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https://www.readbyqxmd.com/read/29789815/challenging-case-robot-assisted-laparoscopic-prostatectomy-after-prior-suprapubic-open-prostatectomy
#1
Shirin Razdan, Sanjay Razdan
Introduction: Given the ubiquity of robot-assisted laparoscopic prostatectomy (RALP) for treatment of localized prostate cancer, more surgeons are encountering challenging cases, either secondary to difficult anatomy, prior abdominal surgery, or prior radiation therapy. Our case is of RALP in a patient after prior suprapubic prostatectomy. Case Presentation: A 61-year-old otherwise healthy Hispanic gentleman presented for consultation after being found to have Gleason 4 + 4 = 8 prostate cancer on transrectal ultrasound-guided biopsy by an outside provider in July 2017...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29784601/the-anatomage-table-and-the-placement-of-titanium-mesh-for-the-management-of-orbital-floor-fractures
#2
Matteo Brucoli, Francesca Boccafoschi, Paolo Boffano, Emanuele Broccardo, Arnaldo Benech
OBJECTIVE: The anatomy of the head and neck region is complex as are its implications for maxillofacial pathologic conditions and their surgical treatments. We hypothesize that the assessment of the surgical management of orbital floor fractures by using titanium mesh could represent an appropriate first experimental field for the use of the Anatomage Table in maxillofacial surgery. STUDY DESIGN: Patients with unilateral orbital floor fractures were searched for in the hospital database of Novara University Hospital, Novara, Italy...
May 2, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29781993/murine-salivary-functional-assessment-via-pilocarpine-stimulation-following-fractionated-radiation
#3
Jomy J Varghese, Isaac L Schmale, Mollie Eva Hansen, Shawn D Newlands, Danielle S W Benoit, Catherine E Ovitt
Hyposalivation is commonly observed in the autoimmune reaction of Sjögren's syndrome or following radiation injury to the major salivary glands. In these cases, questions remain regarding disease pathogenesis and effective interventions. An optimized technique that allows functional assessment of the salivary glands is invaluable for investigating exocrine gland biology, dysfunction, and therapeutics. Here, we present a step by step approach to performing pilocarpine stimulated saliva secretion, including tracheostomy and the dissection of the three major murine salivary glands...
May 4, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29781820/management-of-pediatric-femoral-neck-fracture
#4
Joseph T Patterson, Jennifer Tangtiphaiboontana, Nirav K Pandya
In the pediatric population, femoral neck fracture is a relatively uncommon injury with a high complication rate, despite appropriate diagnosis and management. The anatomy and blood supply of the proximal femur in the skeletally immature patient differs from that in the adult patient. Generally, these fractures result from high-energy trauma and are categorized using the Delbet classification system. This system both guides management and aids the clinician in determining the risk of osteonecrosis after these fractures...
May 16, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29777918/sex-differences-in-the-spatial-distribution-of-bone-in-relation-to-incident-hip-fracture-findings-from-the-ages-reykjavik-study
#5
Elisa A Marques, Julio Carballido-Gamio, Vilmundur Gudnason, Gunnar Sigurdsson, Sigurdur Sigurdsson, Thor Aspelund, Kristin Siggeirsdottir, Lenore Launer, Gudny Eiriksdottir, Thomas Lang, Tamara B Harris
In this case-cohort study, we used data-driven computational anatomy approaches to assess within and between sex spatial differences in proximal femoral bone characteristics in relation to incident hip fracture. One hundred male and 234 female incident hip fracture cases, and 1047 randomly selected noncase subcohort participants (562 female) were chosen from the population-based AGES-Reykjavik study (mean age of 77 years). The baseline -i.e. before hip fracture- hip quantitative computed tomography scans of these subjects were analyzed using voxel-based morphometry, tensor-based morphometry, and surface-based statistical parametric mapping to assess the spatial distribution of volumetric bone mineral density (vBMD), internal structure, and cortical bone properties (thickness, vBMD and trabecular vBMD adjacent to the endosteal surface) of the proximal femur, respectively, in relation to incident hip fracture...
