Science Publishing Group: Advances in Surgical Sciences: Table of Contents
<i> Advances in Surgical Sciences (ASS) </i> provides a forum for the publication of scientific research and review articles. The journal publishes original full-length research papers in all areas related to surgical diseases or exploring pathogenesis, etiology, and mechanisms of disease processes are given priority. Research articles which integrate molecular biological methods, along with functional studies, into the analysis of biological questions and advance basic as well as translational knowledge in surgical pathophysiology are also welcomed.
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Advances in Surgical Sciences
Advances in Surgical Sciences
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Suture Anchors in Orthopaedics – Uses other than Shoulder Surgery
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The various types of suture anchors have become widely accepted in the orthopaedic shoulder surgery. The common uses being for Bankarts repair and rotator cuff repair. The use of suture anchors in orthopaedic surgery for indications other than shoulder surgery is sparsely reported in the literature. We report on our observations from a single centre following use of anchors outside the shoulder joint. We have successfully used the suture anchors for repair of the lateral collateral ligament, the insertional tear of the Tendo-Achilles, fractures of the lower pole of the patella, triceps insertional tear, for repair of quadriceps tendon following partial avulsion. This highlights the importance of this tiny device in the armamentarium of a sports medicine surgeon.
The various types of suture anchors have become widely accepted in the orthopaedic shoulder surgery. The common uses being for Bankarts repair and rotator cuff repair. The use of suture anchors in orthopaedic surgery for indications other than shoulder surgery is sparsely reported in the literature. We report on our observations from a single centre following use of anchors outside the shoulder joint. We have successfully used the suture anchors for repair of the lateral collateral ligament, the insertional tear of the Tendo-Achilles, fractures of the lower pole of the patella, triceps insertional tear, for repair of quadriceps tendon following partial avulsion. This highlights the importance of this tiny device in the armamentarium of a sports medicine surgeon.
Suture Anchors in Orthopaedics – Uses other than Shoulder Surgery
doi:10.11648/j.ass.20130101.11
Advances in Surgical Sciences
2014-01-01
© Science Publishing Group
Ashish Anand
Raviraj A
Manish Kumar
Rajendran Ravindran
Suture Anchors in Orthopaedics – Uses other than Shoulder Surgery
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© Science Publishing Group
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico
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Background: Ovarian cancer is a lethal tumor, 70% of which occurs in locally advanced stages. Despite its high initial response rate to chemotherapy, recurrence takes place in up to 90%. Prognosis of recurrent disease remains poor. In recent years, a new approach has been developed, combining a maximal cytoreductive effort with Hyperthermic intraperitoneal chemotherapy (HIPEC).Methods: We conducted a pilot study of 14 patients with recurrent ovarian cancer who were treated with Cytoreductive surgery (CRS) and HIPEC at the Mexico City-based National Cancer Institute of México (INCan) between January 2007 and January 2012.Results: There were 14 patients with recurrent ovarian cancer, including 13 with clinical stage IIIC and one with clinical stage CEIV due to retroperitoneal tumor with recurrence. Average age was 52 years (range, 20–72 years). Mortality and morbidity rates were 0 and 40%, respectively. Average surgical operative time was 7.5 h (range, 4.7–11 h). Average bleeding amounted to 1,171 mL (range, 100–3,700 mL).Overall median survival (OMS) was 14 months (range, 2–37 months). Peritoneal carcinomatosis index (PCI) showed eight patients with <20 and six with >20 points. Bleeding correlates with the PCI of >20 points. Performance status was a significant prognostic factor in patients with extensive peritoneal carcinomatosis (PCI, >20).Conclusions: Therapy combining CRS and HIPEC is feasible in selected patients with recurrent ovarian carcinoma with high morbidity. With ovarian cancer, novel therapies should be explored, one of which could be HIPEC.
