contained pseudocyst was completely resected and this patient was free from the pain. Due to the great advances in endoscopic techniques and equipment, it is easier to perform lumbar surgery through the endoscope. With this first case of percutaneous endoscopic treatment for the symptomatic epidural gas-containing pseudocyst reported in this study, we believe that this surgical method provides an option to treat this rare condition because it provides sufficient decompression, has a low recurrence rate, and is minimally invasive. Key words: Endoscopic surgery, pseudocyst, epidural gas, intraspinal gas, radiulopathy

scholarly journals Failed knee replacement: incorrect indication?

2019 ◽  
Vol 12 (9) ◽  
pp. e230829
Author(s):  
George Ampat ◽  
Emma Tixerant
Keyword(s):  
Total Knee Replacement ◽  
Knee Replacement ◽  
Surgical Intervention ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
X Rays ◽  
Surgical Interventions ◽  
Mri Scans ◽  
Total Knee ◽  
The Right

A 52-year-old woman sustained a direct soft tissue injury to the right knee following a fall onto the right knee. X-rays did not identify any bony injury. Physiotherapy decreased pain but instability persisted. MRI scans identified early degeneration. An orthopaedic opinion recommended total knee replacement. Following a total knee replacement, the pain has worsened and she remains functionally impaired 2 years following the surgical intervention. Knee replacements are commonly performed successful surgical interventions. The increased numbers of replacements might be due to the lowered threshold in recommending surgical intervention by health professionals. This may increase the failure rate. It also raises the question whether adequate non-operative measures were attempted?

scholarly journals Unusual Mechanism of Facial Nerve Palsy Caused by Penetrating Neck Trauma

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Marisa Klančnik ◽  
Petar Ivanišević ◽  
Marina Krnić Martinić ◽  
Petra Smoje ◽  
Marta Zrinka Vucemilovic
Keyword(s):  
Facial Nerve ◽  
Facial Nerve Palsy ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Complete Recovery ◽  
Neck Injury ◽  
Blunt Injury ◽  
Neck Trauma ◽  
Penetrating Neck Injury ◽  
The Right

We present a case of a low energy penetrating neck injury with only facial nerve (FN) palsy in the clinical finding. A 32-year-old male patient was admitted to the emergency department with a penetrating injury on the right side of the neck just behind the right ear, accompanied by evident right (FN) palsy, evaluated as House Brackmann grade IV. Computed tomography demonstrated an isolated soft tissue injury in the right retroauricular region without bone fracture, parotid gland lesion, or vascular structure involvement. The FN palsy was treated with corticosteroids (CS), and the patient had an uneventful and complete recovery. This case report presents an unusual mechanism of isolated, extratemporal, blunt injury of the FN after a penetrating neck injury followed by complete recovery.

scholarly journals Traumatic Injury from a Tooth Brush: An Unusual Hazard of Oral Hygiene

2009 ◽  
Vol 3 (1) ◽  
pp. 1-2
Author(s):  
Suhas Godhi ◽  
Sandeep Goyal ◽  
Sonia Goyal
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Traumatic Injury ◽  
Soft Tissue Injury ◽  
Medial Aspect ◽  
Experienced Clinician ◽  
History Of ◽  
The Right ◽  
Careful Assessment ◽  
Rule Out

ABSTRACT We present a case of a 6 year old boy with a history of soft tissue injury caused by a toothbrush, the snapped head of which lodged into the medial aspect of the right ramus of the mandible. A survey of literature confirms that most injuries of this kind can be treated conservatively; however careful assessment by an experienced clinician is necessary to rule out other complications. The present paper discusses the prevalence, management and complications associated with impalement injuries of the oral cavity in children.

scholarly journals Posner-Schlossman Syndrome in Common Variable Immunodeficiency

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Madiha Huq ◽  
Neha Sanan ◽  
Phuong Daniels ◽  
Robert Hostoffer
Keyword(s):  
Intraocular Pressure ◽  
Common Variable Immunodeficiency ◽  
Anterior Uveitis ◽  
Rare Condition ◽  
Elevated Pressure ◽  
Normal Limits ◽  
First Case ◽  
Autoimmune Conditions ◽  
The Right ◽  
Common Variable

