Fibrin immobilization vestibular extension (FIVE): A case series

paythelady.61 shared this article with you from Inoreader Fibrin immobilization vestibular extension (FIVE): A case series Via Clinical Implant Dentistry and Related Research Abstract Aims The objective of the present case series is to report on the rationale, surgical technique and outcome of a protocol for peri-implant mucosal phenotype modification therapy, referred to as "fibrin immobilization vestibular extension (FIVE)". Material and Methods The protocol utilized entailed apical positioning and stabilization of peri-implant flap with modular screws. The screws were also used for the immobilization of solid matrix platelet-rich fibrin to fill the gap created between apically positioned flap and the crestal margin of the flap. Results A total of 30 patients (12 male, 18 females) with 93 implants were treated with FIVE protocol for various indications, including for vestibular extension following alveolar ridge augmentation (N = 6), preprosthetic (N = 9), postprosthetic (N = 2), and peri-implantitis (N = 13). The keratinized mucosal width preoperatively was 1.67 mm with 95% confidence interval [CI] (1.46, 1.88). Immediately following FIVE surgery, the vestibule was extended to 9.10 with 95% CI (8.44, 9.76). At 3 months, 4.9 mm (95% CI: 4.5–5.2 mm) of peri-implant keratinized mucosal width was present. The keratinized mucosal width remained relatively stable thereafter and was 4.0 mm (95% CI: 3.5–4.5 mm) at 3 years post-FIVE surgery. When overall group means across all time points were analyzed, maxilla had mean of 6.1 mm (95% CI: 5.8–6.5) versus mandible exhibited mean of 5.1 mm (95% CI: 4.6–5.6 mm). The mean of maxilla was si gnificantly higher than that of the mandible (p < 0.0001) across all time points. Treatment of peri-implantitis with FIVE lead to significant pocket reduction and wide band of keratinized mucosa. Seven of 38 implants in 3 of 13 peri-implantitis patients were removed due to advanced peri-implantitis. Discussion The present case series provides proof-of-principle data for efficacy of FIVE for peri-implant phenotype modification therapy that generated attached keratinized mucosa in a variety of applications. This protocol provides an alternative to procedures involving harvesting of autogenous mucosal graft. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management of Benign Salivary Gland Conditions

a.sfakia shared this article with you from Inoreader Management of Benign Salivary Gland Conditions Via radioactive iodine Surg Clin North Am. 2022 Apr;102(2):209-231. doi: 10.1016/j.suc.2022.01.001. Epub 2022 Mar 8. ABSTRACT In this section, we discuss the management of benign salivary gland disease. Pathologies vary from sialolithiasis, salivary duct stenosis, sialadenitis, infectious glandular disease, autoimmune glandular disease, and radioactive iodine-induced disease. We discuss both novel techniques in the diagnosis and management of these diseases, including ultrasound, sialendoscopy, minor salivary gland biopsy, and botulinum toxin injection, which allow for both the alleviation of symptoms and gland preservation. PMID:35344693 | DOI:10.1016/j.suc.2022.01.001 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

A comparison between sniffing and blowing for olfactory testing before and after laryngectomy

a.sfakia shared this article with you from Inoreader A comparison between sniffing and blowing for olfactory testing before and after laryngectomy 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. 2022 Mar 29. doi: 10.1007/s00405-022-07343-5. Online ahead of print. ABSTRACT PURPOSE: Olfactory dysfunction occurs after laryngectomy due to the loss of nasal airflow and inability to sniff. However, the reason for the loss of olfactory function after laryngectomy is unclear on evaluation with sniffing type tests performed individually. It is expected that the sensorineural olfaction remains, and the results of the sniffing test would be negative, while that of the odour-blowing test would be positive. Therefore, the aim of this study was to investigate both tests and prove normal olfaction in the patients. METHODS: Patients who had undergone laryngectomy were evaluated using the T&T olfactometer for odour-sniffing tests, Jet Stream Olfactometer (JSO) for odour-blowing tests, and visual analogue scale (VAS). Evaluations were performed pre-operatively, and 1 month, 6 months, and 1-year post-laryngec tomy. RESULTS: Thirty-two patients were included in the study. The median recognition thresholds using the T&T and JSO were 1.4 and 2.2 before surgery, 5.8 and 5.4 at 1 month, 5.8 and 5.2 at 6 months, and 5.8 and 5.0 at 1 year after surgery, respectively. Results of the olfactory threshold test in both T&T and JSO and VAS score were significantly worse after surgery compared to that before laryngectomy (p < 0.05). The degree of increase was significantly smaller with JSO than with T&T (p < 0.05). CONCLUSION: While we could not prove normal olfaction in patients after laryngectomy, the odour-blowing test was superior to the odour-sniffing test in detecting patients with residual olfaction. Simply blowing a scent is insufficient to obtain good olfaction; active airflow is crucial for recognizing odours. PMID:35348858 | DOI:10.1007/s00405-022-07343-5 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgical treatment trends and identification of primary breast tumors after surgery in occult breast cancer: a study based on the Japanese National Clinical Database-Breast Cancer Registry