May 16, 2018: Bone
https://www.readbyqxmd.com/read/29776934/coiling-of-ruptured-wide-necked-basilar-tip-aneurysm-using-double-comaneci-technique
#6
Stanimir S Sirakov, Alexander Sirakov, Hristo Hristov, Radoslav Raychev
In this report, we present a novel technique of successful coil embolisation using temporary deployment of two Comaneci devices placed in Y configuration across a wide-neck ruptured basilar tip aneurysm. The placement of two devices across the wide aneurysm neck allowed optimal coverage for safe coil delivery, while maintaining parent vessel patency. This case highlights the unique and safe applicability of two crossed Comaneci devices in a ruptured aneurysm with unfavourable anatomy, ultimately resulting in complete aneurysm obliteration...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29765790/direct-posterior-bipolar-cervical-facet-radiofrequency-rhizotomy-a-simpler-and-safer-approach-to-denervate-the-facet-capsule
#7
Ovidiu Palea, Haroon M Andar, Ramon Lugo, Michelle Granville, Robert E Jacobson
Radiofrequency cervical rhizotomy has been shown to be effective for the relief of chronic neck pain, whether it be due to soft tissue injury, cervical spondylosis, or post-cervical spine surgery. The target and technique have traditionally been taught using an oblique approach to the anterior lateral capsule of the cervical facet joint. The goal is to position the electrode at the proximal location of the recurrent branch after it leaves the exiting nerve root and loops back to the cervical facet joint. The standard oblique approach to the recurrent nerve requires the testing of both motor and sensory components to verify the correct position and ensure safety so as to not damage the slightly more anterior nerve root...
March 14, 2018: Curēus
https://www.readbyqxmd.com/read/29762438/venous-anastomoses-in-anterolateral-thigh-flaps-for-the-lower-extremity-vessel-selection-in-lieu-of-obligatory-number
#8
David Mattos, Shawn Diamond, Anmol S Chattha, Johanna N Riesel, Matthew L Iorio
BACKGROUND: Dual venous drainage for anterolateral thigh flaps has been proposed to protect against flap-related complications in head and neck applications. Here we report our experience with single vs dual venous anastomosis during lower extremity free-tissue transfer. METHODS: All free anterolateral thigh flaps for lower extremity reconstruction from 2011 to 2017 were retrospectively reviewed. An algorithm was used to determine the type and number of venous anastomoses, emphasizing patient anatomy, venous quality, and size match...
May 14, 2018: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29759952/head-and-neck-anatomy-effect-of-focussed-near-peer-teaching-on-anatomical-confidence-in-undergraduate-medical-students
#9
Simon Morris, Max Sallis Osborne, Duncan Bowyer
OBJECTIVES: To assess the effect of near-peer head and neck anatomy teaching on undergraduates and to quantify the benefit from a focussed teaching course. Near-peer teaching involves colleagues within close seniority and age proximity teaching one another on a specified topic. DESIGN: Small group teaching sessions were delivered to medical students on 3 key areas of ENT anatomy. Participants were given a precourse and postcourse questionnaire to determine the benefit attained from the course...
May 11, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29730061/computed-tomographic-angiographic-perforator-localization-for-virtual-surgical-planning-of-osteocutaneous-fibular-free-flaps-in-head-and-neck-reconstruction
#10
Kyle S Ettinger, Amy E Alexander, Kevin Arce
Virtual surgical planning (VSP), computer-aided design and computer-aided modeling, and 3-dimensional printing are 3 distinct technologies that have become increasingly used in head and neck oncology and microvascular reconstruction. Although each of these technologies has long been used for treatment planning in other surgical disciplines, such as craniofacial surgery, trauma surgery, temporomandibular joint surgery, and orthognathic surgery, its widespread use in head and neck reconstructive surgery remains a much more recent event...
