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Gi Soo Lee, Alexandra Irace, Reza Rahbar
OBJECTIVE: To report the use of flexible fiber CO2 laser in the endoscopic management of pediatric airway cases. METHODS: A retrospective review was conducted of patients who underwent CO2 laser-assisted airway procedures between September 2007 and January 2014 at a tertiary pediatric hospital. RESULTS: Sixty-eight patients underwent 80 procedures utilizing flexible fiber CO2 laser. Procedures included supraglottoplasty (n = 32), laryngeal cleft repair (type I [n = 10], type II [n = 7], type III [n = 6]), suprastomal granuloma excision (n = 6), cordotomy (n = 4), laryngeal neurofibroma excision (n = 4), laryngeal granulomatous mass excision (n = 1), subglottic stenosis excision (n = 6), division of glottic web (n = 2), subglottic cyst excision (n = 1), and supraglottic biopsy (n = 1)...
June 2017: International Journal of Pediatric Otorhinolaryngology
A Vedantam, P Hou, T L Chi, K R Hess, P M Dougherty, E Bruera, A Viswanathan
BACKGROUND AND PURPOSE: There are limited data on the use of postoperative imaging to evaluate the cordotomy lesion. We aimed to describe the cordotomy lesion by using postoperative MR imaging in patients after percutaneous cordotomy for intractable cancer pain. MATERIALS AND METHODS: Postoperative MR imaging and clinical outcomes were prospectively obtained for 10 patients after percutaneous cordotomy for intractable cancer pain. Area, signal intensity, and location of the lesion were recorded...
April 2017: AJNR. American Journal of Neuroradiology
Aditya Vedantam, Ping Hou, Linda Chi, Patrick M Dougherty, Ashwin Viswanathan
No abstract text is available yet for this article.
August 1, 2016: Neurosurgery
Aditya Vedantam, Ping Hou, T Linda Chi, Patrick M Dougherty, Kenneth R Hess, Ashwin Viswanathan
BACKGROUND: Up to 20% of patients experience only partial pain relief after percutaneous cordotomy for cancer pain. OBJECTIVE: To determine whether diffusion tensor imaging (DTI) can quantify neural ablation and help evaluate early postoperative outcomes after cordotomy. METHODS: Patients undergoing percutaneous CT-guided cordotomy for intractable cancer pain were prospectively studied. Pre- and postoperative assessment was made using the visual analog scale (VAS) on pain and the pain severity scores of the Brief Pain Inventory Short Form...
2017: Stereotactic and Functional Neurosurgery
T M Shepherd, M J Hoch, B A Cohen, M T Bruno, E Fieremans, G Rosen, D Pacione, A Y Mogilner
Palliative cervical cordotomy can be performed via percutaneous radiofrequency ablation of the lateral C1-2 spinothalamic tract. This rare procedure can be safe, effective, and advantageous in mitigating medically intractable unilateral extremity pain for selected patients with end-stage cancer. This report reviews the indications, techniques, risks, and potential benefits of cordotomy. We describe our recent experience treating 3 patients with CT-guided C1-2 cordotomy and provide the first characterization of spinal cord diffusion MR imaging changes associated with successful cordotomy...
November 3, 2016: AJNR. American Journal of Neuroradiology
Matthew R Naunheim, Phillip C Song, Ramon A Franco, Blake C Alkire, Mark G Shrime
OBJECTIVES/HYPOTHESIS: Endoscopic management of bilateral vocal fold paralysis (BVFP) includes cordotomy and arytenoidectomy, and has become a well-accepted alternative to tracheostomy. However, the costs and quality-of-life benefits of endoscopic management have not been examined with formal economic analysis. This study undertakes a cost-effectiveness analysis of tracheostomy versus endoscopic management of BVFP. STUDY DESIGN: Cost-effectiveness analysis. METHODS: A literature review identified a range of costs and outcomes associated with surgical options for BVFP...
