-
International Journal of Pediatric... Sep 2022We reported the free hyoid bone reconstruction of the cricoid cartilage to treat LTS in children. This retrospective case series study included LTS children who... (Review)
Review
We reported the free hyoid bone reconstruction of the cricoid cartilage to treat LTS in children. This retrospective case series study included LTS children who underwent hyoid bone separation and T tube implantation. Thirty-four children were included. Twenty-five children were with good outcomes after free hyoid bone reconstruction of the cricoid cartilage. Specifically, the cure rate was 92.8% for the children with mixed stenosis, followed by 63.6% in children with glottis stenosis and 55.6% in children with subglottic stenosis. Free hyoid bone reconstruction of the cricoid cartilage for the management of LTS is feasible, with good outcomes and few complications.
Topics: Child; Constriction, Pathologic; Cricoid Cartilage; Humans; Hyoid Bone; Laryngostenosis; Neck Injuries; Retrospective Studies; Tracheal Stenosis; Treatment Outcome
PubMed: 35797923
DOI: 10.1016/j.ijporl.2022.111227 -
British Medical Journal (Clinical... May 1982
Topics: Constriction, Pathologic; Humans; Lumbosacral Region; Spinal Canal; Spinal Diseases
PubMed: 6805616
DOI: 10.1136/bmj.284.6329.1588-a -
AJNR. American Journal of Neuroradiology Jan 2021Dural venous sinus stenosis has been associated with idiopathic intracranial hypertension and isolated venous pulsatile tinnitus. However, the utility of characterizing...
BACKGROUND AND PURPOSE
Dural venous sinus stenosis has been associated with idiopathic intracranial hypertension and isolated venous pulsatile tinnitus. However, the utility of characterizing stenosis as intrinsic or extrinsic remains indeterminate. The aim of this retrospective study was to review preprocedural imaging of patients with symptomatic idiopathic intracranial hypertension and pulsatile tinnitus, classify the stenosis, and assess a trend between stenosis type and clinical presentation while reviewing the frequencies of other frequently seen imaging findings in these conditions.
MATERIALS AND METHODS
MRVs of 115 patients with idiopathic intracranial hypertension and 43 patients with pulsatile tinnitus before venous sinus stent placement were reviewed. Parameters recorded included the following: intrinsic or extrinsic stenosis, prominent emissary veins, optic nerve tortuosity, cephalocele, sella appearance, poststenotic fusiform enlargement versus saccular venous aneurysm, and internal jugular bulb diverticula. χ cross-tabulation statistics were calculated and recorded for all data.
RESULTS
Most patients with idiopathic intracranial hypertension (75 of 115 sinuses, 65%) had extrinsic stenosis, and most patients with pulsatile tinnitus (37 of 45 sinuses, 82%) had intrinsic stenosis. Marked optic nerve tortuosity was more common in idiopathic intracranial hypertension. Cephaloceles were rare in both cohorts, with an increased trend toward the presence in idiopathic intracranial hypertension. Empty sellas were more common in idiopathic intracranial hypertension. Cerebellar tonsils were similarly located at the foramen magnum level in both cohorts. Saccular venous aneurysms were more common in pulsatile tinnitus. Internal jugular bulb diverticula were similarly common in both cohorts.
CONCLUSIONS
In this cohort, most patients with idiopathic intracranial hypertension had extrinsic stenosis, and most patients with pulsatile tinnitus had intrinsic stenosis. Awareness and reporting of these subtypes may reduce the underrecognition of potential contributory stenoses in a given patient's idiopathic intracranial hypertension or pulsatile tinnitus.
Topics: Adult; Aged; Cohort Studies; Constriction, Pathologic; Cranial Sinuses; Female; Humans; Male; Middle Aged; Pseudotumor Cerebri; Retrospective Studies; Tinnitus
PubMed: 33414231
DOI: 10.3174/ajnr.A6890 -
United European Gastroenterology Journal Dec 2022Strictures in Crohn's disease (CD) are a hallmark of long-standing intestinal damage, brought about by inflammatory and non-inflammatory pathways. Understanding the... (Review)
Review
Strictures in Crohn's disease (CD) are a hallmark of long-standing intestinal damage, brought about by inflammatory and non-inflammatory pathways. Understanding the complex pathophysiology related to inflammatory infiltrates, extracellular matrix deposition, as well as muscular hyperplasia is crucial to produce high-quality scoring indices for assessing CD strictures. In addition, cross-sectional imaging modalities are the primary tool for diagnosis and follow-up of strictures, especially with the initiation of anti-fibrotic therapy clinical trials. This in turn requires such modalities to both diagnose strictures with high accuracy, as well as be able to delineate the impact of each histomorphologic component on the individual stricture. We discuss the current knowledge on cross-sectional imaging modalities used for stricturing CD, with an emphasis on histomorphologic correlates, novel imaging parameters which may improve segregation between inflammatory, muscular, and fibrotic stricture components, as well as a future outlook on the role of artificial intelligence in this field of gastroenterology.