April 10, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29709330/does-volumetric-measurement-of-cervical-lymph-nodes-serve-as-an-imaging-biomarker-for-locoregional-recurrence-of-oral-squamous-cell-carcinoma
#11
Ali-Farid Safi, Martin Kauke, Hendrik Jung, Marco Timmer, Jan Borggrefe, Thorsten Persigehl, Hans-Joachim Nickenig, Max Zinser, David Maintz, Matthias Kreppel, Joachim Zöller
In consideration of the 3-R-rule (Refine-Replace-Reduce) as a guideline for promoting ethical use of animals for surgical training, we present a novel training model for microvessel anastomosis. At hand of a rat cadaveric study, we evaluated the surgical anatomy of the common carotid artery (CCA), external jugular vein (EJV) and femoral vessels (FV) which were then used as templates for the present investigation. Anatomical dissection of 30 rat cadavers was performed. Two residents without prior microsurgical experience were included in the study and performed 5 CCA, 5 femoral artery, 5 EJV and 5 femoral vein anastomoses...
April 10, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29707505/acute-airway-management
#12
Nikhil Panda, Dean M Donahue
Acute airway management has challenged clinicians for nearly four millennia. History underscores the discoveries of surgeons and anesthesiologists, whose advances in technology and surgical technique have transformed management algorithms from primarily surgical tracheostomy, to transoral endotracheal intubation under direct laryngoscopy. Despite this progress and a better understanding of airway anatomy, physiology and pathogenesis of disease, the acute airway, whether obstructed, traumatically disrupted, or externally compressed, remains a life-threatening challenge...
March 2018: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29707450/development-of-core-syllabus-for-facial-anatomy-teaching-to-aesthetic-physicians-a-delphi-consensus
#13
Narendra Kumar, Arthur Swift, Eqram Rahman
Background: A detailed understanding of facial anatomy, specifically the vascular framework, is crucial for delivering safe nonsurgical aesthetic procedures. To date, there is no core document based on consensus for the teaching of facial anatomy to aesthetic physicians exists. The aim of this study was to ascertain the most critical anatomical structures for avoiding disastrous complications during nonsurgical aesthetic procedures. Methods: After a detailed literature review, Delphi questionnaire was developed listing 154 anatomical structures of the face and neck for consensus review...
March 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29707056/characterization-of-proximal-femoral-anatomy-in-the-skeletally-immature-patient
#14
B G Beutel, S J Girdler, J A Collins, N Y Otsuka, A Chu
Purpose: The morphology of the proximal femur has been extensively studied in the adult population. However, no literature providing a comprehensive evaluation of the anatomy in paediatric patients exists. The current study aims to characterize such anatomy in skeletally-immature patients, examine potential differences between genders, and analyze how these anatomical parameters change with age. Methods: Cadaveric femurs from the Hamann-Todd Osteological Collection were examined...
April 1, 2018: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29706473/procedural-and-perioperative-results-in-patients-treated-with-fenestrated-endovascular-aneurysm-repair-planned-by-automated-software-in-a-physician-sponsored-investigational-device-exemption-trial-of-physician-modified-endografts
#15
Benjamin W Starnes, Billi Tatum, Niten Singh
OBJECTIVE: Fenestrated endovascular aneurysm repair (FEVAR) has been used successfully to treat patients with juxtarenal abdominal aortic aneurysms (JAAAs). Barriers to wide adoption of FEVAR include complexity in planning of fenestration locations on endografts. The purpose of this study was to validate the use of automated planning software to design fenestrated endografts and to treat patients with complex abdominal aortic aneurysms. METHODS: Patients with JAAA who were not candidates for open repair were enrolled into the automated planning arm of an ongoing investigational device exemption clinical trial and treated with FEVAR...
