Intradural extraarachnoid sutureless technique combined with laminoplasty for indirect repair of ventral dural defects in spontaneous intracranial hypotension: technical note and case series

xlomafota13 shared this article with you from Inoreader Intradural extraarachnoid sutureless technique combined with laminoplasty for indirect repair of ventral dural defects in spontaneous intracranial hypotension: technical note and case series Via leak of cerebrospinal fluid Acta Neurochir (Wien). 2021 May 8. doi: 10.1007/s00701-021-04868-2. Online ahead of print. ABSTRACT BACKGROUND: There is a significant variance in surgical treatment strategies of ventral cerebrospinal fluid (CSF) leaks causing spontaneous intracranial hypotension (SIH). Posterior approaches might represent a preferable alternative to the more invasive anterior and lateral routes, as long as the spinal cord is not exposed to harmful manipulation. The aim of this technical note is to report and illustrate a new surgical technique using an intradural extraarachnoid sutureless technique via laminoplasty for indirect repair of ventral CSF leaks causing intractable SIH symptoms. METHODS: The surgical technique is described in a step by step fashion. Between May 2018 and May 2020, five patients with ventral spinal CSF leaks were operated on, utilizing this technique. All dural defects were located at the level of the thoracic spine. A retrosp ective review on demographic and radiological findings, symptoms, outcome, and follow-up was performed. RESULTS: The intra- and postoperative course was uneventful in all patients with no surgery-related complications. Three patients recovered completely at discharge, while neurological symptoms significantly improved in two patients. A postoperative MRI of the spine was obtained for all patients, demonstrating regressive signs of CSF leak. CONCLUSION: Based on the presented case series, this intradural extraarachnoid sutureless technique combined with laminoplasty seems to be a safe and effective option for indirect repair of ventral dural defects in SIH. In our opinion, it represents a valid alternative to traditional more aggressive approaches. PMID:33963904 | DOI:10.1007/s00701-021-04868-2 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Incus Autograft Partial Ossicular Reconstruction Prosthesis vs. Titanium Angular Clip Prosthesis in Patients with Incudostapedial Joint Erosion Caused by Chronic Otitis Media; A Randomized Clinical Trial

xlomafota13 shared this article with you from Inoreader Incus Autograft Partial Ossicular Reconstruction Prosthesis vs. Titanium Angular Clip Prosthesis in Patients with Incudostapedial Joint Erosion Caused by Chronic Otitis Media; A Randomized Clinical Trial Via Otolaryngology Indian Abstract Chronic otitis media (COM) is a common disease that can cause damage to the middle ear ossicles and thus lead to conductive hearing loss. The purpose of this study was to compare two methods of incus partial ossicular reconstruction prosthesis (PORP) and reconstruction with titanium angular clip prosthesis in patients with incudostapedial joint erosion. In this interventional randomized clinical trial carried out in a tertiary referral hospital, patients with chronic otitis media and incudostapedial joint erosion who were candidates for surgery, were randomly allocated into two groups of incus PORP surgery and reconstruction with a titanium angular clip prosthesis. Audiometry was performed for the patients prior to and six months after surgery. Pre- and post-operative air–bone gap (ABG) and bone conduction (BC) thresholds were calculated and means were compared by analysis of variances (ANOVA). A P value of <0.05 was considered statistically significant. The study consisted of 24 and 14 subjects in the incus PORP and angular clip groups, respectively. There was no statistically significant differ ence between the mean pre- and post-operative ABG, BC thresholds and ABG reduction in the compared groups. Considering issues such as high cost and inaccessibility of titanium angular clips in all centers, incus PORP may be a more acceptable method. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The application of venous nerve conduit trap in the immediate repair and reconstruction of facial nerve in parotid gland tumor: an attempt of a new technique

xlomafota13 shared this article with you from Inoreader The application of venous nerve conduit trap in the immediate repair and reconstruction of facial nerve in parotid gland tumor: an attempt of a new technique 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. 2021 May 4. doi: 10.1007/s00405-021-06732-6. Online ahead of print. ABSTRACT OBJECTIVE: To introduce the application of venous nerve conduit in the immediate repair and reconstruction of facial nerve in parotid gland tumor. METHODS: Three patients with parotid gland tumor in Sichuan Provincial Cancer Hospital were reviewed. All patients were found that the tumor encased and invaded the facial nerve which was difficult to be separated during the operation when all patients were treated with facial nerve repair and reconstruction with the venous nerve conduit trapping technique. RESULTS: After 1-year follow-up, all patients recovered well in facial nerve function. CONCLUSION: The venous nerve conduit trapping technique is an effective attempt in the immediate repair and reconstruction of facial nerve in parotid gland tumor, but it needs to be further confirmed by multiple studies. PMID:< a href="https://pubmed.ncbi.nlm.nih.gov/33948682/?utm_source=Inoreader&utm_medium=rss&utm_content=1dKORAZbU5vxmu8AJAeyXPJqUEPUheKpin0OrtWyufEUk4RYqF&ff=20210505215813&v=2.14.4" target="_blank" rel="noopener" class="underlink bluelink" tabindex="-1">33948682 | DOI:10.1007/s00405-021-06732-6 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intraoperative near‐infrared autofluorescence imaging for hypocalcemia risk reduction after total thyroidectomy: Evidence from a meta‐analysis

