-
Current Opinion in Neurology Feb 2011The aim is to review canal dehiscence involving the superior, lateral, and posterior semicircular canals. The main focus will be on superior semicircular canal... (Review)
Review
PURPOSE OF REVIEW
The aim is to review canal dehiscence involving the superior, lateral, and posterior semicircular canals. The main focus will be on superior semicircular canal dehiscence.
RECENT FINDINGS
Canal dehiscence involving the superior, lateral, and posterior semicircular canal can have different etiologies, including developmental abnormality, congenital defect, chronic otitis media with cholesteatoma, and high-riding jugular bulb. However, their clinical presentation can be very similar, with patients complaining of vertigo, oscillopsia, and sometimes hearing loss. Canal dehiscence causes an abnormal communication between the inner ear and the surrounding structures. This creates a third mobile window within the inner ear, disrupting its normal mechanics and causing symptoms.
SUMMARY
Superior semicircular canal dehiscence is now a well-established entity in the medical literature. Surgical repair is effective at relieving patients' vestibular symptoms. Lateral semicircular canal dehiscence is usually associated with chronic otitis media. Posterior semicircular canal dehiscence is a rare entity, with similar clinical presentations and treatment options as the other canal dehiscences.
Topics: Ear Diseases; Eye Movements; Hearing Loss, Conductive; Humans; Labyrinthitis; Semicircular Canals; Vertigo; Vestibule, Labyrinth
PubMed: 21124219
DOI: 10.1097/WCO.0b013e328341ef88 -
Medsurg Nursing : Official Journal of... Oct 2006Despite advances in preoperative care, the rate of surgical wound dehiscence has not decreased in recent years; 1%-3% of patients experience wound dehiscence. A nursing... (Review)
Review
Despite advances in preoperative care, the rate of surgical wound dehiscence has not decreased in recent years; 1%-3% of patients experience wound dehiscence. A nursing goal for the postoperative patient is always prevention of wound dehiscence. Recognition of risk factors is essential. For example, older males with ascites are at very high risk. Prevention of wound infection and mechanical stress on the incision are important. Management of dehisced wounds may include immediate surgery if bowel is protruding from the wound. If surgery is not needed, management is essentially the same as that of any other wound through maintenance of a moist wound environment, reduction of bioburden and pain, and promotion of granulation tissue. Mortality rates associated with dehiscence have been reported between 14% and 50% (Hanif et al., 2000; Waqar et al., 2005). One of the complications (morbidity) of dehisced wounds is an incisional hernia, which develops in an estimated 43% of patients (van't et al., 2004). Researchers followed 126 patients who had wound dehiscence repair for a mean of 37 months and found that 31% of the hernias were diagnosed more than 2 years postoperatively. Nurses need to ensure adequate nutrition and reduced tension on the abdomen, and implement measures to prevent incisional infections.
Topics: Bandages; Diabetes Complications; Humans; Incidence; Infection Control; Jaundice; Malnutrition; Neoplasms; Nurse's Role; Nursing Assessment; Obesity; Perioperative Care; Perioperative Nursing; Risk Factors; Skin Care; Surgical Wound Dehiscence; Surgical Wound Infection
PubMed: 17128900
DOI: No ID Found -
Journal of Clinical Neuroscience :... Feb 2018The authors provide an update on the clinical manifestations, diagnosis and various approaches to the treatment of superior semicircular canal dehiscence (SSCD). SSCD is... (Review)
Review
The authors provide an update on the clinical manifestations, diagnosis and various approaches to the treatment of superior semicircular canal dehiscence (SSCD). SSCD is a rare condition where the bone overlying the superior semicircular canal thins or dehisces causing characteristic clinical findings. Since this was first reported in 1998 by Minor and colleagues, there has been much advancement made in terms of diagnosis and treatment. Signs and symptoms include a wide variation of both vestibular and auditory manifestations. Diagnosis made solely on clinical signs is difficult due to how varied the presentations can be and the overlap with other otologic pathologies. High-resolution CT temporal scans have been the standard in confirming superior semicircular canal dehiscence, however, MRI FIESTA scans have recently been used to image SSCD. Additionally, audiometry and vestibular evoked myogenic potential (VEMP) testing are useful screening tools. Currently, the middle fossa approach is the most common and standard surgical approach to repair SSCD. The transmastoid, endoscopic and transcanal or endaural approaches have also been recently utilized. Presently, there is no consensus as to the best approach, material or technique for repair of SSCD. As we learn more, newer and less invasive approaches and techniques are being used to treat SSCD. We present a comprehensive review of SSCD, including clinical symptoms and presentation, histopathology, diagnosis, treatment strategies and outcomes of intervention.
