1,720,994 research outputs found
In response to barbed stayed bridge pharyngoplasty (BSBP)
No full textThe strength of BSBP is its total preservative approach with the longitudinal reinforcement of the palatopharyngeal muscle (PPM) with barbed sutures. The remodeling of the palatal system, compared to a cable-stayed bridge, provides an acceptable stiffness combined with higher stability. The other essential step is to leave intact the PPM giving the chance of repeatable surgery considering the developmental reduction of muscular tone during the life
The (templar) knight cap: a new and simple way to prevent hair interference during ear surgery
No full textHair interference is a critical problem in ear surgery. The hair around the surgical area can get stuck unwantedly, making the surgeon habitually struggling with this hair rather than the surgery itself. Hair shaving can cause psychological discomfort, especially for women and data about shaving efficacy are conflicting. With the aim of solving this problem, we developed a new way to clear hair from the operating field named "The (Templar) Knight cap"
Barbed stayed bridge pharyngoplasty (BSBP)
No full textObstructive sleep apnea (OSA) is a chronic disease characterized by recurrent episodes of upper airway collapse and obstruction of the upper airways during sleep.
The gold standard of treatment is continuous positive airway pressure (CPAP), with limited long-term patient
compliance.1 Velo-pharyngeal surgery is a validated treatment option for OSA patients diagnosed with retrovelar and oropharyngeal collapse.
Vicini first proposed the Barbed Reposition Pharyngoplasty (BRP) technique,2 using barbed sutures to increase the cross section of the retropalatal area and oropharyngeal inlet, stiffening the pharyngeal lateral wall.
This mini-invasive technique requires the removal of the “fat pad” area and a section of the palatopharyngeal muscle (PPM) in their inferior portion.
Continuous solicitation of a single vector during palatal activities may weaken the system, inducing a recurrence of pharyngeal collapse. Reoperation is not easy
since the PPM has been transected. Therefore, the authors propose a modified BRP called Barbed Stayed Bridge Pharyngoplasty (BSBP)
New non-invasive electrical stimulation devices for treatment of snoring and obstructive sleep apnoea: a systematic review
No full textIntroduction: Recently, new non-invasive electrical stimulation devices have been developed with the aim to increase the tongue muscle tone for patients with obstructive sleep apnoea (OSA) and snorers. The aim of this study was to provide a review of the first results found in the literature regarding the efficacy of non-invasive electric stimulation devices for the treatment of primary snoring and OSA. Material and Methods: An electronic search was performed on PubMed/MEDLINE, Google Scholar, and Ovid databases. The PRISMA statement was followed. Databases were searched from inception through September, 2021. Results: Four studies met the criteria for inclusion in this review, for a total of 265 patients. Two devices were included in this review, Apone-Stim 400 Muscle Stimulator and eXciteOSA. All studies suggested that these new devices are effective in improving snoring by approximately 50% after device training, without major complications. However data regarding OSA improvement are conflicting. Conclusions: Intraoral non-invasive electrical stimulation devices can be considered a valid option to current therapies for snoring. Further studies are needed to support these interesting new devices for treatment of OSA
L’importanza del lavaggio nasale per l’igiene quotidiana delle fosse nasali in età pediatrica.
No full textMESNA for chemically assisted tissue dissection
No full textImportance of the field: To date, surgical dissection is based only on mechanical forces. The use of a chemical product that is able to ease tissue dissection represents an important advance. MESNA (sodium-2- mercaptoethanesulfonate) has recently been validated for chemically assisted tissue dissection during surgery or invasive procedures. No other drugs are available for this. Areas covered in this review: An extensive literature search was conducted that included published articles and abstracts on the use of MESNA during surgery or invasive procedures in the experimental and clinical setting, since 1997. Clinically validated settings are ear, nose and throat (ENT), gynecological and orthopedic fields. What the reader will gain: A state-of-the-art overview of intraoperative applications of MESNA, and a consideration of the possible mechanisms underlying chemically assisted tissue dissection. Take home message: MESNA has been successfully used to ease abdominal myomectomies and excision of endometrial cysts; in ENT surgery, topical MESNA could be widely used, from ear and skull base to head and neck diseases, in both outpatient and operating-room settings. In revision lumbar spine surgery, its use resulted in significantly easier surgery and reduction of postoperative complications. Given the high efficacy and favorable complications rate, future applications in the surgical field are expected to increase. © 2010 Informa UK Ltd
The use of various biomaterials in computer-guided crestal sinus lift procedures. A report on two case studies with volume comparison