Background: Ovarian cancer is a lethal tumor, 70% of which occurs in locally advanced stages. Despite its high initial response rate to chemotherapy, recurrence takes place in up to 90%. Prognosis of recurrent disease remains poor. In recent years, a new approach has been developed, combining a maximal cytoreductive effort with Hyperthermic intraperitoneal chemotherapy (HIPEC).Methods: We conducted a pilot study of 14 patients with recurrent ovarian cancer who were treated with Cytoreductive surgery (CRS) and HIPEC at the Mexico City-based National Cancer Institute of México (INCan) between January 2007 and January 2012.Results: There were 14 patients with recurrent ovarian cancer, including 13 with clinical stage IIIC and one with clinical stage CEIV due to retroperitoneal tumor with recurrence. Average age was 52 years (range, 20–72 years). Mortality and morbidity rates were 0 and 40%, respectively. Average surgical operative time was 7.5 h (range, 4.7–11 h). Average bleeding amounted to 1,171 mL (range, 100–3,700 mL).Overall median survival (OMS) was 14 months (range, 2–37 months). Peritoneal carcinomatosis index (PCI) showed eight patients with <20 and six with >20 points. Bleeding correlates with the PCI of >20 points. Performance status was a significant prognostic factor in patients with extensive peritoneal carcinomatosis (PCI, >20).Conclusions: Therapy combining CRS and HIPEC is feasible in selected patients with recurrent ovarian carcinoma with high morbidity. With ovarian cancer, novel therapies should be explored, one of which could be HIPEC.
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico
doi:10.11648/j.ass.20130102.11
Advances in Surgical Sciences
2014-01-01
© Science Publishing Group
Horacio Noé López-Basave
Flavia Morales-Vásquez
Juan M. Medina-Castro
Isaías Padilla-Mota
Juan M. Ruiz-Molina
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Recurrent Advanced Ovarian Carcinoma: Initial Experience in Mexico
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Dupuytren Contracture - How Fibromatosis Remodels the Palmar Subcutaneous Tissue and Its Fibrous Environment
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Our understanding of the process of contracture of the fingers is based on extrinsic and intrinsic theories. Yet there has always been an inherent contradiction in these concepts. Additionally, nearly all of these theories proceed from the assumption of a contractio digitorum and this assumption is reflected in basic research as well. The author presents a concept, which describes the finger contracture more accurately as retention in the flexed position. This contraction-free concept, deduced from the function and structure of the palmar subcutaneous tissue, combines the different pathogenic aspects. Palmar fibromatosis primarily manifests itself in the palmar subcutaneous tissue. The function of this tissue was studied in the living hand; the anatomic structure of the subcutaneous fibrofatty tissue was studied for the first time in slice plastinates of adult hands. The palmar tissue exhibits varying tissue consistencies. It is compressed and expanded as the fingers move. In fibromatosis, fibrous nodules infiltrate the finger tissue in its shortened flexion configuration, which predominates both by day and by night. In the normal hand, the anchoring fibers allow nearly tension-free deformation of the skin tissue. In fibromatosis, this tissue loses its extensibility. Motion in the finger subjects the new formed tissue to tensile stress. This in turn provides the decisive stimulus for adaptive tissue transformation. This process does not require any active contraction. It plausibly explains the finger contracture as an extension block. In the contraction-free concept, the myofibroblast is understood to be a form of fibroblast that resists the tension arising in the tissue by isometric contraction. The contraction-free concept can explain all clinical pictures of fibromatosis as reactive remodeling of the specific local host tissue. It can also provide basic research with a conclusive anatomic pattern. Moreover, it implies a specific therapeutic paradigm: Treatment options that influence the formation of pathologic tissue and address the characteristic tensile stress will be able to control the root causes of the deformity.
Our understanding of the process of contracture of the fingers is based on extrinsic and intrinsic theories. Yet there has always been an inherent contradiction in these concepts. Additionally, nearly all of these theories proceed from the assumption of a contractio digitorum and this assumption is reflected in basic research as well. The author presents a concept, which describes the finger contracture more accurately as retention in the flexed position. This contraction-free concept, deduced from the function and structure of the palmar subcutaneous tissue, combines the different pathogenic aspects. Palmar fibromatosis primarily manifests itself in the palmar subcutaneous tissue. The function of this tissue was studied in the living hand; the anatomic structure of the subcutaneous fibrofatty tissue was studied for the first time in slice plastinates of adult hands. The palmar tissue exhibits varying tissue consistencies. It is compressed and expanded as the fingers move. In fibromatosis, fibrous nodules infiltrate the finger tissue in its shortened flexion configuration, which predominates both by day and by night. In the normal hand, the anchoring fibers allow nearly tension-free deformation of the skin tissue. In fibromatosis, this tissue loses its extensibility. Motion in the finger subjects the new formed tissue to tensile stress. This in turn provides the decisive stimulus for adaptive tissue transformation. This process does not require any active contraction. It plausibly explains the finger contracture as an extension block. In the contraction-free concept, the myofibroblast is understood to be a form of fibroblast that resists the tension arising in the tissue by isometric contraction. The contraction-free concept can explain all clinical pictures of fibromatosis as reactive remodeling of the specific local host tissue. It can also provide basic research with a conclusive anatomic pattern. Moreover, it implies a specific therapeutic paradigm: Treatment options that influence the formation of pathologic tissue and address the characteristic tensile stress will be able to control the root causes of the deformity.