Introduction. Posner-Schlossman syndrome (PSS) is a rare glaucomatocyclitic crisis with clinical features including recurrent episodes of unilateral elevated intraocular pressure. Autoimmune and infectious causes have been proposed as potential etiologies of PSS. We report the first case of PSS in the setting of common variable immunodeficiency (CVID). Case Report. A sixty-two-year-old Caucasian female with a medical history of CVID and ulcerative colitis presented to the emergency room with complaints of acute right-sided vision changes. She reported image distortion, blurriness, and loss of central vision. Physical exam was significant for mildly injected right conjunctiva, visual acuity of 20/70 in right eye, and 20/25 in left eye. The right intraocular pressure was measured at 34 mmHg and left at 12 mmHg. The gonioscopy and dilated fundus examination were unremarkable. Cup to disc ratio was within normal limits, and no afferent pupillary defects were recorded. The patient was acutely treated with three rounds of dorzolamide/timolol and 0.2% brimonidine which decreased the right eye intraocular pressure to 24 mmHg. On follow-up exam with an ophthalmologist, anterior uveitis including an elevated pressure of 41 mmHg on the right and 18 mmHg on the left eye was noted and a PSS diagnosis was confirmed. Conclusion. PSS remains a rare condition with uncertain etiology and no associated systemic conditions. PSS has been postulated to be linked to autoimmune conditions. CVID is associated with many autoimmune disorders including Sjogren’s, rheumatoid arthritis, and colitis. There have been a few reported CVID-associated ocular diseases including granulomatous uveitis and conjunctivitis, chronic anterior uveitis, and birdshot retinopathy. We describe the first case of PSS in a patient with CVID.

Minimally invasive endoscopic techniques for treating large, benign processes of the nose, paranasal sinus, and pterygomaxillary and infratemporal fossae: solitary fibrous tumour

2008 ◽  
Vol 123 (4) ◽  
pp. 457-461 ◽  
Author(s):  
A Jurado-Ramos ◽  
F Ropero Romero ◽  
E Cantillo Baños ◽  
J Salas Molina
Keyword(s):  
Paranasal Sinus ◽  
Endoscopic Surgery ◽  
Lateral Wall ◽  
Large Mass ◽  
Solitary Fibrous Tumour ◽  
Nasal Fossa ◽  
Endoscopic Techniques ◽  
Sinonasal Mass ◽  
Endoscopic Sinonasal Surgery ◽  
The Right

AbstractObjectives:We report an extremely rare case of a large solitary fibroma of the paranasal sinus, which we treated by sinonasal endoscopic surgery. We describe its clinical and histopathological features, and we report the endoscopic technique used to deal with such a large sinonasal mass (penetrating the pterygomaxillary and infratemporal fossae); we also offer a brief survey of the literature.Case report:A woman presented with an approximately one-year history of nasal obstruction. Nasal endoscopy revealed an irregularly shaped, friable, reddish mass that occupied the whole of the right nasal fossa. Magnetic resonance imaging of the paranasal sinuses revealed a large mass that occupied the anterior and posterior ethmoids and the maxillary and sphenoid sinuses, displacing the septum and penetrating the pterygomaxillary fossa, having destroyed the lateral wall of the right nasal fossa. The tumour was resected by means of sinonasal endoscopic surgery; an endoscopic medial maxillectomy with extension to the pterygomaxillary and infratemporal regions was performed. Histological analysis confirmed the diagnosis of solitary fibrous tumour. During follow up, we performed regular nasal endoscopies, as well as computed tomography scans one and six months post-operatively.Conclusions:Endoscopic techniques are currently the approach of choice for the treatment of such tumours of the sinonasal cavity and pterygomaxillary and infratemporal regions. The size of the lesion did not contraindicate endoscopic sinonasal surgery as a curative treatment.

Posterior Glottic Stenosis: A Canine Model

1998 ◽  
Vol 107 (10) ◽  
pp. 839-846 ◽  
Author(s):  
Mark S. Courey ◽  
Grady Lee Bryant ◽  
Robert H. Ossoff
Keyword(s):  
Animal Model ◽  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Vocal Folds ◽  
Canine Model ◽  
Treatment Modalities ◽  
Deep Soft Tissue ◽  
Cricoarytenoid Joint ◽  
The Right

Posterior glottic stenosis is a disabling disease in which the vocal folds are fixed near the midline. This allows adequate vocal fold adduction for voicing, but does not permit useful abduction for ventilation. The most common cause is prolonged endotracheal intubation for mechanical ventilation, and the incidence is estimated at 4% for intubations between 5 and 10 days. Currently, our understanding and treatment modalities are based on retrospective reviews of small, nonrandomized clinical experiences. The purpose of this project was to develop an animal model that would improve our understanding of histologic changes and allow future prospective randomized trials for therapeutic intervention. Twelve dogs, 15 to 25 kg, were randomly divided into three groups. Animals in group 1 had a superficial injury produced in the tissue over the right cricoarytenoid joint; animals in group 2 had a deep soft tissue injury produced; and animals in group 3 underwent joint opening. The animals were allowed to recover for 2 months. Morphometric analysis of the harvested larynges demonstrated clinically significant limitation in motion in the animals with deep soft tissue injury and in animals with joint disruption. Histologic analysis revealed various degrees of injury, from loss of subepithelial soft tissue to cartilaginous resorption and fusion of the arytenoid to the cricoid. These findings were directly related to the depth of the initial injury. It is possible to produce posterior glottic stenosis in the canine species. This will serve as a reliable animal model for future study.

scholarly journals Standard cross leg flap, still a work horse for compound fracture leg bones with extensive soft tissue damage: a case report

