Search results for "microsurgery"

Transconjunctival sutureless 25-Gauge versus 20-Gauge standard vitrectomy: correlation between corneal topography and ultrasound biomicroscopy measur…

2009

Purpose: To determine the correlation between corneal shape changes and ultrasound biomicroscopy (UBM) findings at the sclerotomy sites in conventional 20-gauge (G) pars plana vitrectomy (PPV) and 25-G transconjunctival sutureless vitrectomy (TSV) and to compare the effectiveness of the two surgical methods. Design: Prospective, comparative, observational case series. Methods: Sixty consecutive eyes (60 patients) undergoing primary 3-port PPV. Thirty eyes (30 patients, group 20-G) were treated with 20-G standard PPV and 30 eyes (30 patients, group 25-G) with 25-G TSV. We compared healing of the sclerotomy sites in the two groups. We determined the correlation between corneal shape changes (…

Irradiation Delays Tissue Growth but Enhances Osteogenic Differentiation in Vascularized Constructs.

2018

Background Regenerative medicine is still deficient in the reconstruction after cancer due to impaired vascularization after radiotherapy and due to the need to substitute larger defects after tumor excision. Aiming at introducing regenerative medicine for reconstruction after cancer, we tested an axially vascularized bone construct in an experimental setting that mimics the clinical situation after tumor resection and adjuvant radiotherapy. Methods Twenty bone constructs were axially vascularized using microsurgically created arteriovenous loops and were implanted subcutaneously in Lewis rats. After 2 weeks, the animals were randomly allocated either to receive a clinically relevant singl…

Lymphoscintigraphy for the diagnosis of extremity lymphedema: Current controversies regarding protocol, interpretation, and clinical application

2019

Appropriate diagnosis, staging and a further selection of the best treatment are fundamental for the management of patients with extremity lymphedema. Several clinical and imaging tools have been described for these purposes. Lymphoscintigraphy is still considered the gold standard imaging modality for diagnosing lymphedema. However, protocol variability and poor image resolution can make the interpretation challenging. Here, we reviewed technical aspects of lymphoscintigraphy, interpretation of the lymphoscintigraphy findings, staging, and its clinical application.

Botulinum toxin in preparation of oral cavity for microsurgical reconstruction.

2010

CONCLUSIONS: Infiltration of botulinum toxin in the major salivary glands allows a temporary reduction of salivation that begins 8 days afterwards and returns to normal within 2 months. The inhibition of salivary secretion, carried out before the oral cavity reconstructive surgery, could allow a reduction of the incidence of oro-cutaneous fistulas and local complications. OBJECTIVES: Saliva stagnation is a risk factor for patients who have to undergo reconstructive microsurgery of the oral cavity, because of fistula formation and local complications in the oral cavity. The authors suggest infiltration of botulinum toxin in the major salivary glands to reduce salivation temporarily during th…

Porcine Model for Internal Mammary Vessels Harvesting

2018

Recipient vessels selection is crucial for successful microsurgical breast reconstruction. The internal mammary vessels (IMVs) have gained great popularity, and they are often selected as first choice recipient vessels. The IMVs can be exposed for microvascular anastomosis through a rib-removing (trans-costal) or a rib-sparing (intercostal) approach.1–3 Because the vessels are located between the rib cage and the parietal pleura, adequate training is needed to avoid and eventually manage bleedings and pleural perforation. This training is better performed in a nonhuman model. Our aim was to investigate the pig as a surgical model for IMVs harvesting to be used in training.

Transanal Endoscopic Microsurgery for T1 and T2 Rectal Cancers: A Meta–Analysis and Meta-Regression Analysis of Outcomes

2011

The objective of this study is to assess transanal endoscopic microsurgery (TEM) as a surgical strategy for stage I rectal cancer. The literature lacks level I and level II evidence of the oncologic competence of TEM. Three randomized controlled, one prospective, and seven retrospective comparative studies were evaluated. End-points included perioperative outcomes, margin involvement, disease-free and overall survival, and recurrence. The number of patients with major (odds ratio (OR) = 0.24,95% confidence interval (CI) 0.07–0.91) and overall postoperative complications (OR = 0.16, 95% CI 0.06-0.38) were significantly lower in TEM. The disease-free survival was higher in standard resection…

Diagnosis and therapy of vestibular schwannoma.

2009

MRI studies are of paramount importance for diagnosis and follow-up measurements during conservative and postinterventional management of vestibular schwannomas (VS). MRI findings that convey important information for hearing-preservation VS surgery are: length of tumor-cochlear nerve contact, involvement of the internal auditory canal, incomplete filling of internal auditory canal, tumor size less than 15 mm and the intralabyrinthine signal intensity on 3DFT-CISS gradient-echo images. Functional neuro-otologic studies of facial nerve function, hearing and vestibular/balance function provide a valuable means of assessment of the actual impairment of the functional status of the VS patient. …

The impact of sacral root anatomy on selective electrical stimulation for bladder evacuation.

1998

Although different structures have been studied with electrostimulation to elicit bladder evacuation, only the sacral root remains feasible for clinical application at present. However, the resultant concomitant contractions of the bladder and sphincteric muscles have been the principal problem over the last few decades. Attempts to identify fibers within the sacral ventral root that innervate the detrusor predominantly have been made by microsurgery alone or in combination with advanced electrical blocking techniques. This article evaluates our past and present efforts to achieve voiding in light of the mixed nature of sacral root anatomy.

2021

Patients with unilateral vocal fold cancer (T1a) have a favorable prognosis. In addition to the oncological results of CO2 transoral laser microsurgery (TOLMS), voice function is among the outcome measures. Previous early glottic cancer studies have reported voice function in patients grouped into combined T stages (Tis, T1, T2) and merged cordectomy types (lesser- vs. larger-extent cordectomies). Some authors have questioned the value of objective vocal parameters. Therefore, the purpose of this exploratory prospective study was to investigate TOLMS-associated oncological and vocal outcomes in 60 T1a patients, applying the ELS protocols for cordectomy classification and voice assessment. P…

Mesencephalic ependymal cysts: treatment under pure endoscopic or endoscope–assisted keyhole conditions

2008

Object Primary intracranial ependymal cysts are extremely rare. Similar to congenital intraparenchymal cysts in the mesencephalon they usually occur with symptoms of an occlusive hydrocephalus or symptoms like Parinaud syndrome, dizziness, or gait disturbance. The objective of this study was to evaluate the surgical methods for the treatment of these cysts and the clinical outcome of the patients. Methods The authors present the clinical records of 8 patients who were treated in their department for symptomatic mesencephalic ependymal cysts in the past 10 years. The patient age ranged from 22 to 60 years with a mean age of 44 years. In 4 cases the authors performed a suboccipital infratent…