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https://www.readbyqxmd.com/read/30325993/association-between-surgical-trainee-daytime-sleepiness-and-intraoperative-technical-skill-when-performing-septoplasty
#1
Ya Wei Tseng, S Swaroop Vedula, Anand Malpani, Narges Ahmidi, Kofi D O Boahene, Ira D Papel, Theda C Kontis, Jessica Maxwell, John R Wanamaker, Patrick J Byrne, Sonya Malekzadeh, Gregory D Hager, Lisa E Ishii, Masaru Ishii
Importance: Daytime sleepiness in surgical trainees can impair intraoperative technical skill and thus affect their learning and pose a risk to patient safety. Objective: To determine the association between daytime sleepiness of surgeons in residency and fellowship training and their intraoperative technical skill during septoplasty. Design, Setting, and Participants: This prospective cohort study included 19 surgical trainees in otolaryngology-head and neck surgery programs at 2 academic institutions (Johns Hopkins University School of Medicine and MedStar Georgetown University Hospital)...
October 11, 2018: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/30322733/outcomes-of-conversion-total-hip-arthroplasty-from-free-vascularized-fibular-grafting
#2
Sean P Ryan, Benjamin Wooster, William Jiranek, Samuel Wellman, Michael Bolognesi, Thorsten Seyler
BACKGROUND: Conversion total hip arthroplasties (THAs) from prior free vascularized fibular grafting (FVFG) are infrequently reported in the literature. We characterized the perioperative outcomes of patients undergoing conversion THA and compared them with those of a matched cohort of patients undergoing primary THA for osteonecrosis of the femoral head and neck (ONFHN). METHODS: The institutional database was queried for patients with FVFG requiring conversion to THA...
September 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30322289/surgical-review-of-the-anatomical-variations-of-the-internal-jugular-vein-an-update-for-head-and-neck-surgeons
#3
S Mumtaz, M Singh
BACKGROUND: The internal jugular vein is one of the major vessels of the neck. The anatomy of this vessel is considered to be relatively stable. It is an important landmark for head and neck surgeons as well as the anaesthetists for both diagnostic and therapeutic purposes. METHODS: We present two case reports of the posterior tributary of the internal jugular vein and review the surgical literature regarding anatomical variations of the vein. FINDINGS: A total of 1197 patients from 27 published papers were included in this review...
October 16, 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/30320742/porcine-as-a-training-module-for-head-and-neck-microvascular-reconstruction
#4
Mohammad Ali Alessa, Sang Hyun Kwak, Young Woo Lee, Mi-Lan Kang, Hak-Joon Sung, Soon Hyun Ahn, Eun Chang Choi, Won Shik Kim
Live models that resemble surgical conditions of humans are needed for training free-flap harvesting and anastomosis. Animal models for training purposes have been available for years in many surgical fields. We used the female (because they are easy to handle for the procedure) Yorkshire pigs for the head and neck reconstruction by harvesting the deep inferior epigastric artery perforator or the superior epigastric artery perforator flap. The anastomosis site (neck skin defect or tracheal wall defect) was prepared via the dissection of the common carotid artery and the internal jugular vein, in which 3...
September 29, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/30317469/modular-femoral-neck-failure-after-revision-of-a-total-hip-arthroplasty-a-finite-element-analysis
#5
Jan Zajc, Jožef Predan, Nenad Gubeljak, Andrej Moličnik, Samo K Fokter
The authors report on a case of modular femoral neck fracture which appeared 21 months after revision of acetabular component. The revision surgery was performed 8 years after the primary total hip arthroplasty due to aseptic loosening of the acetabular component. During acetabular revision, the primary implanted short (S, - 3.5 mm) femoral head was also exchanged with extra-long (XL, + 7.0 mm) femoral head fitting the modular femoral neck with a longer lever arm. Numerical analysis has shown that this has resulted in a 19...
October 13, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/30313121/double-island-anterolateral-thigh-free-flap-used-in-reconstruction-for-salvage-surgery-for-locally-recurrent-head-and-neck-carcinoma
#6
Di Deng, Jun Liu, Fei Chen, Dan Lv, Weigang Gan, Linke Li, Ji Wang
Salvage surgery is usually the only treatment for recurrent head and neck tumors but often poses a challenge to surgeons due to post-resected defects at 2 or more sites. Here we present the outcomes and rationale for reconstruction by a double-island anterolateral thigh (ALT) free flap following the salvage surgery.Patients treated with double-island ALT free flaps in salvage surgery between September 2012 and January 2017 at West China Hospital, Sichuan University were retrospectively viewed.A total of 18 patients (15 males) underwent reconstruction with double-island ALT free flaps (range from 40 to 77 years old)...
October 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30302496/-treatment-of-cutaneous-malignant-melanoma-in-the-head-and-neck-region-an-update
#7
B Frerich
Major progress has been made in the treatment of malignant melanoma during recent years. On the one hand, reliable evidence-based recommendations regarding surgical resection as well as lymph node management have been established on the basis of results from randomized multicenter studies. On the other hand, the advent of targeted therapies has led to spectacular improvements in the treatment of metastasized melanomas. Knowledge concerning treatment algorithms and updates thereof is also essential for maxillofacial surgeons...