Dupuytren Contracture - How Fibromatosis Remodels the Palmar Subcutaneous Tissue and Its Fibrous Environment
doi:10.11648/j.ass.20130103.11
Advances in Surgical Sciences
2014-01-01
© Science Publishing Group
Albrecht Gerhard Meinel
Dupuytren Contracture - How Fibromatosis Remodels the Palmar Subcutaneous Tissue and Its Fibrous Environment
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© Science Publishing Group
Bilateral Thumb Polydactyly: Case Report
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Polydactyly is the most common congenital digital anomaly of the hand. Surgical treatment is rewarding. In this article, we describe the case of a 15-year-old male who was presenting thumb bilateral polydactyly. The diagnisis was clinic, completed by radiography which has objectified the anomaly type according to Wassel's classification. Operated in our hospital, he received a repair surgery at the level of his right hand by resection of supernumerary hypoplastic thumb, with restoration and anatomical reconstruction of the dominant thumb. He was discharged with no complications. The patient and his family were satisfied with the cosmetic and functional result. We discuss types of duplications, and principle of therapeutic approach of this pathology.
Polydactyly is the most common congenital digital anomaly of the hand. Surgical treatment is rewarding. In this article, we describe the case of a 15-year-old male who was presenting thumb bilateral polydactyly. The diagnisis was clinic, completed by radiography which has objectified the anomaly type according to Wassel's classification. Operated in our hospital, he received a repair surgery at the level of his right hand by resection of supernumerary hypoplastic thumb, with restoration and anatomical reconstruction of the dominant thumb. He was discharged with no complications. The patient and his family were satisfied with the cosmetic and functional result. We discuss types of duplications, and principle of therapeutic approach of this pathology.
Bilateral Thumb Polydactyly: Case Report
doi:10.11648/j.ass.20130103.12
Advances in Surgical Sciences
2014-01-01
© Science Publishing Group
Monsef ELABDI
Majdouline BENCHAFAI
Abdeloihab JAAFAR
Bilateral Thumb Polydactyly: Case Report
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2014-01-01
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© Science Publishing Group
New Technique for Herniotomy in Children-Clinical Trial
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=256&doi=10.11648/j.ass.20140201.11
Objective: to assessment of hernial sac ligation necessity after its transection in children herniotomy and compare the recurrence and complication rates between two methods of hernial repair in children (the classic method with ligation of the hernial sac and a new method without sac ligation). study design: this is a randomized controlled trial (RCT) Method: A total of 200 children ranging from neonates to 12 years of age, with inguinal hernia were admitted to Emam-Reza Hospital, Kermanshah, Iran between march 2011 and march2012, for elective hernial surgery The patients who were more prone to recurrence; such as patients with incarcerated hernia and increased intra-abdominal pressure were excluded from the study. After exclusion of some patients, 182children included in the study. They were randomly allocated into two groups, a study group (herniotomy without sac ligation) and a control group (herniotomy with sac ligation). Both groups were followed up for a period of 1-1.5 years postoperatively for recurrence or other complications. Results: There was only one case of recurrent hernia in the control group, and none in the study group. There was no statistically significant difference in the rate of recurrence or other complications between the two groups. Conclusions: This study showed that hernial sac ligation after its transection is not necessary in pediatric herniotomy. Omitting ligation did not result in any significant effect on early and late complication.
Objective: to assessment of hernial sac ligation necessity after its transection in children herniotomy and compare the recurrence and complication rates between two methods of hernial repair in children (the classic method with ligation of the hernial sac and a new method without sac ligation). study design: this is a randomized controlled trial (RCT) Method: A total of 200 children ranging from neonates to 12 years of age, with inguinal hernia were admitted to Emam-Reza Hospital, Kermanshah, Iran between march 2011 and march2012, for elective hernial surgery The patients who were more prone to recurrence; such as patients with incarcerated hernia and increased intra-abdominal pressure were excluded from the study. After exclusion of some patients, 182children included in the study. They were randomly allocated into two groups, a study group (herniotomy without sac ligation) and a control group (herniotomy with sac ligation). Both groups were followed up for a period of 1-1.5 years postoperatively for recurrence or other complications. Results: There was only one case of recurrent hernia in the control group, and none in the study group. There was no statistically significant difference in the rate of recurrence or other complications between the two groups. Conclusions: This study showed that hernial sac ligation after its transection is not necessary in pediatric herniotomy. Omitting ligation did not result in any significant effect on early and late complication.