Topics: Humans; Crohn Disease; Constriction, Pathologic; Artificial Intelligence; Intestines; Fibrosis
PubMed: 36326993
DOI: 10.1002/ueg2.12326 -
Percutaneous transluminal angioplasty and stenting of post-irradiated stenosis of subclavian artery.Journal of the Formosan Medical... Jun 2022The therapeutic efficacy of percutaneous transluminal angioplasty and stenting (PTAS) of post-irradiated stenosis of subclavian artery (PISSA) was not well clarified....
BACKGROUND/PURPOSE
The therapeutic efficacy of percutaneous transluminal angioplasty and stenting (PTAS) of post-irradiated stenosis of subclavian artery (PISSA) was not well clarified. This retrospective study was designed to evaluate the technical safety and outcome of the patients of severe symptomatic PISSA accepted PTAS.
METHODS
Between 2000 and 2019, 16 cases with 17 lesions of symptomatic and medically refractory PISSA accepted PTAS were included. We evaluated their technical success, peri-procedural complications and diffusion-weight imaging (DWI) of brain magnetic resonance imaging (MRI), results of symptom relief, and long-term stent patency.
RESULTS
The stenosis of the 17 stenotic lesions were 81.2 ± 11.1%. The most common symptom of the 16 patients was dizziness (14/16, 87.5%). All successfully accepted PTAS without neurological complication and had symptom relief after PTAS (17/17, 100%). Of the 12 patients accepted pre-procedural and early post-procedural MRI follow-up, 2 patients had an asymptomatic tiny acute embolic infarct in the territory of vertebrobasilar system. In a 51.9 ± 54.9 months follow-up, all patients had no severe restenosis and no recurrent vertebrobasilar ischemic symptoms.
CONCLUSION
For patients with PISSA and medically refractory ischemic symptoms, PTAS can be an effective alternative management.
Topics: Angioplasty; Constriction, Pathologic; Humans; Retrospective Studies; Stents; Subclavian Artery; Treatment Outcome
PubMed: 34481727
DOI: 10.1016/j.jfma.2021.08.021 -
Medicina (Kaunas, Lithuania) Mar 2022Anal stenosis, which develops as a result of aggressive excisional hemorrhoidectomy, especially with the stoutly use of advanced technologies (LigaSure, ultrasonic... (Review)
Review
Anal stenosis, which develops as a result of aggressive excisional hemorrhoidectomy, especially with the stoutly use of advanced technologies (LigaSure, ultrasonic dissector, laser, etc.), has become common, causing significant deterioration in the patient's quality of life. Although non-surgical treatment is effective for mild anal stenosis, surgical reconstruction is unavoidable for moderate to severe anal stenosis that causes distressing, severe anal pain, and inability to defecate. The problem in anal stenosis, unlike anal fissure, is that the skin does not stretch as a result of chronic fibrosis due to surgery. Therefore, the application of lateral internal sphincterotomy does not provide satisfactory results in the treatment of anal stenosis. Surgical treatment methods are based on the use of flaps of different shapes and sizes to reconstruct the anal caliber and flexibility. This article aims to summarize most-used surgical techniques for anal stenosis regarding functional and surgical outcomes.