October 9, 2018: HNO
https://www.readbyqxmd.com/read/30302154/an-investigation-on-endoscopic-laryngopharyngeal-surgery-and-related-outcomes
#8
Yohei Kawasaki, Yasufumi Omori, Hidekazu Saito, Shinsuke Suzuki, Tamotsu Matsuhashi, Takechiyo Yamada
Introduction: Robotic surgery is used in Europe and the US for oropharyngeal/hypopharyngeal cancers. Although robots can successfully perform procedures that are too delicate for surgeons and quickly learn accurate techniques, robotic surgery is not still authorized for the craniocervical region in Japan. In Japan, endoscopic laryngopharyngeal surgery (ELPS) is widely performed. Because oropharyngeal/hypopharyngeal cancer can be resected at an early stage, we have contributed to an improvement in the survival rate...
September 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/30299285/is-a-cephalomedullary-nail-durable-treatment-for-patients-with-metastatic-peritrochanteric-disease
#9
David H Chafey, Valerae O Lewis, Robert L Satcher, Bryan S Moon, Patrick P Lin
BACKGROUND: Although cephalomedullary nail fixation is often used for metastatic peritrochanteric lesions of the femur, there is concern regarding the durability of the implant in comparison to endoprosthetic reconstruction. Previous studies have reported the proportion of patients who undergo reoperation for loss of stability, but the adequacy of the construct has not been critically evaluated in a competing risk analysis that incorporates death of the patient in the calculation. QUESTIONS/PURPOSES: (1) What is the cumulative incidence of reoperation of cephalomedullary nails with death as a competing risk for metastatic lesions of the proximal femur? (2) What is the survival of patients with metastases to the proximal femur after cephalomedullary nailing? (3) What clinical factors are associated with implant stability in these patients? METHODS: Between 1990 and 2009, 11 surgeons at one center treated 217 patients with cephalomedullary nails for metastatic proximal femoral lesions...
October 2, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/30290583/effect-of-prior-radiotherapy-on-the-outcome-of-submental-island-flap-in-head-and-neck-reconstruction
#10
Ebrahim Karimi, Reza Badiei, Keivan Aghazadeh, Saeed Sohrabpour, Nasrin Yazdani, Sasan Dabiri
The submental island flap is a new alternative to the reconstruction of various head and neck defects. But there has been a relative paucity of information about the use of this flap in irradiated patients. The authors present their preliminary experience in the use of this flap in irradiated and nonirradiated patients. Eighty-one patients (53 nonirradiated and 28 irradiated patients) underwent reconstruction with the submental island flap between March 2011 and August 2017. The authors have 13 patients of venous congestion (7 in nonirradiated and 6 in irradiated group), 7 patients of partial necrosis of the flap (4 in nonirradiated and 3 in irradiated group)...
October 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/30286218/the-2018-american-head-and-neck-society-presidential-address-reflections
#11
Jonathan C Irish
Jonathan C. Irish, President of the American Head and Neck Society (AHNS) for 2017 to 2018, in his Presidential Address highlights the challenges and opportunities of the Society's reorganization in the rapidly changing field of head and neck surgery and details how AHNS members can harness this change to direct the future of their field. Specifically, AHNS members' vital roles as technically proficient surgeons, surgical team members, researchers, teachers, and leaders within an evolving medical system are explored...
October 4, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/30285860/assessing-the-role-of-virtual-reality-training-in-canadian-otolaryngology-head-neck-residency-programs-a-national-survey-of-program-directors-and-residents
#12
Justin T Lui, Evan D Compton, Won Hyung A Ryu, Monica Y Hoy
BACKGROUND: Given mounting pressure of work hour restrictions, resource constraints, and variability of clinical exposure, Otolaryngology-Head & Neck Surgery (OHNS) residency training has shifted away from the apprenticeship model to embrace the Royal College of Physicians and Surgeons of Canada's "Competence by Design" initiative. As a result, appraising both current and potential educational adjuncts has become increasingly important. In this investigation, a national needs assessment survey was performed to identify strengths, weaknesses, and future opportunities of the current training landscape...
October 1, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/30282436/a-rare-case-of-isolated-schwannoma-in-infraorbital-nerve
#13
June Seok Choi, Sang Min Park, Kyung-Un Choi
A schwannoma is a benign tumor that develops from Schwann cells. It is known to occur more frequently in women than men, and about one third of schwannoma cases occur in the head and neck area. It is also known to originate mainly in the auditory nerve. However, it is rarely associated with the trigeminal nerve, and especially, schwannomas related to the infraorbital nerve are very rare. we report a rare case of a schwannoma involving the infraorbital branch of the trigeminal nerve in a 45-year old male adult...