March 2017: Laryngoscope
Toshitaka Seki, Kazutoshi Hida, Shunsuke Yano, Takeshi Aoyama, Izumi Koyanagi, Toru Sasamori, Shuji Hamauch, Kiyohiro Houkin
STUDY DESIGN: Retrospective study. PURPOSE: To obtain information useful in establishing treatment guidelines by evaluating baseline clinical features and treatment outcomes of patients with spinal cord astrocytoma (SCA). OVERVIEW OF LITERATURE: The optimal management of SCA remains controversial, and there are no standard guidelines. METHODS: The study included 20 patients with low-grade and 13 with high-grade SCA surgically treated between 1989 and 2014...
August 2016: Asian Spine Journal
Aditya Vedantam, Ping Hou, Linda Chi, Patrick M Dougherty, Ashwin Viswanathan
INTRODUCTION: Percutaneous cordotomy for intractable cancer pain has variable efficacy. One potential cause is the inability to quantify neural ablation. Diffusion tensor imaging (DTI) can quantify microstructural changes within the spinal cord after neural injury. We aimed to determine if DTI metrics within the spinal cord could quantify neural ablation and evaluate early postoperative outcomes. METHODS: This prospective study was performed on patients undergoing percutaneous CT-guided cordotomy for unilateral intractable cancer pain...
August 2016: Neurosurgery
Min Zhu, Jinrang Li, Hongguang Guo
OBJECTIVE: To investigate the feasibility and efficacy of CO2 laser assisted posterior cordotomy for patients with bilateral paralysis of the vocal cord. METHOD: Twenty-one patients with bilateral paralysis of the vocal cord underwent CO2 laser assisted posterior cordotomy in our hospital from Jul. 2009 to Jun. 2015. The causes of the bilateral paralysis of the vocal cord were thyroidectomy in 15 cases, cervical trauma in 2 cases, resection of pituitary tumor in 1 case, inflammation in 1 case and without cause in 2 cases...
March 2016: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
K Ruf, S Hackenberg, F Kraus, J Wirbelauer, E Frieauff, R Hagen, S Kunzmann
No abstract text is available yet for this article.
July 2016: Klinische Pädiatrie
M B Asik, O Karasimav, H Birkent, A L Merati, M Gerek, Y Yildiz
OBJECTIVES: Carbon dioxide laser posterior transverse cordotomy is a common option for bilateral vocal fold paralysis. This study prospectively evaluated aerodynamic and acoustic effects of unilateral carbon dioxide laser posterior transverse cordotomy in bilateral vocal fold paralysis patients. METHODS: The study comprised 11 bilateral vocal fold paralysis patients (9 females, 2 males), with a mean age of 46.6 ± 14.1 years. All patients were treated by laser posterior transverse cordotomy...
April 2016: Journal of Laryngology and Otology
Ali Dalgic, Murat Caliskan, Pinar Can, Fatih Alagoz, Yahya Guvenc, Ayhan Ocakcioglu, Oktay Algin, Ergun Daglioglu, Esra Erden, Omer Besalti, Deniz Belen
AIM: Interventional pain therapies are usually based on destruction of the related pain-conducting pathways. Current procedures targeting pain have replaced conventional pain treatment modalities while being less invasive. In this study, we investigated the feasibility of the endoscopic percutaneous cordotomy process on the sheep cervical spinal cord. MATERIAL AND METHODS: Seven male sheep, Akkaraman® genus, were operated on in the study. The guide was introduced at C1 to C2 vertebrae...
2016: Turkish Neurosurgery
Edward J Damrose, Daniel M Beswick
Posterior glottic stenosis is a difficult clinical problem that frequently results in bilateral vocal fold immobility, dyspnea, and tracheostomy dependence. Charts were reviewed of all patients undergoing a modified endoscopic postcricoid advancement flap procedure for posterior glottic stenosis between October 1, 2003, and June 30, 2015. Age, sex, operative findings, complications, and outcomes were noted. Follow-up was available in 10 of 11 patients, 10 of whom were successfully decannulated. There were no complications...
