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131.
We report the case of a young patient who developed spontaneous compressive orbital emphysema after an attack of coughing.
At admission the patient presented left proptosis, diplopia, vision impairment and headache. Computer tomography showed air
in the lateral part of left orbit compressing the eyeball and the optic nerve medially. It also revealed a sphenoid bone dysplasia
with hyperpneumatization of the left greater wing and with two dehiscences in its wall. It was very intriguing to discover
that this sphenoid dysplasia and the flap of mucosa covering one dehiscence were causing a ball-valve effect, allowing air
to enter but not leave the orbit. Endoscopic sinus surgery was successfully used to treat this case.
Received: 3 April 2000 / Accepted: 5 September 2000 相似文献
132.
Endoscopic cordectomy. a proposal for a classification by the Working Committee, European Laryngological Society 总被引:6,自引:0,他引:6
M. Remacle Hans E. Eckel Antonio Antonelli Daniel Brasnu Dominique Chevalier Gerhard Friedrich Jan Olofsson Heinrich H. Rudert Walter Thumfart Marco de Vincentiis Thomas P. U. Wustrow 《European archives of oto-rhino-laryngology》2000,257(4):227-231
The European Laryngological Society is proposing a classification of different laryngeal endoscopic cordectomies in order
to ensure better definitions of postoperative results. We chose to keep the word “cordectomy” even for partial resections
because it is the term most often used in the surgical literature. The classification comprises eight types of cordectomies:
a subepithelial cordectomy (type I), which is resection of the epithelium; a subligamental cordectomy (type II), which is
a resection of the epithelium, Reinke’s space and vocal ligament; transmuscular cordectomy (type III), which proceeds through
the vocalis muscle; total cordectomy (type IV); extended cordectomy, which encompasses the contralateral vocal fold and the
anterior commissure (type Va); extended cordectomy, which includes the arytenoid (type Vb); extended cordectomy, which encompasses
the subglottis (type Vc); and extended cordectomy, which includes the ventricle (type Vd). Indications for performing those
cordectomies may vary from surgeon to surgeon. The operations are classified according to the surgical approach used and the
degree of resection in order to facilitate use of the classification in daily practice. Each surgical procedure ensures that
a specimen is available for histopathological examination.
Received: 29 December 1998 / Accepted: 2 July 1999 相似文献
133.
鼻内窥镜加柯-陆手术联合进路治疗慢性鼻窦炎 总被引:5,自引:0,他引:5
目的:探讨提高慢性鼻窦炎疗效的方法。方法:对104例伴有上颌窦病变的慢性鼻窦炎患者行鼻内窥镜和柯-陆手术联合进路鼻窦手术,彻底清除病变。结果:术后随访6~12个月(平均9个月),治愈85例(81.7%),好转15例(14.4%),无效4例(3.8%),总有效率96.1%。结论:该方法可彻底清除上颌窦病变,恢复上颌窦的生理性引流通道,防止复发,弥补了经鼻内窥镜鼻窦手术在处理上颌窦病变时的局限性。 相似文献
134.
《Auris, nasus, larynx》2022,49(6):986-994
ObjectiveDysphagia is a common symptom in Parkinson's disease (PD) and it represents a negative prognostic factor because of its complications. This study is to evaluate pharyngeal dysphagia for boluses of various consistencies with Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Pharyngeal High-Resolution Manometry (PHRM) in a group of PD patients, making a comparison between the information provided by the two exams.MethodsGroup of 20 patients affected by PD was selected and initially subjected to a qualitative evaluation of the swallowing performing FEES. Subsequently, they were evaluated by PHRM to identify quantitative measures associated with pressures expressed by pharyngeal organs during swallowing. Values obtained in the study group were compared with those recorded in a group of 20 healthy subjects.ResultsStudy showed that Pmax (the maximum pressure elicited by the single pharyngeal muscle structures involved in swallowing) was significantly lower than the control group (p<0.05) for all the boluses and consistency tested, in particular for the Tongue base and the Cricopharyngeal muscle. Pmean pre-swallowing pressure (represents the mean value of a contraction in which basal and maximal pressure where normally calculated) was significantly higher compared to normal subjects for the Tongue base and the Cricopharyngeal muscle (p<0.05). Mean intra-swallowing pressure was higher for the Velopharynx and the Cricopharyngeal muscle, but lower for the tongue base. Pmax and Pmean at PHRM were altered independently to the degree of dysphagia detected at FEES, and they did not correlate either with the location of the residue or with the type of bolus. Images displayed at the FEES, found the corresponding biomechanical explanations in the PHRM, which also allowed us to quantify the extent of the dysfunction, through the calculation of the pressures generated in the various structures studied.ConclusionPHRM is particularly useful in the early detection of dysphagia, when FEES may still show no evidence of abnormal swallowing. 相似文献
135.
