Traumatische Tränenwegsstenosen: Epidemiologie und Erfolgsraten nach sekundärer operativer Intervention
Maged AlnawaisehMichael BöhmAndré RosentreterAgneta WienekeG. WirthsRalph-Laurent MertéNicole EterLars Zumhagen
2
Citation
0
Reference
10
Related Paper
Citation Trend
Abstract:
Traumatic lacrimal duct stenosis can be the result of sharp trauma of the eyelid, indirect trauma or surgery in the nasoorbital region, as well as burns, chemotherapy and radiation of the facial region. The aim of the study is to present the demographics, patient satisfaction, and course of different surgical procedures for secondary treatment of traumatic lacrimal duct stenosis.We retrospectively reviewed the medical records of 50 patients who required surgery for traumatic lacrimal duct stenosis from 2009 to 2011 at the University Eye Hospital in Muenster. The evaluation included the following criteria: age, sex, duration of symptoms, complication rate and the rate of recurrence. We systematically evaluated the medical data and asked the patients about the recent symptoms via telephone questionnaire.60 eyes of 50 patients were included (18 women; 32 men; age: 51.8 ± 17.1 years); 34 eyes (56.7 %) had already had operations of the lacrimal system. The success rate was 58.1 %. The mean postoperative follow-up was 52.3 ± 10.7 months. In 11 cases (18.3 %), a dakryocystorhinostomy (DCR) was necessary.Traumatic lacrimal stenosis is more common in men, and has a poorer prognosis than lacrimal duct stenosis from other causes.Keywords:
Lacrimal duct
Demographics
Medical record
Dacryocystitis
Objective:To explore the treatment effection of 131I for hyperthyroidism and the method of preventative complication.Method: 187 cases hyperthyroidism patients were treated with 131I.The complications and effection were observed.Results: 142 cases recovered,10 cases relieved.Conclusions: It is an effective and safe treatment method for hyperthyroidism with 131I.
Cite
Citations (0)
Objective Nasolacrimal duct obstruction is a common change clinically manifested by the presence of epiphora and/or dacryocystitis. The objective is to analyze the technique and evaluate the success of endoscopic endonasal dacryocystorhinostomy to remove obstructions in the lacrimal ducts, using the same surgical technique for all cases. Method This is a retrospective study. All 17 surgeries were performed from May 2006 to January 2011. Variables of interest were age, gender, duration, clinical presentation, etiology, surgical technique, use of silicone tubes, complications, and postoperative success. Successful surgery: absence of symptoms and tear flow after 7 months of follow‐up. Results Although drug therapy may resolve the symptoms, the definitive approach consists of surgical procedure to restore patency of the lacrimal drainage system. We noticed that females were predominant (70.59%). There were 11 women, 1 girl, and 5 boys ages 3 to 71 years (average age range, 40.11 years) submitted to surgery performed by unciform process incision and posterior flap of lacrimal sac. The most involved side was the right (n = 11). Etiology was idiopathic, and the most predominant clinic was dacryocystitis. Silicone tube was used in 2 cases. We obtained a primary success of 94.11%. Complication: major bleeding in 1 case (anterior tamponade). Conclusion Primary success rate in most cases. Endoscopic surgery is a safe technique with excellent results for nasolacrimal duct obstruction. It is an excellent surgical option for otorhinolaryngology residents in university hospitals.
Nasolacrimal Duct Obstruction
Dacryocystitis
Nasolacrimal duct
Etiology
Lacrimal sac
Lacrimal duct
Cite
Citations (0)
Seroma
Wound dehiscence
Incisional Hernia
Fat necrosis
Cite
Citations (15)
We reviewed a consecutive series of 16 patients above 60 years of age (mean age 71 years) who underwent reconstruction with pedicled flaps in the lower extremity. The soft tissue defects ranged from 9 to 50 cm and were caused in 11 patients (70%) by surgical complications from previous surgeries. Of these, 5 patients underwent a total joint replacement of the knee (4 cases) and of the ankle (1 case). Surgery consisted of 19 muscular flaps, and 3 fasciocutaneous flaps. Six patients were treated with a combination of 2 flaps. The overall surgical complication rate after reconstruction was 44%. There was no perioperative mortality and there were no medical complications. One patient required an above-the-knee amputation because of uncontrollable postoperative bleeding. A thrombectomy was performed in another patient to treat a postoperative popliteal artery occlusion with critical ischemia of the leg. Other complications included recurrent total joint replacement infections (2 cases), marginal flap necrosis (4 cases), and skin necrosis at the donor site (1 case). The mean hospitalization stay was 46 days. All patients but 1 completely healed, although secondary surgery was performed in 7 patients. The occurrence of complications was not correlated with the preoperative morbidity or an age above 75 years. The local complication rate was higher than reported for free flap in the same age category, but the lack of perioperative mortality and medical complications make it a low-risk option for reconstruction of small- to middle-sized defects in the elderly.