Topics: Audiometry; Humans; Labyrinth Diseases; Magnetic Resonance Imaging; Otologic Surgical Procedures; Semicircular Canals; Temporal Bone; Tomography, X-Ray Computed; Vestibular Evoked Myogenic Potentials
PubMed: 29224712
DOI: 10.1016/j.jocn.2017.11.019 -
Clinical Practice and Cases in... Aug 2022A 31-year-old female presented to the emergency department with abdominal pain and a 15-centimeter bloody vaginal protrusion, which resulted during an attempted bowel...
CASE PRESENTATION
A 31-year-old female presented to the emergency department with abdominal pain and a 15-centimeter bloody vaginal protrusion, which resulted during an attempted bowel movement. Reduction of the mass was unsuccessful, and the patient was taken to the operating room for examination.
DISCUSSION
In patients with a history of vaginal hysterectomy, the vaginal cuff can dehisce and abdominal contents may protrude through the vaginal canal. In this case presentation, the vaginal mass was found to be omental tissue, which could be mistaken for a prolapse of vaginal mucosa. Therefore, a proper pelvic exam is imperative, as prolapse through a cuff dehiscence can lead to severe complications.
PubMed: 36049188
DOI: 10.5811/cpcem.2022.2.56353 -
Annual Review of Plant Biology 2002Cell separation is a critical process that takes place throughout the life cycle of a plant. It enables roots to emerge from germinating seeds, cotyledons, and leaves to... (Review)
Review
Cell separation is a critical process that takes place throughout the life cycle of a plant. It enables roots to emerge from germinating seeds, cotyledons, and leaves to expand, anthers to dehisce, fruit to ripen, and organs to be shed. The focus of this review is to examine how processes such as abscission and dehiscence are regulated and the ways new research strategies are helping us to understand the mechanisms involved in bringing about a reduction in cell-to-cell adhesion. The opportunities for using this information to manipulate cell separation for the benefit of agriculture and horticulture are evaluated.
Topics: Cell Separation; Plant Cells; Plant Physiological Phenomena; Plants
PubMed: 12221970
DOI: 10.1146/annurev.arplant.53.092701.180236 -
Frontiers in Plant Science 2020Hairy vetch, (Roth), is a cover crop that does not exhibit a typical domestication syndrome. Pod dehiscence reduces seed yield and creates weed problems for subsequent...
Hairy vetch, (Roth), is a cover crop that does not exhibit a typical domestication syndrome. Pod dehiscence reduces seed yield and creates weed problems for subsequent crops. Breeding efforts aim to reduce pod dehiscence in hairy vetch. To characterize pod dehiscence in the species, we quantified visual dehiscence and force required to cause dehiscence among 606 genotypes grown among seven environments of the United States. To identify potential secondary selection traits, we correlated pod dehiscence with various morphological pod characteristics and field measurements. Genotypes of hairy vetch exhibited wide variation in pod dehiscence, from completely indehiscent to completely dehiscent ratings. Mean force to dehiscence also varied widely, from 0.279 to 8.97 N among genotypes. No morphological traits were consistently correlated with pod dehiscence among environments where plants were grown. Results indicated that visual ratings of dehiscence would efficiently screen against genotypes with high pod dehiscence early in the breeding process. Force to dehiscence may be necessary to identify the indehiscent genotypes during advanced stages of selection.
