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Diabetic Neuropathy
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
Carpal tunnel syndrome should be treated as early as possible. Prior to treatment, patients can take breaks from work to rest the hands, avoid activities that worsen symptoms, and use ice packs to reduce inflammation. Other options include wrist splinting, medications, and surgery. Patients are advised to see their physician if there is numbness in the hands. Medications include NSAIDs and injected corticosteroids. For severe or nonresponsive symptoms, there are two surgical techniques. In endoscopic surgery, an endoscope allows visualization of the inside of the carpal tunnel, and the ligament is cut via one or two small incisions. Endoscopic surgery causes less pain than the other technique, which is open surgery.
Achilles disorders
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Maneesh Bhatia, Nicholas Eastley, Kartik Hariharan
To eliminate its local compressive effects on the AT several groups have advocated the surgical division of the Plantaris tendon. This can be performed during open or endoscopic surgery and has shown promising results with improved pain and function reported (24).
Head and Neck Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Lorcan O’Toole, Nicholas D. Stafford
This is not an HNC but a locally aggressive benign tumor usually found in the nasal cavity with a high risk of post-treatment recurrence if subperiosteal resection is not undertaken. Endoscopic surgery is increasingly being used. However approximately 5% will be found to have undergone malignant change with foci of squamous cell carcinoma seen on histological inspection post-resection.
Cost-effectiveness analysis of intradiscal condoliase injection vs. surgical or conservative treatment for lumbar disc herniation
Published in Journal of Medical Economics, 2023
Shu Takaki, Hiroshi Miyama, Motoki Iwasaki
The estimated medical costs for surgery were 953,985 yen for open surgery, 839,645 yen for endoscopic surgery, and 30,252 yen for two postoperative follow-ups (detailed summary in Table S3, Supplementary Material). Adverse-event related medical costs were estimated at 13,436 yen for open surgery and 2,286 yen for endoscopic surgery (Table 7). For each adverse event, we assumed the following: dural injury, no increase in medical costs other than intraoperative material costs for both procedures; caudal disorder, hospital stay increased by 28 days for both procedures; nerve root disorder, hospital stay increased by 7 days for both procedures; postoperative hematoma, hospital stay increased by 10 days for both procedures; deep wound infection, hospital stay increased by 28 days for both procedures; tooth damage, crown fractures that do not require nerve treatment and require two outpatient treatments; misidentification of level for endoscopic surgery, no additional medical costs due to intraoperative correction; articular process fracture for endoscopic surgery, pain persists for 1 month and is followed up with analgesics; conversion to open surgery from endoscopic surgery, no additional medical cost is incurred because the reimbursement score for endoscopy is higher and the higher reimbursement score is adopted (detailed summary in Table S4, Supplementary Material).
Surgical outcomes in patients with endoscopic versus transcranial approach for skull base malignancies: a 10-year institutional experience
Published in British Journal of Neurosurgery, 2022
John W. Rutland, Corey M. Gill, Travis Ladner, David Goldrich, Dillan F. Villavisanis, Alex Devarajan, Akila Pai, Amir Banihashemi, Brett A. Miles, Sonam Sharma, Priti Balchandani, Joshua B. Bederson, Alfred M. Iloreta, Raj K. Shrivastava
Open transcranial surgery remains the gold standard for resection of skull base malignancies, despite considerable morbidity and long recovery time.1 In the present study, we assess surgical outcomes of patients with skull base malignancies who were treated with open or purely endoscopic resection at our institution over the last 10 years. At the authors’ institution, the authors have moved almost entirely to an endoscopic approach for those cases in which there is single anatomic involvement without distant metastasis. Advantages of endoscopic surgery include reduced bony disassembly and brain retraction, and absence of external scars. In the context of skull base cancers in particular, endoscopic surgery may offer an opportunity to shorter the interval between surgery and prompt adjuvant radiotherapy due to shorter postoperative recovery times as compared with transcranial surgery. Given that a purely endoscopic approach to large skull base malignancies remains controversial due concern regarding the ability to achieve negative margins endoscopically, and that many centers maintain that a traditional open approach is required for gross total resection, the present study aimed to evaluate surgical and oncological outcomes in a matched series of open and endoscopic tumors. Results from this study further compare outcomes of different surgical approaches, which may useful as paradigms for skull base malignancy surgery shift away from open transcranial surgery and towards endoscopic procedures.
Nerve root entrapment with pseudomeningocele after percutaneous endoscopic lumbar discectomy: A case report
Published in The Journal of Spinal Cord Medicine, 2020
Wei Shu, Haipeng Wang, Hongwei Zhu, Yongjie Li, Jiaxing Zhang, Guang Lu, Bing Ni
The aim of surgical treatment is to dissect the tethering nerve roots and to repair the dural defect. Endoscopic surgery could be used to explore the surgical site, distinguish etiology and provide uncomplex treatment. For this case, endoscopic surgery provides a helpful visual angle to observe the pseudomeningocele at the ventrolateral of the dural sac which would be probably broken in the traditional surgery. However, untethering and suturing are much more difficult to complete under an endoscope, the microsurgical technique is the preferred approach for entrapped nerve root. Any entrapped nerve root should be freed and relocated into the dura. Either Gelfoam or muscle alone placed over the dural breach is ineffective in stopping the leak. Use of non-absorbable suture to close the dural defect is recommended. In addition, artificial dura, tissue glue, free fat grafts and myofascial grafts have also been used to enhance the dura.16