Cite
Citations (8)
Free flap reconstruction of complex defects has revolutionized cancer and trauma treatment and offers a reliable and efficient method for reconstructing tissue defects. We analyzed the donor, flap, and systemic complications in an aging group and in a group of younger patients to identify whether age is an important factor in complication rates. This study was a retrospective review of the medical records of 43 consecutive patients who underwent free flap reconstructions. Patients were divided into two groups according to age (group A: younger than 60 years, group B: 60 years or older). We analyzed the free flap types and donor site, flap, and postoperative systemic complications. Statistical analyses were performed to determine the influence of age on complication rate. Donor site complications developed in three cases in group A and in three cases in group B. Flap complications occurred in 17 cases in group A and in 5 cases in group B. Systemic complications occurred in two cases in group A and in five cases in group B. Age did not have a statistically significant impact on free flap complications, and old age was not a risk factor for free flap surgery.
Medical record
Group B
Group A
Cite
Citations (15)
Dacryocystitis
Lacrimal apparatus
Cite
Citations (14)
Abstract Some 114 patients (median age 52 years) underwent laparoscopic hernia repair as a day-case procedure. Twenty-one patients had bilateral and 11 recurrent hernias. Some 113 patients underwent transabdominal preperitoneal mesh repair but one required conversion to open operation. Mean operating time was 24 min for unilateral and 38 min for bilateral repair. In an operating session of 3·5 h, up to five patients (mean 4·4) underwent surgery and as many as seven hernias were repaired. More than 10 per cent of patients were found to have a previously undiagnosed hernia on the opposite side. A total of 111 patients were discharged home on the day of surgery. Major complications included one omental bleed and one small bowel obstruction. Seroma was the commonest minor complication and occurred in 7 per cent of patients. More than 35 per cent of patients needed no postoperative analgesia. To date there has been one recurrence (follow-up range 2–18 months).
Seroma
Bleed
Hernia Repair
Cite
Citations (40)
Objective
To explore the effect of endoscopic transnasal dacryocystorhinostomy(ET-DCR)by suture in the treatment of acute dacryocystitis(AD)as early as possible.
Methods
The clinical data of 32 patients with unilateral AD who underwent ET- DCR by suture as early as possible were retrospectively analyzed.
Results
All patients presented clear anatomic structure, intraoperative hemorrhage increased in 3 cases, swelling and pain was rapidly relieving in all patients in the first day of postoperation, the mean resolution time of congestion and swelling in the middle canthus was average 3 days(range 1- 6 days), no spread of infection occurred, no facial scar appeared in all patients except one case of abscess rupture. Complete complaint relief in 26 cases, slight epiphora presented in 6 patients who confirmed for lacrimal duct obstruction and cured by intubation,and all ostial patency with no AD recurrences at the mean follow- up of 2 years(range 12 months- 5 years).
Conclusion
ET-DCR by suture as early as possible can be used to cure acute dacryocystitis and it is effective safe and economy.
Key words:
Dacryocystitis; Dacryocystorhinostomy
Dacryocystitis
Chronic dacryocystitis
Canthus
Nasolacrimal Duct Obstruction
Lacrimal duct
Cite
Citations (0)
Incisional hernias develop in up to 11% of surgical abdominal wounds with a possible recurrence following repair of 44%. We describe our experience with a combined fascial and prosthetic mesh repair. Thirty-five patients (16M:19F) have been treated. The original operation was bowel related in 19 cases, gynaecological in 8, hepatopancreaticobiliary in 3 patients, aortic aneurysm repair in 2 and involved a thoraco-laparotomy in 3. The incisions were midline in 26 cases, transverse in 6, paramedian in 2 and rooftop in one patient. The hernias were considered subjectively to be large in 15, medium in 14 and small in 6 of the patients. A proforma was completed for each patient noting intra-operative and post-operative complications, post-operative hospital stay and analgesic requirements. Post-operative complications included seroma formation in 6 patients, deep vein thrombosis in one and a non-fatal pulmonary embolism in another. One patient developed a wound haematoma and one had a superficial wound infection. Post-operative in-hospital stay ranged from 1 to 27 days with a mean of 6.2 days. Of the 35 patients 33 were available for follow-up. Follow-up was for a median of 20.3 months (range 6.0 to 54.1 months). Two of these (6%) patients reported a persistent lump and one (3%) reported persistent pain but none of the remaining 33 was found to have a recurrence. We advocate this technique because it is applicable to all hernias, most of the mesh is behind the rectus sheath and has 2 points of fixation, it is relatively pain-free allowing early mobilisation, has a modest complication rate and a low recurrence rate.
Seroma
Incisional Hernia
Cite
Citations (57)