scholarly journals Preservation of olfactory function following endoscopic resection of select malignancies of the nasal vault

2012 ◽  
Vol 2 (1) ◽  
pp. 5 ◽  
Author(s):  
Yew Kwang Ong ◽  
C. Arturo Solares ◽  
Ricardo L. Carrau ◽  
Daniel M. Prevedello ◽  
Amin B. Kassam

Preservation of olfactory function during anterior skull base surgery has been previously described. However, its feasibility during oncological resection remains undefined. The aim of this study was to clarify the feasibility of preserving olfactory function in select patients undergoing oncological anterior skull base resection via endonasal endoscopic approach. This is a retrospective case series study. Postoperatively, all patients underwent a standardized smell identification test (Sensonics Inc., Haddon, NJ, USA). From January 2002 to December 2009, we attempted to preserve olfactory function in 9 patients who required an endoscopic resection involving the anterior skull base for treatment of various malignancies presenting unilateral extension. These included: esthesioneuroblastoma (n=6), squamous cell carcinoma (n=1), adenocarcinoma (n=1) and hemangiopericytoma (n=1). In 7 patients, resection included a unilateral endoscopic craniectomy with preservation of the contralateral middle and superior turbinates. Two patients underwent resection of the entire lateral nasal wall and the olfactory epithelium as the superior limit of tumor resection. Six patients received adjuvant radiotherapy. Postoperatively, olfaction was documented in 7 patients (3 normosmic, 4 microsmic). All patients are free of recurrence at the original site at a mean follow-up period of 55.7 months (range 21-101 months). One patient with an esthesioneuroblastoma developed a cervical lymph node recurrence four years after surgery. In selected cases, it is feasible to preserve olfactory function without apparent compromise of oncological outcomes. The success rate depends largely on the extent of the resection, which, in turn, is dictated, by the extent of the tumor.

Author(s):  
Ilkka Rauma ◽  
Tiina Mustonen ◽  
Juha Matti Seppä ◽  
Maritta Ukkonen ◽  
Marianne Männikkö ◽  
...  

Abstract Background Alemtuzumab is an effective disease-modifying therapy (DMT) for highly active multiple sclerosis (MS). However, safety concerns limit its use in clinical practice. Objectives To evaluate the safety of alemtuzumab in a nationwide cohort of Finnish MS patients. Methods In this retrospective case series study, we analyzed the data of all but two MS patients who had received alemtuzumab in Finland until 2019. Data were systematically collected from patient files. Results Altogether 121 patients were identified, most of whom had received previous DMTs (82.6%). Median follow-up time after treatment initiation was 30.3 months and exceeded 24 months in 78 patients. Infusion-associated reactions (IARs) were observed in 84.3%, 57.3%, and 57.1% of patients during alemtuzumab courses 1–3, respectively. Serious adverse events (SAEs) were observed in 32.2% of patients, serious IARs in 12.4% of patients, and SAEs other than IARs in 23.1% of patients. Autoimmune adverse events were observed in 30.6% of patients. One patient died of hemophagocytic lymphohistiocytosis, and one patient died of pneumonia. A previously unreported case of thrombotic thrombocytopenic purpura was documented. Conclusions SAEs were more frequent in the present cohort than in previous studies. Even though alemtuzumab is a highly effective therapy for MS, vigorous monitoring with a long enough follow-up time is advised.


2014 ◽  
Vol 86 (1) ◽  
pp. 15 ◽  
Author(s):  
Ali Abdel Raheem ◽  
Hassan El-Tatawy ◽  
Ahmed Eissa ◽  
Abdel Hamid Elbahnasy ◽  
Mohamed Elbendary