September 2018: Archives of Craniofacial Surgery
https://www.readbyqxmd.com/read/30277996/retrieval-findings-of-recalled-dual-taper-hips
#14
Anna Di Laura, Harry S Hothi, Johann Henckel, Young-Min Kwon, John A Skinner, Alister J Hart
BACKGROUND: The recent high-profile recalls of several dual-taper hip designs pose questions regarding why those designs perform poorly. We aimed to characterize taper damage in 1 recalled design to understand failure mechanisms to inform surgeons on which patients should be considered at risk of revision and when to revise. METHODS: High-precision measurement equipment was used to characterize the metal loss from the neck-stem interface of 116 retrieved Rejuvenate femoral stems (Stryker Howmedica Osteonics) revised because of an adverse reaction to metal debris...
October 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/30277954/jug-handle-tributary-of-internal-jugular-vein-a-potentially-dangerous-venous-variation
#15
Satheesha B Nayak
Variations of internal jugular vein (IJV) are rare and are surgically important. Here an unreported variation of IJV is presented. Right IJV had an unusual vein joining it in the form of a "jug handle." This vein arose from the junction of IJV and common facial vein (CFV), coursed down for 3 cm and joined IJV again. The CFV was dilated. Knowledge of this rare case could be useful to craniofacial surgeons, radiologists, and anesthesiologists. It might decrease the chances of iatrogenic bleeding during head and neck surgeries and radiologic procedures...
October 1, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/30275676/transoral-endoscopic-thyroidectomy-a-systematic-review-of-the-practice-so-far
#16
REVIEW
Christian Camenzuli, Pierre Schembri Wismayer, Jean Calleja Agius
Background and Objectives: Thyroid disease largely affects young females, but the incidence is also increasing among males. In an effort to avoid the scarring of the neck that is synonymous with conventional thyroidectomy, endoscopic techniques have been developed over the years. The transoral endoscopic approach is the latest of these innovations that promises a scarless surgical outcome. This review evaluates whether this technique is safe and feasible in live patients and outlines the outcomes in published literature so far...
July 2018: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/30272610/acetabular-retroversion-and-decreased-posterior-coverage-are-associated-with-sports-related-posterior-hip-dislocation-in-adolescents
#17
Eduardo N Novais, Mariana G Ferrer, Kathryn A Williams, Sarah D Bixby
BACKGROUND: Leverage of the femoral head against the acetabular rim may lead to posterior hip dislocation during sports activities in hips with femoroacetabular impingement (FAI) deformity. Abnormal concavity of the femoral head and neck junction has been well described in association with posterior hip dislocation. However, acetabular morphology variations are not fully understood. QUESTIONS/PURPOSES: The purpose of this study was to compare the acetabular morphology in terms of acetabular version and coverage of the femoral head in adolescents who sustained a posterior hip dislocation during sports and recreational activities with a control group of patients without a history of hip disease matched by age and sex...
September 27, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/30267078/understanding-risk-factors-associated-with-unplanned-reoperation-in-major-head-and-neck-surgery
#18
Neel R Sangal, Kalin Nishimori, Eric Zhao, Sana H Siddiqui, Soly Baredes, Richard Chan Woo Park
Importance: Understanding the preoperative, intraoperative, and postoperative risk factors of reoperation is the optimal way to approach decreasing its incidence. Objective: To identify risk factors of unplanned reoperation following major operations of the head and neck. Design, Setting, and Participants: This retrospective cohort study queried the American College of Surgeons National Surgical Quality Improvement Program database and identified 2475 cases of major operations of the head and neck performed between 2005 and 2014...
September 27, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/30258308/vibroacoustographic-system-for-tumor-identification
#19
Peter A Pellionisz, Nikan K Namiri, Gregory Suematsu, Yong Hu, Ameet Braganza, Khuzaima Rangwalla, Daniel J Denson, Karam Badran, Nathan C Francis, Ashkan Maccabi, George Saddik, Zachary Taylor, Maie A St John, Warren S Grundfest
Oral and head and neck squamous cell carcinoma (OSCC) is the sixth most common cancer worldwide. The primary management of OSCC relies on complete surgical resection of the tumor. Margin-free resection, however, is difficult given the devastating effects of aggressive surgery. Currently, surgeons determine where cuts are made by palpating edges of the tumor. Accuracy varies based on the surgeon's experience, the location and type of tumor, and the risk of damage to adjacent structures limiting resection margins...
September 2018: Yale Journal of Biology and Medicine
https://www.readbyqxmd.com/read/30251324/the-neurosurgical-wound-and-factors-that-can-affect-cosmetic-functional-and-neurological-outcomes
#20
James A D Berry, Dan E Miulli, Benjamin Lam, Christopher Elia, Julia Minasian, Stacey Podkovik, Margaret R S Wacker
Surgically accessing pathological lesions located within the central nervous system (CNS) frequently requires creating an incision in cosmetic regions of the head and neck. The biggest factors of surgical success typically tend to focus on the middle portion of the surgery, but a vast majority of surgical complications tend to happen towards the end of a case, during closure of the surgical site incisions. One of the most difficult complications for a surgeon to deal with is having to take a patient back to the operating room for wound breakdowns and, even worse, wound or CNS infections, which can negate all the positive outcomes from the surgery itself...
September 24, 2018: International Wound Journal
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