April 26, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29702024/video-preoperative-ct-angiography-for-fibular-free-flap-reconstructions
#16
Bilal Mujtaba, Gaurav K Synghal, Patrick B Garvey, Behrang Amini, Tamara Miner Haygood, John E Madewell, Colleen M Costelloe
OBJECTIVE: The objective of this video article is to provide an introduction to the use of fibular free flaps. Normal and variant vascular anatomy of the fibular free flap is discussed, as are imaging acquisition and CT angiography interpretation, computer-assisted design and manufacturing, and the limitations of the fibular free flap. CONCLUSION: The fibular free flap is commonly used for head and neck reconstructive surgery. Variation exists between individuals regarding the origin of the peroneal artery and the perforating arteries...
April 27, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29701850/safeguarding-the-anomalous-vertebral-artery-while-dissecting-drilling-and-instrumentation-of-c1-2-joint-for-congenital-atlantoaxial-dislocation-2-dimensional-operative-video
#17
Pravin Salunke, Sushanta K Sahoo
The pathology in congenital atlantoaxial instability is usually in C1-2 joints. Addressing the joints appears to be the most rationale approach. The joints are usually approached posteriorly, manipulated, and fused. Understanding the normal and abnormal anatomy is important. Normally, the third segment of the vertebral artery courses lateral to the C1-2 joint. However, in about 20% of the cases with complex congenital craniovertberal junction anomalies the artery crosses the joint posteriorly. The artery in such cases may be injured while joint manipulation and instrumentation with disastrous consequences...
April 26, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29701428/anaesthetic-management-in-a-duchennne-muscle-dystrophy-patient-for-treatment-of-recurrent-pneumothorax
#18
Sara Mota, Liuba Germanova, Joana Cortesão, Teresa Paiva
INTRODUCTION: Duchenne muscular dystrophy (DMD) is an x linked recessive disorder. Long term prognosis is ominous, with development of respiratory distress and cardiomyopathy in advanced stage of the disease and expected death in the teens-to-mid 20s due to respiratory or cardiac failure. Peri-operative management of this patients is challenging due to difficult airway anatomy (macroglossia, limited neck and mandibular mobility). Additionally, they are at risk of developing malignant hyperthermia, rhabdomyolysis and hyperkalemic cardiac arrest when exposed to halogenated inhalational anaesthetics and depolarizing muscle relaxants...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701400/endovascular-treatment-of-carotid-blowout-syndrome
#19
Roger Rodrigues, João Costa, Gabriel Anacleto, Diogo Roriz, Óscar Gonçalves
INTRODUCTION: Carotid blowout syndrome (CBS) is a life threatening complication associated with head and neck cancers (HNC) and its treatment. The mortality rate was reported to range from 3% to over 50% in the literature. Direct surgical repair of the ruptured internal carotid artery is often not technically possible due to the difficult anatomy and underlying poor co-morbid status. Endovascular techniques such as coil embolization and stent grafting offer an alternative to surgical ligation with better patient outcomes...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29685536/a-subjective-and-objective-comparison-of-tissue-contrast-and-imaging-artifacts-present-in-routine-spin-echoes-and-in-iterative-decomposition-of-asymmetric-spin-echoes-for-soft-tissue-neck-mri
#20
Subhendra N Sarkar, David B Hackney, Robert L Greenman, Behroze A Vachha, Emelia A Johnson, Sue Nagle, Gul Moonis
OBJECTIVE: FSE sequences play key roles in neck MRI despite the susceptibility issues in neck region. Iterative decomposition of asymmetric echoes (IDEAL, GE) is a promising method that separates fat and water images resulting in high SNR and improved fat suppression. We tested how neck tissue contrasts, image artifacts and fat separation as opposed to fat suppression in terms of image quality compare between routine and IDEAL FSE. METHODS: IDEAL based and routine T1 and T2 -weighted FSE sequences were applied for neck MRI at 1...
May 2018: European Journal of Radiology
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