xlomafota13 shared this article with you from Inoreader Intraoperative near‐infrared autofluorescence imaging for hypocalcemia risk reduction after total thyroidectomy: Evidence from a meta‐analysis Via Head & Neck Abstract This meta‐analysis evaluates whether near‐infrared autofluorescence (NIRAF) imaging reduces the risk of hypocalcemia after total thyroidectomy. A systematic literature search in PubMed, EMBASE, Web of Science, and Cochrane Library for studies from June 2011 to January 2021 comparing total thyroidectomy with NIRAF and conventional surgery (naked eye). Six eligible studies involving 2180 patients were included. The prevalence of transient hypocalcemia was 8.11% (40/493) and 25.19% (425/1687) in the NIRAF and naked eye groups (p < 0.0001), respectively. The prevalence of permanent hypocalcemia was 0% (0/493) and 2.19% (37/1687) in the NIRAF and naked eye groups (p = 0.05), respectively. NIRAF reduces the risk of transient hypocalcemia and may possibly lower the rate of permanent hypocalcemia. Nonetheless, further studies are needed to verify our results and evaluate the cost‐effectiveness of NIRAF in real‐world clinical practice. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Intact Parathyroid Hormone Levels in Predicting Postoperative Hypocalcaemia After Total Thyroidectomy in South Indian Population: Cross Sectional Study

xlomafota13 shared this article with you from Inoreader Intact Parathyroid Hormone Levels in Predicting Postoperative Hypocalcaemia After Total Thyroidectomy in South Indian Population: Cross Sectional Study Via Otolaryngology Indian Abstract Hypocalcaemia being one of the most common complications after total thyroidectomy may not be avoidable in all cases. This study evaluated the effectiveness of intact Parathyroid hormone (iPTH) measured at 1-h after total thyroidectomy in predicting postoperative hypocalcaemia in early postoperative period in South Indian population. Patients who underwent total thyroidectomy in our institute from 2016 to 2018 were included. Preoperative calcium and iPTH levels were measured. Patients' iPTH level was measured 1 h after surgery and serum calcium level was measured at 24 h after surgery. Patients were also monitored clinically for any symptoms and signs of hypocalcaemia. A total of 57 patients were studied. The malignant causes accounted for 75.4% with papillary carcinoma thyroid being the most common cause. 65.7% of patients who underwent total thyroidectomy and 100% of patients who underwent total thyroidectomy with neck dissection developed hypocalca emia. 70% of patients with low iPTH developed hypocalcaemia and none of the patients who had normal iPTH developed hypocalcaemia. This relation was statistically significant with p value of 0.018 (< 0.05). The positive predictive value is 70% and negative predictive value is 100%. Though our study supports the hypothesis that iPTH is effective in predicting hypocalcaemia after total thyroidectomy in the early postoperative period, a larger sample study is needed to further support this. It can be used to consider patients for early discharge or to prophylactically start oral calcium and Vitamin D supplementation based on iPTH levels at 1 h after surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bacterial Biofilms on Tracheostomy Tubes

xlomafota13 shared this article with you from Inoreader Bacterial Biofilms on Tracheostomy Tubes Via Otolaryngology Indian Abstract Tracheostomy is a commonly performed airway surgery for critically ill patients. Tracheostomy tube is an indwelling prosthesis, providing potential surface for growth of bacteria. Biofilm formation by bacteria as a self-protective mechanism, has led to worrisome antibacterial resistance and thus higher rate of nosocomial infections. A prospective observational study was conducted with a purpose of knowing most common organisms capable of forming biofilm on tracheostomy tube and their antibiotic sensitivity in our setting. Fifty seven percent of the isolates were found to be capable of biofilm production. Acinetobacter baumannii (45%) was the commonest biofilm producer isolated and the commonest multidrug resistant organism (35.7%), followed by Klebsiella pneumoniae (28.5%). Both biofilm producers and non-biofilm producers were found most susceptible to Amikacin (43%), followed by Gentamicin (30%) and Ciprofloxacin (18.5%). No significant associa tion was found between biofilms and ventilators (p value = 0.558) or pre-existing infection (p value = 0.66) using Chi square test. Potentially biofilm producing bacteria were isolated from tracheostomy tube inner surfaces just after a week of their insertion, in majority of patients. Acinetobacter baumannii and Klebsiella pneumoniae were the commonest biofilm forming organisms and Amikacin, Gentamicin and Ciprofloxacin were most sensitive drugs. Multi drug resistant organisms were also commonly found, stressing the need for sensitivity-based antibiotics. Ventilator usage had no strong association with biofilm formation. Patients with non-infectious conditions also harboured bacteria capable of biofilms in tracheostomy tubes demanding the need for stringent tube hygiene measures and prophylactic antibiotics. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary Hydatid Cyst of Neck, A Rare Case Report

xlomafota13 shared this article with you from Inoreader Primary Hydatid Cyst of Neck, A Rare Case Report Via Otolaryngology Indian Abstract Hydatid cyst is a result of parasite infection. The neck is an uncommon site for this infection so it is not considered as a differential diagnosis of neck swelling commonly. We hereby report a case of 24 year female with left postero-lateral neck swelling for 5 years that was insidious in onset and gradually increased in size. We diagnosed the case as hydatid cyst of neck on FNAC and MRI. Pre operatively oral albendazole was given for 1 month and continued post operatively. Our case has not shown recurrence for 6 months after successful surgical excision. So primary hydatid cyst should be considered as a differential diagnosis of neck swelling and should be treated accordingly. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.