Objectives: Penile fracture with concomitant complete urethral disruption is an uncommon urologic disorder. Data about the treatment and outcome measurements of this condition are scarce in the literature. The aim of the present study is to evaluate the long term urinary and sexual functions of patients with penile fracture associated with complete urethral injury after immediate surgical reconstruction. Patients and methods: Twelve patients met our inclusion criteria and were included in this retrospective case series study; however, one was lost during follow-up. Patient's medical records were reviewed and all patients were interviewed for clinical evaluation. Urinary function was assessed by history, uroflometry and retrograde urethrography, while, sexual function was assessed by questionnaire (Sexual Health Inventory for Men) and penile Doppler for patients with erectile dysfunction. Results: Patients’ mean age was 32.3 ± 7.5 years (range 21-43) and the mean follow-up period was 72.6 ± 45.4 months (range 14-187). Vigorous sexual intercourse was the main cause in 91% of our patients. No serious long term complications was found. Only 1 patient (9%) suffered from anterior urethral stricture, 1 patient (9%) complained of weak erection, 3 patients (27%) had a palpable fibrosis and 2 patients (18%) reported a slight penile curvature during erection. Ninety one percent of all our patients maintained their normal urinary and sexual functions. Conclusion: On the long term follow-up, most of the patients maintained their normal erectile and voiding functions with no harmful long-term complications. We advocate immediate surgical intervention and reconstruction of both corpora cavernous and urethra as a first line treatment for those patients.


2020 ◽  
pp. 112070002090183
Author(s):  
Josko Jelicic ◽  
Antea Buterin ◽  
Goran Vrgoc ◽  
Zeljko Butorac ◽  
Anton Tudor ◽  
...  

Background: The modern indications for Chiari pelvic osteotomy (CPO) have narrowed and the number of such operations performed has diminished markedly. So far published long-term experience with CPO indicate the fact that in selected patients satisfactory functional results can be achieved. The aim of this study was to investigate the parameters which influence CPO survival and its conversion into total hip arthroplasty (THA). Methods: This is a single-centre retrospective case-series study. In the period from 1976 to 2012, it included 172 CPO in 158 patients. Of those, in 43 patients (48 hips) the follow-up was discontinued, leaving 115 patients (124 hips) for final analyses. The median age at the time of the surgery was 34 years, and the mean duration of the follow-up was 19 years. Results: In 115 patients (124 CPO) included in the study, a total of 51 THA was performed in 49 patients. The median period between CPO and THA was 14 years. Conclusion: Supporting our results, we suggest that CPO should still be indicated in a selected group of younger patients even with advanced stage of hip osteoarthritis who prefer a joint-conserving procedure and consent to a predicted less optimal outcome.


2020 ◽  
Author(s):  
Yi Qu ◽  
Xinshu Liu ◽  
Anyi Liang ◽  
Chan Zhao ◽  
Fei Gao ◽  
...  

Abstract Background: To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME). Methods: This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6 months. The main outcome measure was central macular thickness. The secondary outcome measures included best corrected visual acuity, recurrence rate and intraocular pressure. Results: In total, 68 patients (83 eyes) were enrolled in this study. The mean CMT decreased from 456.9 ± 171.1 μm at baseline to 324 ± 175.9 μm, 305.6 μm ± 147.7 μm, 331.8 ± 154.3 μm and 281.1 ± 147.6 μm at 1-, 2-, 3- and 6-months post injection, respectively (all P < 0.01). A total of 21/83 eyes exhibited elevated IOPs, of which 14 were controlled with topical IOP-lowering agents and 7 eyes underwent surgical removal of subconjunctival TA deposit. Conclusion: Subconjunctival TA injections appear to be safe and effective for UME.


PEDIATRICS ◽  
1995 ◽  
Vol 95 (3) ◽  
pp. 345-349
Author(s):  
Robert L. Davis ◽  
Michael Hughes ◽  
K. Dean Gubler ◽  
Patti L. Waller ◽  
Frederick P. Rivara