New Technique for Herniotomy in Children-Clinical Trial
doi:10.11648/j.ass.20140201.11
Advances in Surgical Sciences
2014-01-01
© Science Publishing Group
Omid Amanollahi
Diana Noemi Diaz
Vahid Moetamedi
New Technique for Herniotomy in Children-Clinical Trial
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2014-01-01
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=256&doi=10.11648/j.ass.20140201.11
© Science Publishing Group
The Prevalence of Fibrocystic Changes of Breast Tissue of Patients who Underwent Reduction Mammoplasty in Rasool-Akram, Firuzgar and Sadr Hospitals during 2007-2012
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Introduction: Fibrocystic changes are considered as common and benign changes in the breast tissue. This study aimed to determine the prevalence of pathologic changes Including fibrocystic changes, hyperplasia, and carcinoma in breast tissue specimens of patients underwent reduction Mammoplasty.Methods: 128 consecutive patients over a period of 5 years from 2007 to 2012, who were admitted at the Rasool-Akram, Firoozgar, and Sadr Hospitals for reduction mammoplasty, were investigated in this study. In all patients an average of 500 grams of breast tissue from each side during mammoplasty was sent for pathologic evaluation. The variables measured in the study included age, fibrocystic changes, and hyperplastic changes in the pathology specimens of these patients. Data analysis was performed using SPSS 18 software. Results: 71 patients (55.5%) had fibrocystic changes. 6 patients (4.7%) were reported to have hyperplasia. Carcinoma was not observed in any of the samples. The prevalence of fibrocystic changes increased with age. Hyperplastic changes were not associated with age and with fibrocystic changes. But it was the most common in the ages between 31 and 40 years. Conclusion: Fibrocystic breast changes are common, and their prevalence increases with age. However, they are not associated with hyperplasia and cancer risk.
Introduction: Fibrocystic changes are considered as common and benign changes in the breast tissue. This study aimed to determine the prevalence of pathologic changes Including fibrocystic changes, hyperplasia, and carcinoma in breast tissue specimens of patients underwent reduction Mammoplasty.Methods: 128 consecutive patients over a period of 5 years from 2007 to 2012, who were admitted at the Rasool-Akram, Firoozgar, and Sadr Hospitals for reduction mammoplasty, were investigated in this study. In all patients an average of 500 grams of breast tissue from each side during mammoplasty was sent for pathologic evaluation. The variables measured in the study included age, fibrocystic changes, and hyperplastic changes in the pathology specimens of these patients. Data analysis was performed using SPSS 18 software. Results: 71 patients (55.5%) had fibrocystic changes. 6 patients (4.7%) were reported to have hyperplasia. Carcinoma was not observed in any of the samples. The prevalence of fibrocystic changes increased with age. Hyperplastic changes were not associated with age and with fibrocystic changes. But it was the most common in the ages between 31 and 40 years. Conclusion: Fibrocystic breast changes are common, and their prevalence increases with age. However, they are not associated with hyperplasia and cancer risk.
The Prevalence of Fibrocystic Changes of Breast Tissue of Patients who Underwent Reduction Mammoplasty in Rasool-Akram, Firuzgar and Sadr Hospitals during 2007-2012
doi:10.11648/j.ass.20140201.12
Advances in Surgical Sciences
2014-01-01
© Science Publishing Group
Mostafa Hosseini
Adnan Tizmaghz
Hamidreza Alizadeh Otaghvar
Marjan Shams
The Prevalence of Fibrocystic Changes of Breast Tissue of Patients who Underwent Reduction Mammoplasty in Rasool-Akram, Firuzgar and Sadr Hospitals during 2007-2012
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© Science Publishing Group
Laparoscopic Treatment of Retroperitoneal Lymphangioma in an Adult: A Rare Case
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Retroperitoneal lymphangiomas are rare lesions and usually asymptomatic and the masses are often found incidentally by imaging technique or surgery for other purposes. Sypmthomatic abdominal lymphangiomas most often present as acute abdomen mimicking intestinal obstruction or appendicitis. Pre-operative diagnosis of retroperitoneal lymphangioma, in general, is challenging and rare, prior to laparatomy or laparoscopy. The diagnosis of lymphangiomas is based on histopathological examination of the mass. Surgery is often required for symptom control or diagnosis and the outcomes of surgery are excellent. Diagnostic tools can not always able to support differential diagnosis in such cases and laparoscopic surgical excision could be safely performed. Herein, we report a 66 year old female patient presented with right upper quadrent pain and underwent surgery to carry out for definitive diagnosis and relief of symptoms.