PubMed: 32194580
DOI: 10.3389/fpls.2020.00082 -
Journal of Obstetrics and Gynaecology :... Apr 2014Postpartum episiotomy dehiscence is a rare complication of vaginal delivery. Infection rates in episiotomy wounds are surprisingly low; however, it remains the most... (Review)
Review
Postpartum episiotomy dehiscence is a rare complication of vaginal delivery. Infection rates in episiotomy wounds are surprisingly low; however, it remains the most common cause of wound dehiscence, which may lead to major physical, psychological and social problems if left untreated. Most dehisced perineal wounds are left to heal naturally by secondary intention. This approach often results in a protracted period of significant morbidity for women. There is emerging evidence that early re-suturing closure of broken-down perineal wounds may have a better outcome, but randomised controlled trials are needed to yield evidence-based guidance for this management approach.
Topics: Episiotomy; Female; Humans; Pregnancy; Surgical Wound Dehiscence
PubMed: 24484355
DOI: 10.3109/01443615.2013.866080 -
Frontiers in Neurology 2023This review aims to draw attention to the multiple ipsilateral otic capsule dehiscences (OCDs), which may cause therapeutic failure in operated patients. A series of six... (Review)
Review
Why should multiple dehiscences of the otic capsule be considered before surgically treating patients with superior semicircular canal dehiscence? A radiological monocentric review and a case series.
This review aims to draw attention to the multiple ipsilateral otic capsule dehiscences (OCDs), which may cause therapeutic failure in operated patients. A series of six severely disabled patients with symptoms and signs consistent with a superior semicircular canal dehiscence (SSCD) diagnosis, confirmed by a high-resolution CT scan, is presented here. Five of the patients underwent surgery, and in four of the cases, the postoperative results were poor and/or disappointing. The ethical principles underlying modern medicine encourage medical staff to learn from past experience even when the results are modest despite the accuracy of the treatment applied to a patient. Consequently, we reviewed the radiological records of symptomatic and asymptomatic patients diagnosed or referred to our center for confirmation over the past 5 years to determine the incidence of multiple OCD in this population. Multiple localizations of suspected OCD in the ipsilateral ear did not appear to be rare and were found in 29 of 157 patients (18.47%) in our retrospective review using high-resolution thin-sliced CT scans. The decision to perform surgery for a documented symptomatic superior SSCD should be made with caution only after ruling out concomitant lesser-known variants of OCD in the ipsilateral ear.
PubMed: 37614976
DOI: 10.3389/fneur.2023.1209567 -
Home Healthcare Nurse Jun 2004Most surgical wounds heal uneventfully--the dehisced surgical incision is definitely the exception to the rule. However, management of a dehisced incision is a fairly... (Review)
Review
Most surgical wounds heal uneventfully--the dehisced surgical incision is definitely the exception to the rule. However, management of a dehisced incision is a fairly common home care challenge that must be understood. This month's column answers the questions: Why do some incisions dehisce, and what, if anything, can be done to prevent dehiscence? Are there early warning signs to look for? How should a dehisced wound be managed?
Topics: Female; Follow-Up Studies; Humans; Male; Nurse's Role; Practice Guidelines as Topic; Primary Prevention; Surgical Wound Dehiscence; Surgical Wound Infection; Wound Healing
PubMed: 15184776
DOI: 10.1097/00004045-200406000-00003 -
Frontiers in Neurology 2023Intraoperative identification of a superior semicircular canal (SSC) dehiscence the middle cranial fossa approach (MCFA) remains a difficult endeavor without a...
BACKGROUND
Intraoperative identification of a superior semicircular canal (SSC) dehiscence the middle cranial fossa approach (MCFA) remains a difficult endeavor without a neuronavigation system. To address these challenges, we propose a technique to localize the SSC dehiscence intraoperatively using certain anatomical landmarks.
METHOD
Three anatomical landmarks should be identified on preoperative radiological images: the distance from the squamous part of the temporal bone to the dehiscent SSC, the lower limit of the craniotomy, and the exact location of the craniotomy in relation to the bony external auditory canal. The use of these landmarks intraoperatively can allow the surgeon to correctly identify the position of the SSC. Two instructional videos explaining this technique are presented.
CONCLUSION
The proposed manual neuronavigation technique seems to be an accurate, safe, and cost-effective alternative technique for use in SSC dehiscence surgery.
PubMed: 37064194
DOI: 10.3389/fneur.2023.1105869