a.l.s.f.akia shared this article with you from Inoreader Surgical treatment trends and identification of primary breast tumors after surgery in occult breast cancer: a study based on the Japanese National Clinical Database-Breast Cancer Registry Via Breast Cancer CONCLUSIONS: Breast surgery for cT0N+ decreased between 2010 and 2018. Despite the high identification rate of primary tumors, most tumors were small, and there was no significant change in the identification rate or invasive diameter of the identified tumors after 2010.PMID:35316446 | DOI:10.1007/s12282-022-01348-y (Source: Breast Cancer) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Stereotactic radiosurgery for the treatment of hypoglossal schwannoma: a multi-institutional retrospective study

xlomafota.13 shared this article with you from Inoreader Stereotactic radiosurgery for the treatment of hypoglossal schwannoma: a multi-institutional retrospective study Via Latest Results for Acta Neurochirurgica Abstract Background Surgical removal has been performed as the first line treatment for symptomatic or enlarging hypoglossal schwannomas (HS). Stereotactic radiosurgery (SRS) offers a minimally invasive approach that may afford long-term tumor control for patients with HS particularly those who refuse or are unfit for surgery. This study evaluates outcomes after SRS performed for both newly diagnosed and residual tumors after incomplete resection. Methods This retrospective, multi-institutional study involved patients treated with adjuvant or primary SRS for HS. The study end-points included local tumor response, clinical outcomes, and procedure-related complications. All the patients had Gamma Knife SRS. Results The cohort included 12 patients (five females), median age at SRS 49.5 years (range, 37–76)]. The median tumor target volume was 5.9 cm3 (range, 0.7–27.23). At median imaging follow-up of 37 months (range, 6–153), tumor control was achieved in 11 patients. Tumor enlargement that was managed with surgical resection was noted at the 6-month follow-up in one patient. At median clinical follow-up of 30.5 months (range, 6–157), stability, or improvement of all pre-SRS signs and symptoms was noted in nine patients. Two patients experienced worsening of at least one pre-existing symptoms or sign. New-onset trapezius weakness was noted in one patient and tongue atrophy in two patients. Conclusion Single-fraction SRS appears to be a safe and effective upfront and adjuvant treatment option for HS. SRS may be recommended as an alternative to surgery for patients presenting with HS or as an adjuvant treatment following subtotal resection and at HS recurrence. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

How I do it: management of M2 tear injury caused by drilling during intradural anterior clinoidectomy for microsurgical clipping of intracranial aneurysms

xlomafota.13 shared this article with you from Inoreader How I do it: management of M2 tear injury caused by drilling during intradural anterior clinoidectomy for microsurgical clipping of intracranial aneurysms Via Latest Results for Acta Neurochirurgica Abstract Background High-speed drilling is associated with potential injury to neurovascular structures, particularly during intradural drilling of the anterior clinoid process. Method During an anterior clinoidectomy, a cotton patty and middle cerebral artery branches became inadvertently wrapped around the bit, causing a tear on the inferior M2 trunk. Following temporary clipping of the internal carotid artery, the tear was identified. Temporary clips were placed proximally and distally. The tear was then repaired with interrupted microsutures. Conclusion Extreme care should be exercised during clinoidectomy. Should small vascular injury occur, direct microsuturing can be a good alternative to sacrificing or implantation anastomosis repair. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Perigraft seroma after total aortic arch replacement using Triplex graft

xlomafota.13 shared this article with you from Inoreader Perigraft seroma after total aortic arch replacement using Triplex graft Via Latest Results for General Thoracic and Cardiovascular Surgery Abstract A 42-year-old gentleman underwent total aortic arch replacement with Triplex graft (Terumo corporation, Tokyo, Japan) for acute type A dissection. Sixteen months later, a computed tomography revealed a rapidly enlarging low-density area around the graft, with no contrast enhancement. The area was compressing the mediastinal structures, such as the superior vena cava and right pulmonary artery. Suspecting lymphorrhea or perigraft seroma (PGS), surgical drainage was performed. Although fluid accumulation around the graft was cloudy and yellowish, Gram stain was negative. A fatty preparation was administered from the nasogastric tube, demonstrating no leakage of chyle. Intraoperative lymphangiography with indocyanine green also showed no lymphatic leak. Therefore, PGS was suspected. Fibrin glue was applied to the graft and the surgery was completed. PGS drainage after arch replacement, especially with Triplex graft, is extremely rare. We discuss the strategies of di agnosis and treatment for this uncommon complication after aortic surgery. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.