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Laryngologie, Rhinologie, Otologie Jan 1984Until now there have been isolated reports on cleft larynx in American journals only. The cleft, which is hidden behind mucous membrane humps on the posterior larynx...
Until now there have been isolated reports on cleft larynx in American journals only. The cleft, which is hidden behind mucous membrane humps on the posterior larynx wall can evade diagnosis for a considerable time. Basing on a thorough examination (endoscopy, computed tomography), a case history, characterised by repeated aspiration pneumonia, and the surgical treatment of this extremely rare malformation are described.
Topics: Humans; Larynx; Male; Middle Aged
PubMed: 6700328
DOI: No ID Found -
Foot & Ankle International Jul 2005Extensive midfoot fusions can be challenging because of bone loss, deformity, and soft tissue anatomy. Several options have been advocated, including multiple screw...
BACKGROUND
Extensive midfoot fusions can be challenging because of bone loss, deformity, and soft tissue anatomy. Several options have been advocated, including multiple screw fixation, medial plating, and plantar plating. We report a new technique using a dorsally-placed, modified calcaneal plate for treatment of this difficult clinical problem.
METHODS
Patients undergoing extensive (more than four joints) midfoot arthrodeses with a dorsally-placed, modified calcaneal plate between 2000 and 2003 were retrospectively reviewed. Diagnoses included Charcot arthropathy (four), osteoarthritis (two), posttraumatic osteoarthritis (two), massive bone loss from previous infection (one), and residual clubfoot deformity (one). Patients with active midfoot infections were excluded. During the study period, midfoot arthrodeses with a dorsal calcaneal plate were done in 10 patients. Of these, nine patients were available for review. Arthrodeses were attempted in 62 joints in these nine patients. Autogenous grafting was used in three patients (23 joints), allograft was used in six patients (39 joints). Patients were maintained nonweightbearing until radiographs or computed tomography conclusively showed union.
RESULTS
One of the 10 patients died from an unrelated cause. In the nine remaining patents, 95% (59 of 62) of joints fused within 4 months of surgery. Postoperative complications included nonunion with broken screws in one patient, and three wound problems successfully treated with local dressings. Secondary procedures included one revision arthrodesis and two hardware removals. Patient satisfaction with this procedure was very high (eight of nine).
CONCLUSIONS
The use of a dorsal calcaneal plate is a viable method of fixation for achieving fusion in extensive midfoot arthropathy. The plate is low-profile and easily moldable to conform to dorsal midfoot anatomy. It can be placed without extensive plantar or medial foot dissection and maintains midfoot alignment until bony fusion occurs. In patients with complex midfoot pathology requiring multijoint fusions, the results have been satisfactory.
Topics: Adult; Arthritis; Arthrodesis; Arthropathy, Neurogenic; Bone Plates; Calcaneus; Female; Foot Joints; Humans; Male; Middle Aged; Retrospective Studies
PubMed: 16045838
DOI: 10.1177/107110070502600701 -
Handbook of Clinical Neurology 2015The language-relevant brain regions, Brodmann's area in the inferior frontal cortex and Wernicke's area in the superior temporal cortex, are connected via long-range... (Review)
Review
The language-relevant brain regions, Brodmann's area in the inferior frontal cortex and Wernicke's area in the superior temporal cortex, are connected via long-range fiber bundles, which are located dorsally and ventrally to the sylvian fissure. These dorsal and ventral pathways consist of a number of partly parallel-running fiber tracts, which can be differentiated by their termination regions and by the particular language functions of these termination regions. Dorsally, there are two major fiber tracts connecting the posterior temporal cortex with the frontal cortex: one terminating in the premotor cortex that subserves sensory-to-motor mapping and one terminating in posterior Broca's area, the pars opercularis, that supports the processing of complex syntactic structures. Ventrally, two language-related fiber tracts are discussed: one connects the inferior frontal cortex, i.e., the pars triangularis and orbitalis, with Wernicke's area and supports semantic processes and another one connects the most ventral portions of the inferior frontal cortex, including the frontal operculum, with the anterior temporal cortex. This latter ventral tract is suggested to subserve elementary combinatorial processes in language. Together these fiber tracts guarantee the transmission of information between different brain regions within the neural language network.
Topics: Brain Mapping; Humans; Language; Neural Pathways; Speech; White Matter
PubMed: 25726269
DOI: 10.1016/B978-0-444-62630-1.00010-X -
Journal of Korean Neurosurgical Society Mar 2010A 73-year-old male presented with a rare dorsally sequestrated lumbar disc herniation manifesting as severe radiating pain in both leg, progressively worsening weakness...
A 73-year-old male presented with a rare dorsally sequestrated lumbar disc herniation manifesting as severe radiating pain in both leg, progressively worsening weakness in both lower extremities, and urinary incontinence, suggesting cauda equina syndrome. Magnetic resonance imaging suggested the sequestrated disc fragment located in the extradural space at the L4-L5 level had surrounded and compressed the dural sac from the lateral to dorsal sides. A bilateral decompressive laminectomy was performed under an operating microscope. A large extruded disc was found to have migrated from the ventral aspect, around the thecal sac, and into the dorsal aspect, which compressed the sac to the right. After removal of the disc fragment, his sciatica was relieved and the patient felt strength of lower extremity improved.
PubMed: 20379476
DOI: 10.3340/jkns.2010.47.3.217 -
Urology Jun 2014To describe our 14-year experience with a 1-stage tissue transfer urethroplasty technique.
OBJECTIVE
To describe our 14-year experience with a 1-stage tissue transfer urethroplasty technique.
