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Cosmetic Facial Interventions
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Pre-operative planning should include accurate documentation of patient concerns, medical photographs, a complete ophthalmic assessment and a plan to define and alleviate the anatomical cause of the eyelid abnormality, and an informed discussion. Any additional procedures that may be required such as repositioning of the lacrimal gland, correcting the brow ptosis and lateral canthal procedures should be discussed. Surgery may be carried out under local anaesthetic with sedation or general anaesthetic.
Laparoscopic-Assisted Myomectomy
Published in Rooma Sinha, Arnold P. Advincula, Kurian Joseph, FIBROID UTERUS Surgical Challenges in Minimal Access Surgery, 2020
Rooma Sinha, Bana Rupa, Neha Singh
Approximation and hemostasis of the inner myometrial layers are carried out using interrupted sutures via an intracorporeal suture technique. The serosal layer is finally sutured by inverting the raw edges as in a baseball suture (Figure 8.8a–d). We close the suprapubic incision once the complete uterine reconstruction is achieved. The pneumoperitomeum is re-established and telescope is introduced for a final survey to irrigate the abdominal cavity and check for complete hemostasis (Figure 8.9). All trocars are removed under vision and ports closed (Figure 8.10). In the postoperative period, clear liquids are started in 4–6 h and solid food by 6–8 h. Recovery is quick and most patients are discharged in 24–48 hours after surgery.
Laparoscopic Rectopexy for Rectal Prolapse
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
Sanjiv Haribhakti, Jitender Singh Chauhan
For patients with a history of constipation, an aggressive bowel regimen is maintained for the first 1–2 weeks following surgery to avoid constipation and excessive straining that may lead to recurrence of rectal procidentia. Most patients will be able to return to normal activities, including work, in four weeks after surgery. Heavy lifting or straining of the abdominal and perineal muscles is to be avoided until the muscles are fully healed in approximately a few month's time.
Acute presentation of papillary glioneuronal tumor due to intra-tumoral hemorrhage in a toddler: an odd presentation of a rare pathology
Published in British Journal of Neurosurgery, 2023
Amin Tavallaii, Ehsan Keykhosravi, Hamid Rezaee
After administration of prophylactic antibiotic (Cefalexin) and prophylactic antiepileptic (Phenytoin), a horse-shoe incision was made on right frontal region extending medially to midline and posteriorly to coronal suture. After subgaleal elevation of skin flap, a rectangular craniotomy was performed extending from 1cm anterior to coronal suture 3cm anteriorly and from approximately 1cm off midline 2cm laterally (Figure 2(C)). A U-shaped dural incision was made and dura was reflected medially. After identification of middle frontal gyrus, a small corticotomy and subsequent blunt dissection was performed through white matter fibers with a posterior, inferior and medial trajectory to reach tumor. Yasargil (Leyla) brain retractors were placed to maintain surgical access. Tumor had a thick purple capsule with adjacent yellowish gliotic tissue. Tumor capsule was friable and entered using suction and bipolar cautery. Hemorrhagic fluid contentand blood clots mixed with necrotized tissue were suctioned. Tumor capsule was totally resected using suction and bipolar cautery under microscopic view till the gliotic tissue could be seen in entire periphery of surgical cavity. CSF egression from a small rent into right ventricle frontal horn was encountered during resection of deep medial parts of tumor capsule which was secured with a cotton patty to prevent blood backflow into ventricle. Meticulous hemostasis was achieved using oxidized regenerated cellulose and surgical site irrigation was done. Dura was sutured in a watertight fashion and bone flap was secured in place. Surgery duration was approximately two hours.
The association between upper limb function and variables at the different domains of the international classification of functioning, disability and health in women after breast cancer surgery: a systematic review
Published in Disability and Rehabilitation, 2022
An De Groef, Elien Van der Gucht, Lore Dams, Margaux Evenepoel, Lien Teppers, Julie Toppet–Hoegars, Liesbet De Baets
No less than 8 out of 12 studies investigated the association between treatment-related factors and UL function. Remarkably, no clear associations were identified between applied medical treatments and the subsequent UL function. Clear associations may not have been detected due to complexity and heterogeneity of the (combinations of) treatment modalities for breast cancer. With breast cancer treatment becoming more personalized, different treatment modalities are combined depending on the stage and type of cancer. In particular for the topic of this review, different surgical approaches and radiotherapy modalities may affect UL function in different ways. Patient and treatment characteristics of the included studies are indeed highly variable and heterogeneous (Table 1). Assis et al. was e.g., the only study including women with bilateral surgery [30] and two studies did not exclude women with a history of shoulder pathologies [30,31]. Another explanation may be the variable time after surgery the included studies took place. Time after surgery ranged from 6 months up to 6 years after surgery. Questions may raise to which extent treatment-related variables are relevant and attributable to UL function at these time points post-surgery.
Role of laryngopharyngeal reflux (LPR) in complications after tonsillectomy in adult patients
Published in Acta Oto-Laryngologica, 2021
Jie Tan, Xueshi Li, Yixin Zhao, Yuguang Wang, Jinxia Shen, Lihong Zhang, Lin Han, Lisheng Yu
Of the 150 patients, 79 were male and the other 71 were female. There were 68 patients (45.3%) who had LPR and they constituted the LPR group. The remaining 82 patients (54.7%) did not have LPR and formed the control group. The mean age was 34.67 years (SD 2.59) in the LPR group and 32.86 years (SD 2.77) in the control group. There were no differences between the groups with regard to age or gender distribution. The average BMI was 27.9 in the LPR group and 21.6 in the control group, respectively. There was a significant statistical (p < .05) for this difference. All patients accepted the surgery of tonsillectomy under general anesthesia that was performed by an experienced surgeon using the low-temperature plasma knife. During surgery, two-sided tonsils were excised and a rigorous and carefully hemostatic procedure was performed. We observed and compared the postoperative complications of the two groups. The evaluated complications were pain, hemorrhage, fever, infection, and pulmonary problems. The pain was assessed using a visual analog scale (VAS) completed by the patients themselves on the first day, the 7th day, and the 14th day after surgery, respectively. Both the bleed events and severity of the bleeds were classified according to the Flinders modification (Table 3) of the original Stammberger classification system. Other complications were evaluated clinically by the surgeon two weeks after surgery. All the patients had no PPI medication at the time of surgery.