No full textPurpose. In the context of the transcrestal maxillary sinus lift a wide variety of biomaterials have been used to fill the subantral space over the years. In this study, two types of biomaterials were used in order to fill the maxillary sinus: a nanocrystallized hydroxyapatite in an aqueous solution and a micronized heterologous bone in a collagen matrix. Materials and methods. The surgical procedures were designed and carried out using computer-guided surgery. The filling volume obtained was measured with a comparative software program. Results. A ≥ 6 millimeter augmentation of osseous volume was obtained. This result is comparable to those obtained in lifts where conventional techniques were applied. The technique used was very precise and the difference between the projected and clinical outcome of the implant position had an average of less than 0.3 millimeters. Conclusions. This technique allows for the surgery to be performed in a way which is both minimally traumatic and invasive, and represents a viable alternative to those surgical techniques for crestal sinus lift currently in use
Management of Parapharyngeal Space Tumor Using Transoral Robotic Surgery: The Tonsillar Fossa Battlefield
No full textIntroduction:The management of parapharyngeal space (PPS) tumors is surgical, but the approach remains a challenge. Attention should be paid to avoid intra-operative bleeding, cranial nerves damage, and external scars.Presentation of Case:The authors report a case of a 23-year-old female, with complaint of progressive, painless swelling just below the right angle of the mandible of 6-month's duration. Magnetic resonance imaging images reported the presence of an oval-shaped expansive lesion (maximum diameter 3 cm), from the lower polar region of the parotid gland while fine needle aspiration cytology (FNAC) was not diagnostic. We performed a Trans Oral Robotic surgical excision of the tumors with Da Vinci Robot.Discussion:Thanks to a detailed magnification, the authors were able to reach the PPS region through the tonsillar fossa saving the palatine tonsil without any significant bleeding or nerve lesions. The histological examination confirmed the diagnosis of pleomorphic adenoma of parotid gland. The decision on which surgical approach to be used is determined by site, size vascularity, histology of the tumor, and knowledge of radiological images.Conclusion:There is not only 1 surgical approach for PPS tumors but the surgeon must know all the different options and possible outcomes. Transoral Robotic Surgery approach with Da Vinci could represent a valid option with a good knowledge of Robot surgical instruments and a detailed preoperative plan
Cervical spine disorders and its association with tinnitus: The "triple" hypothesis
No full textSubjective tinnitus and cervical spine disorders (CSD) are among the most common complaints encountered by physicians. Although the relationship between tinnitus and CSD has attracted great interest during the past several years, the pathogenesis of tinnitus induced by CSD remains unclear. Conceivably, CSD could trigger a somatosensory pathway-induced disinhibition of dorsal cochlear nucleus (DCN) activity in the auditory pathway; furthermore, CSD can cause inner ear blood impairment induced by vertebral arteries hemodynamic alterations and trigeminal irritation. In genetically-predisposed CSD patients with reduced serotoninergic tone, signals from chronically stimulated DCNs could activate specific cortical neuronal networks and plastic neural changes resulting in tinnitus. Therefore, an early specific tailored CSD treatments and/or boosting serotoninergic activity may be required to prevent the creation of 'tinnitus memory circuits' in CSD patients. (C) 2016 Elsevier Ltd. All rights reserved
Different barbed pharyngoplasty techniques for retropalatal collapse in obstructive sleep apnea patients: a systematic review
No full textBackground: The use of barbed sutures (BS) for the treatment of retropalatal collapse and vibration in patients suffering from snoring and obstructive sleep apnea (OSA) has significantly increased in the last few years. Many surgeons have discovered the advantages and unique properties of the BS and allowed the popular surgical pharyngoplasty techniques to be updated and improved. Methods: A systematic review was performed to identify all the clinical studies concerning the different barbed pharyngoplasty (BP) techniques used for the treatment of palatal collapse in snoring and OSA patients. A qualitative analysis of data extracted was conducted. Results: We included 12 studies of which 10 are prospective and 2 retrospective: 9 single-arm studies on the efficacy of a specific BP technique, 1 randomized clinical trial on the comparison between BP and control groups, and 2 studies on the correlation between two different BP techniques. To date, in the literature, 5 different types of BP techniques have been described: barbed snore surgery, barbed reposition pharyngoplasty, barbed expansion sphincter pharyngoplasty, barbed suture suspension, and barbed soft palate posterior webbing flap pharyngoplasty. All the studies showed an overall improvement in the primary efficacy parameters investigated (apnea-hypopnea index, oxygen desaturation index, and Epworth sleepiness scale) in each of the surgical techniques performed without any major complications. Conclusions: Given the extreme heterogeneity of the studies analyzed, it is necessary to perform more randomized and control studies on large samples aimed to define the best BP technique based on its effectiveness, surgical success rate, patient’s compliance, and complications
- …