Retroperitoneal lymphangiomas are rare lesions and usually asymptomatic and the masses are often found incidentally by imaging technique or surgery for other purposes. Sypmthomatic abdominal lymphangiomas most often present as acute abdomen mimicking intestinal obstruction or appendicitis. Pre-operative diagnosis of retroperitoneal lymphangioma, in general, is challenging and rare, prior to laparatomy or laparoscopy. The diagnosis of lymphangiomas is based on histopathological examination of the mass. Surgery is often required for symptom control or diagnosis and the outcomes of surgery are excellent. Diagnostic tools can not always able to support differential diagnosis in such cases and laparoscopic surgical excision could be safely performed. Herein, we report a 66 year old female patient presented with right upper quadrent pain and underwent surgery to carry out for definitive diagnosis and relief of symptoms.
Laparoscopic Treatment of Retroperitoneal Lymphangioma in an Adult: A Rare Case
doi:10.11648/j.ass.20140202.11
Advances in Surgical Sciences
2014-05-06
© Science Publishing Group
Mutlu Ünver
Şafak Özturk
Varlık Erol
Eyüp Kebabcı
Cezmi Karaca
Ümit Bayol
Cengiz Aydın
Gökhan Akbulut
Laparoscopic Treatment of Retroperitoneal Lymphangioma in an Adult: A Rare Case
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Evaluation of the Role of Endoscopic Endonasal Surgery in Management of Orbital Complications of Rhinosinusitis
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The methods for the treatment of orbital complications of rhinosinusitis are often debated: conservative, surgical or combined. Surgical options include both endoscopic and open surgery. However, in the era of endoscopic surgery of the nose and paranasal sinuses, there are still no clear advantages of these techniques over open interventions. Therefore, our study aimed to clarify and evaluate the results of intranasal endoscopic procedures performed in individuals with orbital complications of rhinosinusitis in search for optimal treatment of this group of patients. 30 patients were divided based on Velasco classification into 3 groups; 1st group (14 patients) for patients with orbital cellulitis, 2nd group (10 patients) for patients with subperiosteal orbital abscess and the 3rd one (6 patients) was for patients with intraorbital abscess. Endoscopic endonasal surgery was done for all patients in group II and III and in 4 patients indicated for surgery in group I. Our result showed a highly significant postoperative improvement in proptosis, ocular motility, diplopia and vision acuity. Conclusion: Endoscopic Sinus Surgery offers a convenient, safe, and effective alternative to open procedures and can be successfully performed in well-selected cases of orbital complications of rhinosinusitis with many advantages.
The methods for the treatment of orbital complications of rhinosinusitis are often debated: conservative, surgical or combined. Surgical options include both endoscopic and open surgery. However, in the era of endoscopic surgery of the nose and paranasal sinuses, there are still no clear advantages of these techniques over open interventions. Therefore, our study aimed to clarify and evaluate the results of intranasal endoscopic procedures performed in individuals with orbital complications of rhinosinusitis in search for optimal treatment of this group of patients. 30 patients were divided based on Velasco classification into 3 groups; 1st group (14 patients) for patients with orbital cellulitis, 2nd group (10 patients) for patients with subperiosteal orbital abscess and the 3rd one (6 patients) was for patients with intraorbital abscess. Endoscopic endonasal surgery was done for all patients in group II and III and in 4 patients indicated for surgery in group I. Our result showed a highly significant postoperative improvement in proptosis, ocular motility, diplopia and vision acuity. Conclusion: Endoscopic Sinus Surgery offers a convenient, safe, and effective alternative to open procedures and can be successfully performed in well-selected cases of orbital complications of rhinosinusitis with many advantages.