Objective. Recent evidence suggests that patients with a normal cranial CT scan after head injury can be safely discharged home from the emergency department. However, supporting data from previous studies has relied on incomplete patient follow-up. We utilized a statewide comprehensive hospital abstract reporting system (CHARS) to assess whether children with normal CT scans after head injury subsequently developed intracranial sequelae in the month following their initial injury. Design. Retrospective case-series study, with comprehensive statewide follow-up for 1 month. Setting. The emergency department of a Level 1 Trauma Center in Seattle, Washington. Participants. All children (n = 400) with head injury, Glasgow Coma Score of 13 to 15, and initial normal CT scan seen over a 4.5-year time period. All were matched against CHARS to evaluate admissions within 30 days after emergency department disposition. For readmissions, International Classification of Diseases (9th revision) discharge and procedure information was collected. All children were also matched against the state death files. Results. Four children were readmitted for neurologic reasons within 1 month following injury. One child on coumadin for heart disease developed a symptomatic subdural hematoma 5 days after head injury, requiring neurosurgical drainage. One child developed a symptomatic hemorrhagic contusion 3 days after injury, requiring observation only. Two children were readmitted 1 day after injury for concussive symptoms; both were discharged home after observation only. There were no deaths among the study population. Conclusions. Among children with a normal cranial CT scan after mild head injury, delayed intracranial sequelae requiring intervention are extremely uncommon. In otherwise stable patients, a normal cranial CT scan can identify patients to be safely discharged from the emergency department, and would be more cost-effective than 1 to 2 days of hospital observation.


Author(s):  
Ahmed Mourad ◽  
Hussein Jaffal ◽  
Ismaeel El-Hakim ◽  
Hamdy El-Hakim

Abstract Background Inferior turbinoplasty (IT) and adenoidectomy (Ad) are frequently resorted to in children with chronic rhinitis (CR) refractory to medical therapy. The aim of this study is to document the long-term improvement in quality of life (QOL) in children with CR following endoscopic IT with or without Ad. Methods A retrospective case series study was conducted. We searched a prospectively kept surgical database for children ≤18 years old who had CR who underwent endoscopic IT with or without Ad between 2009 and 2016 at a tertiary care children’s center. Patients with sinonasal pathologies other than CR, had craniofacial syndromes or dysmorphism and had other sinonasal procedures or trauma were excluded. Collected data included demographics, secondary diagnoses, duration of follow-up, and complications of procedures. The Glasgow Children’s Benefit Inventory (GCBI) was administered by phone to assess QOL improvement. Results One hundred sixty-five eligible subjects were identified. Eighty-nine subjects met the inclusion criteria. Data was collected for the 60 subjects that were reached. Forty-two patients had IT only while 18 had IT and Ad. The mean age was 10.7 ± 2.7 years, with 31 males and 29 females. The median duration of follow-up (25th, 75th percentile) was 38.1 months (24.6, 55.8). The median GCBI score (25th, 75th percentile) was 22.9 (6.3, 39.6) revealing an overall positive benefit in all domains. There was only one complication. Conclusions This study validates prior findings regarding improvement of QOL and safety of IT with or without Ad for children with CR and indicates it is maintained in the long term.


2019 ◽  
Author(s):  
Yi Qu ◽  
Xinshu Liu ◽  
Anyi Liang ◽  
Chan Zhao ◽  
Fei Gao ◽  
...  

Abstract Background: To evaluate the efficacy and safety of subconjunctival triamcinolone acetonide (TA) injections for treating uveitic macular edema (UME). Methods: This retrospective case series study included patients with UME who received subconjunctival TA injections with a minimum follow-up period of 6 months. The main outcome was central macular thickness. The secondary outcomes included the best corrected visual acuity, recurrence rate and intraocular pressure. Results: In total, 68 patients (83 eyes) were enrolled in this study. The mean CMT decreased from 456.9 ± 171.1 μm at baseline to 324 ± 175.9 μm, 305.6 μm ± 147.7 μm, 331.8 ± 154.3 μm and 281.1 ± 147.6 μm at 1, 2, 3 and 6 months postinjection, respectively (all P < 0.01). A total of 21/83 eyes exhibited elevated IOPs, which was controlled with topical IOP-lowering agents in 14 eyes, whereas 7 eyes got subconjunctival TA deposit surgically removed. Conclusion: subconjunctival TA injections appear to be safe and effective for UME.Key Words: Triamcinolone acetonide; subconjunctival injection; uveitis; macular edema


