Search results for "Operative"
showing 10 items of 2781 documents
The influence of surgical experience on the rate of intraoperative aneurysm repture and its impact on aneurysm treatment outcome.
2001
Abstract BACKGROUND The influence of surgical experience on the result of aneurysm surgery remains unclear. To determine the impact of surgical experience we considered the occurrence of intraoperative aneurysm rupture (IAR) during microneurosurgery for intracranial aneurysms as an objective factor that could be evaluated. METHODS A retrospective study was performed on 379 consecutive patients with 490 cerebral aneurysms operated upon from 1989 to 1995. RESULTS IAR occurred in 6.7% of aneurysms and 8.7% of patients. There was a direct inverse relationship between the annual caseload of the surgeon and the risk of IAR. New neurological deficits (NND) occurred in 21% of patients with IAR, whi…
Spinal cord monitoring during intraspinal extramedullary tumor operations (Peroneal nerve evoked responses)
1990
Longterm scalp recording of early SEP components triggered by peroneal or tibial nerve stimulation detects functional disturbances of spinal cord transmission due to mechanical trauma. We confirm previous observations that preoperative SEP patterns reflect neurological deficits and clearly show functional disturbances even on the side where they are not manifest. Peroneal nerve SEP have a well-known P40-peak corresponding to activities of neurons at the postcentral cortical layers. The P40-peak was identified in only 55% of our recordings. We therefore, tried to use the P50-peak that could be identified in 100% of the recordings under the difficult recording circumstances in the operating r…
Development and external validation of a clinical prediction model for functional impairment after intracranial tumor surgery
2021
OBJECTIVE Decision-making for intracranial tumor surgery requires balancing the oncological benefit against the risk for resection-related impairment. Risk estimates are commonly based on subjective experience and generalized numbers from the literature, but even experienced surgeons overestimate functional outcome after surgery. Today, there is no reliable and objective way to preoperatively predict an individual patient’s risk of experiencing any functional impairment. METHODS The authors developed a prediction model for functional impairment at 3 to 6 months after microsurgical resection, defined as a decrease in Karnofsky Performance Status of ≥ 10 points. Two prospective registries in…
Optical coherence tomography of macular thickness after biaxial vs coaxial microincision clear corneal cataract surgery
2009
PURPOSE To evaluate macular thickness changes after biaxial microincision versus coaxial small incision cataract surgery using optical coherence tomography (OCT). METHODS This prospective, randomized, marked study comprised 70 patients (70 eyes) undergoing biaxial microincision surgery or conventional coaxial phacoemulsification. Patients were evaluated by Stratus OCT preoperatively and 1 day, 4 weeks, and 8 weeks postoperatively. Best-corrected visual acuity (BCVA), phacoemulsification power, and effective phacoemulsification time (EPT) were evaluated. RESULTS In the biaxial group, median foveal thickness changed from 160 microm preoperatively to 168 microm 8 weeks postoperatively (p=0.018…
Optic nerve decompression in trauma and tumor patients
1999
Optic nerve decompression is a procedure that is now receiving increasing clinical attention. However, there are currently no standardized treatment protocols in the therapy of traumatic or pressure insults to the nerve. The present retrospective study was designed to report our experience with microscopic endonasal transethmoid-sphenoid optic nerve decompression in 24 unilateral trauma cases and 11 unilateral skull base tumor patients. In general preoperative visual acuities in the trauma patients were worse than in the tumor patients. Following surgery, 9 of 11 tumor patients (82%) had at least some improvement of their vision, including 5 complete recoveries. In the group with traumatic …
Incidence of posterior vitreous detachment after cataract surgery
2009
Purpose To report the incidence of posterior vitreous detachment (PVD) after uneventful state-of-the-art small-incision phacoemulsification with implantation of a posterior chamber intraocular lens (PC IOL). Setting Department of Ophthalmology, Ludwigshafen Hospital, Ludwigshafen, Germany. Methods This prospective study evaluated the vitreous status of eyes by biomicroscopic examination, indirect binocular ophthalmoscopy, and B-scan ultrasonography before planned cataract surgery. Patients with the posterior vitreous attached were included for follow-up and examined 1 week, 1 month, and 1 year after uneventful phacoemulsification with PC IOL implantation. The preoperative prevalence and pos…
Giant olfactory groove meningiomas: extent of frontal lobes damage and long-term outcome after the pterional approach.
2010
The treatment of giant olfactory groove meningiomas (OGMs; maximum diameter ≥ 6 cm) poses special problems and represents a surgical challenge. We discuss the long-term results in a series of 18 patients with giant OGMs and report our experience on a global strategy encompassing the pterional approach to manage the lesion and an extended transbasal approach to treat recurrences.Between February 1991 and December 2007, 18 patients with giant OGMs were surgically managed via a pterional craniotomy. Postoperative follow-up imaging was obtained at one, six, and 12 months and then yearly. In preoperative images, data from tumor volume were assessed. The volume of the residual right frontal poren…
Prediction of postoperative facial swelling, pain and trismus following third molar surgery based on preoperative variables
2012
Objective: This paper investigates the relationship between preoperative findings and short-term outcome in third molar surgery. Study design: A prospective study was carried out involving 80 patients who required 160 surgical extractions of impacted mandibular third molars between January 2009 and December 2010. All extractions were performed under local anesthesia by the same dental surgeon. Swelling and maximal inter-incisor distance were measured at 48 h and on the 7th day postoperatively. Mean visual analogue pain scores were determined at four different time periods. Results: One-hundred eight (67.5%) of the 160 extractions were performed on male subjects and 52 (32.5%) were performed…
Efficacy of naproxen with or without esomeprazole for pain and inflammation in patients after bilateral third molar extractions: a double blinded cro…
2017
Background Using a double-blinded randomized crossover design, this study aimed to evaluate acute postoperative pain management, swelling and trismus in 46 volunteers undergoing extractions of the two lower third molars, in similar positions, at two different appointments who consumed a tablet of either NE (naproxen 500 mg + esomepraz ole 20 mg) or only naproxen (500 mg) every 12 hours for 4 days. Material and Methods Parameters were analyzed: self-reported pain intensity using a visual analog scale (VAS) pre- and postoperative mouth opening; incidence, type and severity of adverse reactions; total quantity consumed of rescue medication; and pre- and postoperative swelling. Results Female v…
Evaluation of Kharma scale as a predictor of lower third molar extraction difficulty
2017
Background The Evaluation of the degree of lower third molar (L3M) extraction difficulty is extremely important for both clinicians and patients. This study aimed to evaluate the validity of a new index (Kharma scale) as a preoperative predictor index of the difficulty of surgical removal of impacted L3M. Material and Methods Extraction difficulty of a series of 49-impacted L3M was predicted preoperatively by Kharma scale, and postoperative difficulty was assessed with a modified Parant scale. Results The sensitivity of Kharma scale, as a predictor of difficulty, was 18.2% and the specificity was 68.4%. Likelihood ratios for the Kharma categories also indicated that the scale is of little v…