Τρίτη 22 Μαρτίου 2022

ROBOTIC REPAIR OF ATRIAL SEPTAL DEFECT WITH PARTIAL PULMONARY VENOUS RETURN ANOMALY: OUR 5‐YEAR EXPERIENCE

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ABSTRACT

Introduction

Partial pulmonary venous return anomalies (PPVRA) were not considered as a good candidate for robotic surgery in early time of robotic cardiac surgery. In this study, we present our experience in patients undergoing robotic atrial septal defect (ASD) and PPVRA surgery.

Methods

Between November 2014-January 2020, data of 21 patients underwent robotic ASD with PPVRA was collected. Inclusion criterion was presence of right-sided PPVRA with ASD. All operations were performed robotically.

Results

The mean age of patients was 26.7±10.3 years. 17 patients (81 %) had superior-caval ASD with supracardiac PPVRA and double-patch technique was used. Four patients had inferior-caval ASD with intracardiac PPVRA and single-patch technique was preferred. Cross-clamp time and cardiopulmonary bypass time were 92.8±29.6 and 127.8±38.1, respectively. There was no mortality. One patient had atrioventricular-block and required pacemaker.

Conclusion

Robotic repair of ASD with PPVRA is feasible and effective method as an alternative to conventional surgery.

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The effectiveness of topical 1% lidocaine with systemic oral analgesics for ear pain with acute otitis media

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Publication date: May 2022

Source: International Journal of Pediatric Otorhinolaryngology, Volume 156

Author(s): Ateş Kara, Ayşe Büyükcam, Murat Sütçü, Enes Sali, Şefika Elmas Bozdemir, Manolya Kara, Eda Çullas İlarslan, Cemil Kaya, Sabahat Karakaşlılar, Gülsüm Sönmez, Soner Sertan Kara, Tuğba Bedir, Eda Albayrak, Tuğçe Tural Kara, Solmaz Çelebi, Fatma Nur Öz, Adem Karbuz, Ayper Somer, Derya Alabaz, Hasan Tezer

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The Endonasal Endoscopic Approach to Different Sinonasal Fungal Balls

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Background. Fungal ball sinusitis is a sinonasal fungus ball that usually affects immunocompetent adults with female predominance. The most affected sinus is the maxillary sinus. Aspergillus species is the most typically found fungus. Computed tomography (CT) scan is the gold standard tool in order to diagnose fungal ball sinusitis. The ultimate method for a fungal ball is functional endoscopic sinus surgery (FESS), which has a high success rate and a low morbidity rate. Objective. This study aims to demonstrate the various clinical presentations of fungal ball sinusitis including isolated maxillary sinus, sphenoid sinus, simultaneous occurrence of maxillary and sphenoid fungal ball, and post endonasal endoscopic pituitary surgery fungal ball with various age groups. Also, this study aims t o emphasize the importance of early diagnosis and treatment in such cases. Patients and Methods. A retrospective study that was carried in the otorhinolaryngology department of two hospitals: King Fahad Specialist Hospital and Qatif Central Hospital, Eastern Region, Saudi Arabia. The study was conducted on a total of 16 patients who were diagnosed with paranasal sinuses fungal ball in an 11-year period from January 2008 and November 2019. Results. Out of 16 patients with paranasal sinuses fungal ball, 11 cases were female and 5 males, with age ranging between 16 and 46 years. Results showed eight isolated sphenoid (50%), six isolated maxillary fungal ball (38%), one simultaneous occurrence of the sphenoid and maxillary fungal ball (6%), and one post endonasal endoscopic pituitary surgery for pituitary adenoma (6%). CT scan was performed for all 16 cases which is the standard tool for the diagnosis of the fungal ball. Conclusion. Fungal ball may present with variety of symptoms but m ost commonly with postnasal discharge (PND), headache, and facial pain. CT sinuses is the diagnostic radiological modality to confirm the diagnosis. The FESS functional endoscopic sinus surgery is the gold safe approach for patients with fungal ball to manage their symptoms, confirm the diagnosis, and removal of disease with no morbidities.
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Evolution of midface microvascular reconstruction: three decades of experience from a single institution

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Eur Arch Otorhinolaryngol. 2022 Mar 22. doi: 10.1007/s00405-022-07321-x. Online ahead of print.

ABSTRACT

PURPOSE: Midface reconstruction poses a complex set of challenges for reconstructive surgeons. The optimal midface reconstruction must possess a durable underlying bone construct capable of integrating dental implants. Facial contour is restored by the overlying microvascular soft tissue reconstruction with reestablishment of the oral cavity. A plethora of microvascular flaps used in clinical practice have been described including those harvested from the iliac crest, scapula, fibula, forearm and back (latissimus dorsi). The objective was to share our experiences with each of these treatment options that have continued to evolve over time for the benefit of patients.

METHODS: Our institution has over three decades of experience in reconstructing complex midface defects and this article summarizes midface reconstruction from an evolutionary perspective (for type II, III and IV defect; Browns classification, Supplementary Table I). We broadly divide this into (i) flaps supplied by the subscapular system (ii) autologous reconstruction with titanium mesh and (iii) fibula microvascular flaps using 3D planning.

RESULTS: The advantages and disadvantages for each approach are discussed (Supplementary Table II).

CONCLUSION: In the future, it is expected that 3D planning coupled with rapid prototyping, intraoperative navigation and CT imaging will become standard procedural practice.

PMID:35316380 | DOI:10.1007/s00405-022-07321-x

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