METHODS
Eighteen patients underwent reconstruction with circumferential buccal grafting. All patients had anterior urethral strictures that included segments of total or near-total obliteration not amenable to excisional or augmented anastomotic repair and intact corpus spongiosum that could serve as a graft recipient bed. The mobilized corpus spongiosum was incised dorsally without transection, thereby preserving the continuity of the blood supply within the spongy tissue. Buccal mucosa was quilted to the corporal bodies to reconstruct the dorsal aspect of the urethra. Where there was obliterative or near-obliterative stricture disease, additional buccal mucosa was quilted to the dorsally incised, nontransected corpus spongiosum in continuity with the distally and proximally spatulated urethra. The repair was then completed by approximating dorsal and ventral buccal mucosal graft segments.
RESULTS
Follow-up included voiding cystourethrogram at 3 weeks, cystoscopy 4 months after surgery (1 patient refused), and subsequent follow-up. There was 1 early stricture recurrence, which was successfully treated with direct vision internal urethrotomy (success 94%, and 100% after 1 urethrotomy). Every patient was contacted and assessed at the time of manuscript preparation. All patients are currently free of obstructive symptoms attributed to stricture disease with a mean follow-up of 50 months (range, 5-171 months).
CONCLUSION
Dorsal and ventral buccal grafting appears to be an excellent option for a 1-stage repair of long obliterative anterior urethral strictures and strictures that include segments of obliterative or near-obliterative disease in selected cases.
Topics: Adult; Aged; Cohort Studies; Follow-Up Studies; Graft Survival; Humans; Male; Middle Aged; Mouth Mucosa; Plastic Surgery Procedures; Retrospective Studies; Risk Assessment; Severity of Illness Index; Treatment Outcome; Urethral Stricture; Urologic Surgical Procedures, Male; Young Adult
PubMed: 24745799
DOI: 10.1016/j.urology.2014.01.024 -
The Physician and Sportsmedicine Jul 1999Dislocations of the metacarpophalangeal (MCP) joint are not common, but when they do occur, they are usually dorsal (the proximal phalanx is displaced dorsally relative...
Dislocations of the metacarpophalangeal (MCP) joint are not common, but when they do occur, they are usually dorsal (the proximal phalanx is displaced dorsally relative to the metacarpal), and typically involve the index finger. Prompt recognition of this injury is important to ensure the best possible outcome.
PubMed: 20086734
DOI: 10.3810/psm.1999.07.923 -
Medicinski Pregled 2011We have presented a case of rare dorsally sequestrated lumbar disc herniation manifesting as cauda equina syndrome. The patient was admitted to the Neurological...
We have presented a case of rare dorsally sequestrated lumbar disc herniation manifesting as cauda equina syndrome. The patient was admitted to the Neurological Department of Canton Hospital Zenica due to urinary retention and weakness in both lower extremities. Magnetic resonance imaging showed a compressing mass located in the dorsal extradural space at the L2-L3 level. An extruded intervertebral disc was found intraoperatively. The decompression was followed by good recovery.
Topics: Humans; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Middle Aged; Polyradiculopathy
PubMed: 21970073
DOI: 10.2298/mpns1108419j -
Acta Chirurgica Belgica 2006The physiopathology of anal fissures is still not completely elucidated. Most probably, chronic anal fissures are ischaemic ulcers, continuously enhanced by sphincter... (Review)
Review
The physiopathology of anal fissures is still not completely elucidated. Most probably, chronic anal fissures are ischaemic ulcers, continuously enhanced by sphincter hypertonia. The dorsal location of most fissures is attributed to the scarcity of arteriolar anastomoses dorsally. The healing process is obstructed by fibrosis, provoked by repeated mechanical injuries and chronic inflammation.
Topics: Chronic Disease; Fissure in Ano; Humans
PubMed: 17168260
DOI: 10.1080/00015458.2006.11679942 -
Hand Surgery & Rehabilitation Feb 2018The purpose of the study was to evaluate the reliability of the dorsal tangential view (DTV) of the wrist using direct visualization of the extensor compartments in...
UNLABELLED
The purpose of the study was to evaluate the reliability of the dorsal tangential view (DTV) of the wrist using direct visualization of the extensor compartments in vivo. Twelve patients with extensor tendon complications [nine patients with extensor synovitis, two patients with isolated extensor pollicis longus (EPL) rupture, one patient with EPL and extensor indicis proprius rupture] after volar plating of a distal radius fracture were enrolled in the study. We obtained DTVs in the operating room before implant removal and explored the extensor compartments during synovectomy or tendon reconstruction to confirm suspected screw penetration. We confirmed screw penetration on 10 patients during exploration of the extensor compartments. DTV was able to detect seven of these dorsal cortex breaches. There were no false positive results, which we had defined as a screw penetrating an extensor compartment preoperatively, but not visible on the DTV. Of these seven breaches, one was in the second compartment, four were in the third compartment, and the remaining two were in the fourth compartment. The DTV is sufficiently reliable to be used routinely to reduce postoperative extensor tendon complications during volar plating of the distal radius.
LEVEL OF EVIDENCE
4 (case series) diagnostic.
Topics: Bone Plates; Device Removal; Fluoroscopy; Fracture Fixation, Internal; Humans; Radius Fractures; Reproducibility of Results; Synovectomy; Tendon Injuries; Wrist Joint
PubMed: 29229540
DOI: 10.1016/j.hansur.2017.11.002 -
Der Unfallchirurg Feb 2015
Topics: Finger Injuries; Humans; Plastic Surgery Procedures; Soft Tissue Injuries; Surgical Flaps; Treatment Outcome
PubMed: 25672639
DOI: 10.1007/s00113-014-2736-7