Evaluation of the Role of Endoscopic Endonasal Surgery in Management of Orbital Complications of Rhinosinusitis
doi:10.11648/j.ass.20150301.11
Advances in Surgical Sciences
2015-05-06
© Science Publishing Group
Omar Abd El-Moniem El-Banhawy
Ibrahim Abd El-Shafy El-Hateem
Esam Abd El-Wanis Behery
Hassan Gamal El-Din Farahat
Osama Mohamed Salah El-Naqib
Evaluation of the Role of Endoscopic Endonasal Surgery in Management of Orbital Complications of Rhinosinusitis
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© Science Publishing Group
Dilemma of Inferior Turbinate Surgery
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=256&doi=10.11648/j.ass.20150302.11
Background and objectives: Inferiorturbinate surgery is considered as one of most commonly performed surgery in rhinology. It is usually done to reduce the bulk of inferior turbinates. It can be conducted for different indications such as relieving the mechanical nasal obstruction due to hypertrophied inferior turbinates, or to achieving a sufficient nasal surgical access during endoscopic sinus surgery, or removing the inferior turbinates as a part of wide and complete resection of rhino-sinus neoplastic lesions. The inferior turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. In spite of availability of well-established variable techniques for this surgery, the main goal of this surgery is yet not completely achieved. This could bean effect of different factors that are difficult to be predicted and controlled. Hence this pattern of surgery has become dilemmas in rhinology which need to be deeply evaluated and subsequently resolved. In order to evaluate and resolve this dilemma, this serial study was conducted prospectively. Patients and methods: 1337 patients aged 3 to -65 years suffering from hypertrophied inferior turbinates, presented with clinical pictures of mechanical nasal obstruction at ENT department – of Althowra central hospital and Al-tarahom private center Elbyda city- Libya between September 2005 to September 2014 they were operated by variable techniques of inferior turbinate surgery, namely sub-mucosal diathermy (SMD) (n=864 ), partial inferior turbinectomy (PIT) (n=427), CO2 laser vaporization of inferior turbinate (n=21), and turbinoplasty (n=25) . Post-operative atrophic rhinitis, and persistence, or recurrence of mechanical nasal obstruction the outcomes are that were studied in relation to different factors to shed-light on existing dilemma. Results and Conclusion: Proper selection of patient for this pattern of surgery is considered one of the main aspects of this issue and one of significant steps towards resolving of this dilemma. On the other hand, type of the technique for this surgery is an important selection criterion. In addition the amount of the inferior turbinate needed to be resected must be decided.
Background and objectives: Inferiorturbinate surgery is considered as one of most commonly performed surgery in rhinology. It is usually done to reduce the bulk of inferior turbinates. It can be conducted for different indications such as relieving the mechanical nasal obstruction due to hypertrophied inferior turbinates, or to achieving a sufficient nasal surgical access during endoscopic sinus surgery, or removing the inferior turbinates as a part of wide and complete resection of rhino-sinus neoplastic lesions. The inferior turbinates have important role in the maintenance of nasal breathing function by providing the nasal valve mechanism necessary for the regulation of air flow through the nose. In spite of availability of well-established variable techniques for this surgery, the main goal of this surgery is yet not completely achieved. This could bean effect of different factors that are difficult to be predicted and controlled. Hence this pattern of surgery has become dilemmas in rhinology which need to be deeply evaluated and subsequently resolved. In order to evaluate and resolve this dilemma, this serial study was conducted prospectively. Patients and methods: 1337 patients aged 3 to -65 years suffering from hypertrophied inferior turbinates, presented with clinical pictures of mechanical nasal obstruction at ENT department – of Althowra central hospital and Al-tarahom private center Elbyda city- Libya between September 2005 to September 2014 they were operated by variable techniques of inferior turbinate surgery, namely sub-mucosal diathermy (SMD) (n=864 ), partial inferior turbinectomy (PIT) (n=427), CO2 laser vaporization of inferior turbinate (n=21), and turbinoplasty (n=25) . Post-operative atrophic rhinitis, and persistence, or recurrence of mechanical nasal obstruction the outcomes are that were studied in relation to different factors to shed-light on existing dilemma. Results and Conclusion: Proper selection of patient for this pattern of surgery is considered one of the main aspects of this issue and one of significant steps towards resolving of this dilemma. On the other hand, type of the technique for this surgery is an important selection criterion. In addition the amount of the inferior turbinate needed to be resected must be decided.