2018 ◽  
Vol 46 (9) ◽  
pp. 3819-3823 ◽  
Author(s):  
Abdulwahid M. Salih

Objective To investigate the prevalence of hypothyroidism following thyroid lobectomy with isthmus preservation. Methods This retrospective, case series study included patients who had undergone thyroid lobectomy with preserved isthmus that was reversed onto the contralateral lobe. Neck ultrasound was performed in all patients and the patients were followed for 2 years. Results Out of 170 patients enrolled into the study, three were excluded due to preoperative hypothyroidism and one due to isthmusectomy; of the remaining 166 included in the final analyses, 139 patients (83.7%) were female, 27 (16.3%) were male, and patient age ranged between 17 and 77 years. The indication for intervention was thyroid swelling in 141 patients (84.9%). Final diagnoses following histopathological examination comprised benign lesion in 145 cases (87.3%), malignancy (follicular carcinoma and papillary thyroid carcinoma) in 12 cases (7.2%) and thyroiditis in nine cases (5.4%). During the 2-year post-surgery follow-up, 165 patients (99.4%) were euthyroid and one patient (0.6%) developed hypothyroidism. Conclusion Postoperative hypothyroidism following thyroid lobectomy appears to be very rare when the isthmus is preserved and reversed onto the contralateral lobe.


2021 ◽  
Vol 12 (1) ◽  
pp. 217
Author(s):  
Pietro Gentile ◽  
Simone Garcovich ◽  
Soo-Ik Lee ◽  
Sangbum Han

A new biotechnology based on micro-needling (MND) with low-level light/laser therapy (LLLT) that is used for hair re-growth (HR-G) needs to be standardized. The study aims to report the clinical outcomes resulting from a multicentric, retrospective, observational, case-series study in which MND with LLLT was used on patients affected by androgenic alopecia (AGA). Twenty-six patients were initially enrolled of which 15 males were classified as stages I–III of vertex by the Norwood–Hamilton scale, and 11 females was classified in stages I–II by the Ludwig scale. Twenty patients (10 females and 10 males) were analyzed after their screening (the exclusion and inclusion criteria evaluation). The HR-G assessment was evaluated with photography, as well as the physician’s and patient’s global assessment scales, in addition to standardized phototrichograms, during a short follow-up at T0-baseline, T1-16 weeks. Encouraging results represented by a hair density increase of 12 ± 2 hairs/cm2 at T1 after 16 weeks (16 weeks vs. 0 weeks) in the targeted area, compared with the baseline results (59 ± 2 hairs/cm2 at T1 versus 47 ± 2 hairs/cm2 at baseline), were observed using computerized trichograms with a statistically significant difference in hair re-growth (p = 0.0238). The effectiveness of MND with LLLT use has been demonstrated in mild to moderate AGA patients.


2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Mustafa Erman Dörterler

Objective. To present the clinical profile and outcomes of esophageal button battery ingestion cases treated at our institution over an 8-year period. Methods. A total of 17 children who presented after ingesting a button battery and were treated at a tertiary care clinic over an 8-year period were included in this retrospective case series study. Data on patient demographics and esophageal location of the battery, time from ingestion to admission, symptoms, grade of mucosal injury, size of the battery, management, complications, and follow-up outcome were recorded. Results. Median age was 29 months (range, 2–99 months). Boys comprised (n=11, 64.7%) of the study population. The most common location was the proximal esophagus (n=10, 58.8%). The median time from ingestion to admission was 6 h (range, 3–24 h). Hypersalivation alone (n=6, 35.3%) or together with vomiting (n=5, 29.4%) was the most common symptom. Grade IIA mucosal injury was noted in six (n=6, 35.3%) patients. The diameter of the battery was a median of 18.0 mm (range, 14–22 mm). We did not observe any correlation between the size of the battery and the grade of the injury. Early postoperative complications were encountered in one patient (n=1, 5.8%) and late postoperative complications were noted in eight patients (n=8, 47.1%) which required further esophageal dilatations, and follow-up revealed normal findings in eight patients (n=8, 47.1%) and mortality occurred in one patient. Conclusion. The current case series study describing the clinical profiles and outcomes of 17 children who had ingested an esophageal button battery revealed male predominance, young patient age, and admission after a median of 6 h (3–24 h) of ingestion with nonspecific symptoms. Our findings confirm the success of rigid endoscopy to remove esophageal button batteries and indicate the likelihood of severe complications after removal.


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