March 2016: Otolaryngology—Head and Neck Surgery
Toshitaka Seki, Kazutoshi Hida, Syunsuke Yano, Takeshi Aoyama, Izumi Koyanagi, Kiyohiro Houkin
STUDY DESIGN: A retrospective study. PURPOSE: The purpose of this study was to obtain useful information for establishing the guidelines for treating high-grade spinal cord gliomas. OVERVIEW OF LITERATURE: The optimal management of high-grade spinal cord gliomas remains controversial. We report the outcomes of the surgical management of 14 high-grade spinal glioma. METHODS: We analyzed the outcomes of 14 patients with high-grade spinal cord gliomas who were surgically treated between 1989 and 2012...
December 2015: Asian Spine Journal
Petros D Karkos, Marios Stavrakas
BACKGROUND: For more than 25 years, posterior laser transverse cordotomy has been generally considered the ideal endoscopic minimally invasive procedure of choice for bilateral vocal fold immobility. The main drawback of this procedure, when compared to more aggressive "glottic aperture improvement" operations, is the high revision rates, caused by granulations, adhesion, and scar, for example. METHODS: We describe a technique using a combination of conventional and flexible lasers...
May 2016: Head & Neck
Petra Vayne-Bossert, Banafsheh Afsharimani, Phillip Good, Paul Gray, Janet Hardy
PURPOSE: Pain is the most common symptom in cancer patients. Standard pain treatment according to the WHO three-step analgesic ladder provides effective pain management in approximately 70-90% of cancer patients. Refractory pain is defined as not responding to "standard" treatments. Interventional analgesic techniques can be used in an attempt to control refractory pain in patients in whom conventional analgesic strategies fail to provide effective pain relief or are intolerable due to severe adverse effects...
March 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Faisal R Jahangiri
This case illustrates the benefits of utilizing intraoperative neurophysiological monitoring (IONM) for preventing injury to sensory/motor pathways of the spinal cord during a cordotomy procedure to relieve pain. Cordotomy has been used effectively in the treatment of visceral pain but comes with a high risk of damaging motor and sensory pathways due to close proximity of lesion. The subject is a 47-year-old female with a pancoast tumor of the left lung, left brachialplexopathy, and severe neuropathic pain syndrome, refractory to medical therapy...
September 2015: Neurodiagnostic Journal
Ekin Ermiş, Mark Teo, Karen E Dyker, Chris Fosker, Mehmet Sen, Robin Jd Prestwich
INTRODUCTION: A wide variety of fractionation schedules have been employed for the treatment of early glottic cancer. The aim is to report our 10-year experience of using hypofractionated radiotherapy with 55Gy in 20 fractions at 2.75Gy per fraction. METHODS: Patients treated between 2004 and 2013 with definitive radiotherapy to a dose of 55Gy in 20 fractions over 4 weeks for T1/2 N0 squamous cell carcinoma of the glottis were retrospectively identified. Patients with prior therapeutic minor surgery (eg...
September 23, 2015: Radiation Oncology
Erich Talamoni Fonoff, William Omar Contreras Lopez, Ywzhe Sifuentes Almeida de Oliveira, Manoel Jacobsen Teixeira
OBJECTIVE: The aim of this study was to show that microendoscopic guidance using a double-channel technique could be safely applied during percutaneous cordotomy and provides clear real-time visualization of the spinal cord and surrounding structures during the entire procedure. METHODS: Twenty-four adult patients with intractable cancer pain were treated by microendoscopic-guided percutaneous radiofrequency (RF) cordotomy using the double-channel technique under local anesthesia...
February 2016: Journal of Neurosurgery
Ahmed Geneid, Heikki Rihkanen, Teemu J Kinnari
In this study, we aimed to assess the long-term effects of the mucosal layer plastic surgery of the vocal folds performed on the voices of male-to-female transgenders. This retrospective cohort study enrolled 22 patients who were operated during 2004-2010 by a combined technique of transmucosal anterior suturing and stiffening of the vocal folds through a longitudinal cordotomy incision using CO2 laser. Long-term effects were assessed based on completed questionnaires on four different categories including subjective evaluation of patient's own voice perception and a standardized voice inventory (VHI), as well as an acoustic assessment and videolaryngoscopic examination...
December 2015: European Archives of Oto-rhino-laryngology
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