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Diagnosis and Treatment Model of the COVID-19 Rehabilitation Unit
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
CRUs help to reduce various complications because of the guidance of professional trainers and medical staff in the CRU. They can more sensitively pay attention to the complications of patients, such as the formation of deep vein thrombosis of the lower limbs, urinary tract infections, muscle atrophy, osteoporosis, etc., and provide early prevention and treatment. In addition, they can pay attention to patient position management and psychological counseling as soon as possible and can guide patients in comprehensive rehabilitation treatment more comprehensively and systematically. Therefore, they can reduce the healing time of lung inflammation, reduce complications, and reduce mortality.
Fundoplication
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Douglas C. Barnhart, Robert A. Cina
The peritoneum at the junction between the right crus and the esophagus is scored with the electrocautery to allow for a blunt retroesophageal dissection (Figure 28.8). It is helpful to ensure that the preoperatively placed bougie is still in position before proceeding with this dissection. A minimal dissection technique is used, to achieve only what is necessary to safely visualize the pertinent anatomy. It is imperative that the retroesophageal window is made above the left gastric artery, and that the right and left crus can be identified. The fascia overlying the crura should be left intact, and the crura should not be divided. A key technical point during this step is that the dissection be directed transversely, as an oblique dissection can lead to injury of the left crura or left pleural. Surgeons vary in terms of routine placement of crural sutures. We do not advocate routine cruraplasty, reserving this maneuver for the presence of a hiatal hernia. When a cruraplasty is necessary, placement of theses sutures can be facilitated by pulling the bougie in the proximal esophagus to allow for better visualization of this area. This is performed with either 2/0 braided Nylon (Nurolon•) or 2/0 silk on a SKI or BB tapered needle.
Aesthetic
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Under-correction (residual deformity) or overcorrection (new deformity) Saddle deformity. Excessive removal of the dorsal bone and cartilage.Pinched-tip deformity from the fracture of the lateral crura.Supra-tip deformity may be due to several reasons.Inadequate septal dorsal hump reductionInadequate correction of a bulbous tipOver-reduction of the cartilaginous skeleton
Paraconduit hernia after minimally invasive esophagectomy – incidence and risk factors
Published in Scandinavian Journal of Gastroenterology, 2023
Henriikka Hietaniemi, Tommi Järvinen, Ilkka Ilonen, Jari Räsänen
The majority (71.4%, N = 10) of the paraconduit hernias in this study were diagnosed more than one year after the esophagectomy, and only one case within 3 months. To prevent early paraconduit hernia in our institution, the graft is sutured to the crura. If the hiatal opening is loose, we perform hiatoplasty at the posterior or anterior hiatus, depending on the anatomy. We also leave most of the omentum to the gastric conduit, which fills up the crura. Some authors greatly advocate for hiatoplasty during esophagectomy, especially anterior hiatoplasty. We believe that these methods could prevent paraconduit hernia formation in the immediate postoperative period. However, no comparative data on the effect of these maneuvers exist. In previous studies, the hernias that appeared early after esophagectomy were associated with high morbidity [29]. To the authors’ knowledge, no data on prevention of late paraconduit hernia have been published, but we believe that prevention of malnutrition, weight loss and cancer recurrence are the most significant factors.
Otosclerosis and stapedotomy: hearing improvement, complications, and analysis of potential prognostic factors in a series of 93 cases
Published in Acta Oto-Laryngologica, 2023
Charlotte Wedel, Niels H. Holm, Frank Mirz, Therese Ovesen
All surgeries were performed under general anaesthesia by one of three ear surgeons trained in the stapedotomy procedure. The small fenestra technique was used, involving Rosen’s incision and elevation of a tympanomeatal flap. The chorda tympany was identified, and a proper view of the facial canal and the stapes footplate was obtained. A 0.5 mm fenestration of the footplate was created using a Lumenis CO2-laser. In two cases, microdrill (Medtronic Xomed Skeeter Drill Ultra-Lite) was used in conjunction with the laser during the stapedotomy. The appropriately sized prosthesis was selected and fitted into the fenestration. The incudo-stapedial joint was separated, and the stapes tendon and the posterior crus of the stapes were severed using a Lumenis CO2 laser. The anterior crus was then divided. The prostheses used were either Fisch Piston, Kurz Titanium Matrix or Kurz Angular Piston (in the case of revision surgery).
Efficacy of vertical lid split versus lateral canthotomy and cantholysis in the management of orbital compartment syndrome
Published in Orbit, 2021
Julia Elpers, Christopher Areephanthu, Peter J. Timoney, William R. Nunery, H.B. Harold Lee, Roxana Fu
Orbital compartment syndrome necessitates emergent intervention to prevent permanent vision loss.6,7 The lateral canthotomy and cantholysis (LC/C) is considered the gold standard treatment to decompress the orbit.4,6-10 Lateral canthotomy is performed by horizontally incising the lateral canthus, then cantholysis is performed by feel to transect the inferior crus of the lateral canthal tendon.7 Transection of the superior crus is also often required for adequate decompression.4 Classic teaching is that OCS is a clinical diagnosis, and intervention should not be delayed to obtain imaging or to transfer the patient.11 In the acute setting, as in traumatic retrobulbar hemorrhage, emergency medicine physicians are the first line of defense against blindness due to OCS.