2016 ◽  
Vol 2 (3) ◽  
pp. 198
Author(s):  
Rajneesh Galwa ◽  
Pookhraj Choudhary ◽  
Ramratan Yadav
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Road Traffic Accident ◽  
Traffic Accident ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Compound Fracture ◽  
The Right ◽  
Leg Bones

<p><span lang="EN-IN">This case report presents a 32 year old male patient with h/o road traffic accident resulting in compound fracture of the right tibia and fibula with extensive soft tissue injury and exposed tibia of 12×5 cm. The fractures were stabilized with ext. fixator and exposed tibia was covered by a medially based standard Cross Leg flap of dimensions 16×12 cm, though the largest dimensions described for standard cross leg is 22×10 cm.</span></p>

scholarly journals Endovascular Treatment for Dural Arteriovenous Fistula of the Anterior Condylar Confluence Involving the Anterior Condylar Vein

2008 ◽  
Vol 14 (3) ◽  
pp. 313-318 ◽  
Author(s):  
M. Abiko ◽  
F. Ikawa ◽  
N. Ohbayashi ◽  
T. Mitsuhara ◽  
N. Ichinose ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Rare Condition ◽  
Jugular Bulb ◽  
Craniocervical Junction ◽  
Source Image ◽  
Transvenous Embolization ◽  
First Case ◽  
The Right ◽  
Anterior Condylar Vein

Anterior condylar confluence (ACC) dural arteriovenous fistula (AVF) is a rare anomaly. We describe two cases of ACC dural AVF involving the anterior condylar vein that were successfully treated with selective transvenous coil embolization. The first patient presented with headache and right pulse-synchronous tinnitus, and demonstrated abnormal flow medial to the jugular bulb within the right hypoglossal canal on source image of magnetic resonance angiography (MRA). Arterioangiography disclosed a dural AVF in this area, supplied mainly by the meningeal branches of the bilateral ascending pharyngeal artery. We diagnosed ACC dural AVF involving the anterior condylar vein and transvenous embolization was successfully performed. The second patient presented with right pulse-synchronous tinnitus. Views of source image of MRA and arterioangiography were similar to the first case and, again, transvenous embolization was successfully performed. ACC dural AVF is a rare condition and knowledge of the anatomy of the venous system around the craniocervical junction is required for successful treatment.

Impairment Tutorial: Functionally Limiting Upper Extremity Pain: Controversies in Impairment Rating

2003 ◽  
Vol 8 (5) ◽  
pp. 4-12
Author(s):  
Lorne Direnfeld ◽  
James Talmage ◽  
Christopher Brigham
Keyword(s):  
Upper Extremity ◽  
Radicular Pain ◽  
Illness Behavior ◽  
Orthopedic Surgeon ◽  
First Case ◽  
Clinical Presentations ◽  
Whole Person ◽  
Physical Examinations ◽  
Upper Extremity Impairment ◽  
The Individual

Abstract This article was prompted by the submission of two challenging cases that exemplify the decision processes involved in using the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). In both cases, the physical examinations were normal with no evidence of illness behavior, but, based on their histories and clinical presentations, the patients reported credible symptoms attributable to specific significant injuries. The dilemma for evaluators was whether to adhere to the AMA Guides, as written, or to attempt to rate impairment in these rare cases. In the first case, the evaluating neurologist used alternative approaches to define impairment based on the presence of thoracic outlet syndrome and upper extremity pain, as if there were a nerve injury. An orthopedic surgeon who evaluated the case did not base impairment on pain and used the upper extremity chapters in the AMA Guides. The impairment ratings determined using either the nervous system or upper extremity chapters of the AMA Guides resulted in almost the same rating (9% vs 8% upper extremity impairment), and either value converted to 5% whole person permanent impairment. In the second case, the neurologist evaluated the individual for neuropathic pain (9% WPI), and the orthopedic surgeon rated the patient as Diagnosis-related estimates Cervical Category II for nonverifiable radicular pain (5% to 8% WPI).

Adult-to-Adult Living-Donor Liver Transplantation

Swiss Surgery ◽  
2003 ◽  
Vol 9 (5) ◽  
pp. 227-236 ◽  
Author(s):  
Majno ◽  
Mentha ◽  
Berney ◽  
Bühler ◽  
Giostra ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Therapeutic Option ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Multidisciplinary Program ◽  
First Case ◽  
Living Donor Transplantation ◽  
The Right

Living donor liver transplantation is a relatively new procedure in which the right side of the liver is harvested in a healthy donor and transplanted into a recipient. After the first case in 1994, over 3000 cases have been done worldwide. This review summarizes the reasons why the procedure is needed, describes its main technical aspects, highlights the boundaries in which it can be done safely, summarizes the current experience worldwide and describes the main points of the program in our unit. We argue that living-donor transplantation is a viable alternative to a long time on the waiting list for several patients, and it can be performed safely and successfully provided that all precautions are undertaken to minimize the risks in the donor and to increase the chances of a good outcome in the recipients. If these prerequisites are met, and within the framework of a structured multidisciplinary program, we believe that living-donor liver transplantation should be funded by health insurances as a recognized therapeutic option.

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