蝶腭,筛前神经及鼻甲联合手术治疗常年性变应性鼻炎 总被引:1,自引:0,他引:1
在鼻内窥镜下为40例行蝶腭、筛前神经及鼻甲联合手术治疗常年性变应性鼻炎。结果:术后1月全部患者症状消失,显效100%;术后1年显效33例,占82.5%;有效6例,占15%,有效率为97.5%。提示该方法可广泛阻滞鼻腔副交感神经来源,降低鼻粘膜感觉灵敏部位敏感性以及感觉—副交感神经反射,破坏喷嚏反射弧的传入通路,使鼻粘膜对外界刺激敏感性下降,血管扩张减轻,腺体分泌减少,对常年性变应性鼻炎有明显疗效。 相似文献
136.
137.
Background: In this study we tried to estimate the local surgical trauma in patients undergoing endoscopic or conventional hernia repair
via the changes in peripheral blood T cell subpopulations (i.e., T-helper 1 (TH1) and TH2 cells), recently shown to be recruited
differentially to inflammatory sites.
Methods: Cells were identified flow-cytometrically by intracellular cytokine staining on a single cell level in 30 patients undergoing
conventional (Shouldice) or total extraperitoneal patch (TEPP) hernia repair.
Results: The TH1 cells decreased postoperatively in Shouldice patients on an average of 20.8–31.4%, whereas in TEPP patients only
a minor decline (mean, 7.8–9.2%) was observed. The TH2 cells did not change significantly in TEPP patients, and a small increase
(mean, 7.7%) was detected in Shouldice patients.
Conclusions: Our results suggest that the postoperative reduction in TH1 cells reflects local surgical trauma and can be helpful in evaluating
different surgical procedures. When conventional and endoscopic hernia repair were compared, the latter proved less traumatizing.
Received: 18 March 1998/Accepted: 24 July 1998 相似文献
138.
The results of surgical treatment for a ruptured type B aortic dissection remain far from satisfactory. It is believed that
additional perfusion from the right axillary artery might be more beneficial than perfusion from only the femoral artery during
surgery for a ruptured thoracic aneurysm. The right axillary perfusion is more likely to perfuse the vital organs proximal
to the ruptured area, and thus avoid retrograde emboli. In addition, if the open proximal method is performed, then the right
axillary perfusion is able to facilitate the evacuation of air from the aortic lumen. We present herein the case of a patient
in whom a ruptured type B acute aortic dissection was successfully treated by applying right axillary perfusion through a
left thoracotomy. 相似文献
139.
内窥镜辅助下显微神经血管减压术治疗
特发性偏侧面肌痉挛 总被引:2,自引:0,他引:2
张开文 《中国神经精神疾病杂志》1999,(3)
目的为进一步提高神经血管减压术治疗特发性偏侧面肌痉挛的疗效。方法经乙状窦后小骨窗开颅加用内窥镜辅助显微血管减压术治疗特发性偏侧面肌痉挛35例。结果术后34例症状消失,1例症状减轻,35例随访6个月至3年半,术后面肌抽搐消失者33例,1例症状减轻,1例1年后复发。结论内窥镜可弥补手术显微镜的不足之处,减少组织损伤和判断错误,提高治疗效果。 相似文献
140.
The introduction of fiberoptic endoscopes has fostered the development of minimally invasive aesthetic facial plastic surgery.
The application of this new technology is most widely used in rejuvenation of the mildly to moderately ptotic brow. The concept
of endoscopic foreheadplasty is based upon the following maneuvers. First, a sub- or supraperiosteal dissection of the parietal,
occipital, and frontal scalp to the level of the superior and lateral orbital rims and zygomatic arch must be accomplished.
Second, incision and release of the superior and lateral orbital periosteum are performed. Third, selective myotomies of the
brow depressor muscles are completed. These maneuvers allow the brow to be permanently elevated into a desired position following
fixation and healing. A significant limitation of this procedure appears to be the ability to predict the long-term forehead
and brow elevation. We believe that permanent fixation is one of the best methods to ensure that the desired elevation is
maintained. We contrast two series of patients, one with temporary fixation technique and the other with permanent fixation.
We review the results and discuss the rationale and advantages of permanent fixation. 相似文献