Dilemma of Inferior Turbinate Surgery
doi:10.11648/j.ass.20150302.11
Advances in Surgical Sciences
2015-07-06
© Science Publishing Group
Khaled Mohamed Bofares
Dilemma of Inferior Turbinate Surgery
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2015-07-06
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http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=256&doi=10.11648/j.ass.20150302.11
© Science Publishing Group
Comparativestudy Between Tramadol Hydrochloride and Sodium Hyaloronatefor Management of Tempromandibular Joint Internal Derangement
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=256&doi=10.11648/j.ass.20150303.11
Purpose. This study was conducted to evaluate the efficacy and safety of arthrocentesis with injection of tramadol hydrochloridefor management of tempromandibular joint with internal derangement compared with traditional method with sodium hyaloronate injection.Patient&methods.The study was conducted on forty patients classified as class ASA type I with chief complain of limited mouth opening, TMJ pain, and clicking sounds in the TMJ was included in this study. All patients included in the study was selected from the outpatient clinic oforal and maxillofacial department, faculty of dentistry, Suez canal university.The selected patients were divided randomly into two equal groups,group I:consists of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml, commercially available tramadolhydrochloride.GroupII: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml. commercially available sodium hyaloronate.Evaluation of the patients was done preoperatively, after1,3,6 months postoperativelywhich includedmaximal mouth opening, pain&clicking sound presence in TMJ.Results.patients with either disc displacement with reduction or without reductionwere benefited from the arthrocentesis procedure with injection of Sodium Hyaluronate and also with tramadol hydrochloride.Both treatments were able to reduce pain levels, increase maximal mouth opening and reduce clicking withstatistically significant difference. However, arthrocentesis with injection of tramadol hydrochloride was superiorto arthrocentesiswithinjection of sodium hyaluronate in terms oftreatment of internal derangements of the temporomandibular joint.Conclusion. It has been concluded arthrocentesis is an effective conservative procedure in treatment of temporomandibular joint internal derangement,clinical efficacy of arthrocentesis with tramadolhydrochloride in the temporomandibular joint internal derangements&safty of tramadolintraarticular injection in the temporomandibular joint.
Purpose. This study was conducted to evaluate the efficacy and safety of arthrocentesis with injection of tramadol hydrochloridefor management of tempromandibular joint with internal derangement compared with traditional method with sodium hyaloronate injection.Patient&methods.The study was conducted on forty patients classified as class ASA type I with chief complain of limited mouth opening, TMJ pain, and clicking sounds in the TMJ was included in this study. All patients included in the study was selected from the outpatient clinic oforal and maxillofacial department, faculty of dentistry, Suez canal university.The selected patients were divided randomly into two equal groups,group I:consists of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml, commercially available tramadolhydrochloride.GroupII: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml. commercially available sodium hyaloronate.Evaluation of the patients was done preoperatively, after1,3,6 months postoperativelywhich includedmaximal mouth opening, pain&clicking sound presence in TMJ.Results.patients with either disc displacement with reduction or without reductionwere benefited from the arthrocentesis procedure with injection of Sodium Hyaluronate and also with tramadol hydrochloride.Both treatments were able to reduce pain levels, increase maximal mouth opening and reduce clicking withstatistically significant difference. However, arthrocentesis with injection of tramadol hydrochloride was superiorto arthrocentesiswithinjection of sodium hyaluronate in terms oftreatment of internal derangements of the temporomandibular joint.Conclusion. It has been concluded arthrocentesis is an effective conservative procedure in treatment of temporomandibular joint internal derangement,clinical efficacy of arthrocentesis with tramadolhydrochloride in the temporomandibular joint internal derangements&safty of tramadolintraarticular injection in the temporomandibular joint.
Comparativestudy Between Tramadol Hydrochloride and Sodium Hyaloronatefor Management of Tempromandibular Joint Internal Derangement
doi:10.11648/j.ass.20150303.11
Advances in Surgical Sciences
2015-09-02
© Science Publishing Group
Yasser Mohammed El-Gerby
Mohammed Ahmed El-Sholkamy
Eman Abdelhalim El-Sharrawy
Comparativestudy Between Tramadol Hydrochloride and Sodium Hyaloronatefor Management of Tempromandibular Joint Internal Derangement
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2015-09-02
2015-09-02
10.11648/j.ass.20150303.11
http://www.sciencepublishinggroup.com/journal/paperinfo.aspx?journalid=256&doi=10.11648/j.ass.20150303.11
© Science Publishing Group