Topics: Anorectal Malformations; Constriction, Pathologic; Fissure in Ano; Hemorrhoids; Humans; Quality of Life
PubMed: 35334538
DOI: 10.3390/medicina58030362 -
Journal of Visceral Surgery Feb 2019Stenosis of the pancreatico-enteric anastomosis following pancreatoduodenectomy (PD), a late post-operative complication that is seen mainly after PD for diseases with... (Review)
Review
Stenosis of the pancreatico-enteric anastomosis following pancreatoduodenectomy (PD), a late post-operative complication that is seen mainly after PD for diseases with good prognosis, has been reported in less than 3% of cases in the literature. Most often asymptomatic, pancreatic-enteric anastomotic stenosis can lead to pancreatitis, pain or pancreatic insufficiency. Symptomatic stenosis is difficult to treat and its management is not standardized. Magnetic resonance cholangiopancreatography is the best investigation to confirm the diagnosis of stenosis. The Endoscopic UltraSonography (EUS) « rendezvous » technique, associating an endoscopic approach and EUS-guided puncture of the main pancreatic duct, has been available since 2010. Of note, however, the failure rate of the EUS series is as high as 25%, leading to repeat procedures. Surgical reconstruction of the anastomosis has been reported with good results in terms of morbidity. Surgical re-do of the pancreatico-enteric anastomosis for stenosis following PD carries a low risk of pancreatic fistula (around 5%) and an overall morbidity rate of around 20%.
Topics: Anastomosis, Surgical; Asymptomatic Diseases; Cholangiopancreatography, Endoscopic Retrograde; Cholangiopancreatography, Magnetic Resonance; Constriction, Pathologic; Endosonography; Exocrine Pancreatic Insufficiency; Humans; Image-Guided Biopsy; Pancreatic Ducts; Pancreaticoduodenectomy; Pancreaticojejunostomy; Pancreatitis, Chronic; Postoperative Complications; Reoperation
PubMed: 30119964
DOI: 10.1016/j.jviscsurg.2018.07.009 -
Archives of Gynecology and Obstetrics Mar 2024To date hysteroscopy is the gold standard technique for the evaluation and management of intrauterine pathologies. The cervical canal represents the access route to the... (Review)
Review
BACKGROUND
To date hysteroscopy is the gold standard technique for the evaluation and management of intrauterine pathologies. The cervical canal represents the access route to the uterine cavity. The presence of cervical stenosis often makes entry into the uterine cavity difficult and occasionally impossible. Cervical stenosis has a multifactorial etiology. It is the result of adhesion processes that can lead to the narrowing or total obliteration of the cervical canal.
PURPOSE
In this review, we summarize the scientific evidence about cervical stenosis, aiming to identify the best strategy to overcome this challenging condition.
METHODS
The literature review followed the scale for the quality assessment of narrative review articles (SANRA). All articles describing the hysteroscopic management of cervical stenosis were considered eligible. Only original papers that reported data on the topic were included.
RESULTS
Various strategies have been proposed to address cervical stenosis, including surgical and non-surgical methods. Medical treatments such as the preprocedural use of cervical-ripening agents or osmotic dilators have been explored. Surgical options include the use of cervical dilators and hysteroscopic treatments.
CONCLUSIONS
Cervical stenosis can present challenges in achieving successful intrauterine procedures. Operative hysteroscopy has been shown to have the highest success rate, particularly in cases of severe cervical stenosis, and is currently considered the gold standard for managing this condition. Despite the availability of miniaturized instruments that have made the management of cervical stenosis more feasible, it remains a complex task, even for experienced hysteroscopists.
Topics: Pregnancy; Female; Humans; Constriction, Pathologic; Uterus; Cervix Uteri; Uterine Cervical Diseases; Hysteroscopy
PubMed: 37428263
DOI: 10.1007/s00404-023-07126-1 -
Zhejiang Da Xue Xue Bao. Yi Xue Ban =... May 2020Stenting for iliac vein stenosis or compression has become a common therapeutic approach in recent years. The antithrombotic therapy after the stent deployment, however,... (Review)
Review
Stenting for iliac vein stenosis or compression has become a common therapeutic approach in recent years. The antithrombotic therapy after the stent deployment, however, reaches no consensus. Medications strategies and patients' prognoses differ in non-thrombotic, acute thrombotic and chronic thrombotic these three circumstances. Non-thrombotic patients usually possess satisfactory stent patency whatever antithrombotic therapy is used. Anticoagulant is the basic medication for acute thrombotic patients, benefits from additional antiplatelet drug remains to be clarified. In terms of chronic thrombotic patients, their prognoses are unsatisfactory under all antithrombotic therapies. In this review, we outlined the recent progress of antithrombotic therapy after iliac vein stenting, aiming to provide feasible medication plans for each circumstance.
Topics: Constriction, Pathologic; Fibrinolytic Agents; Humans; Iliac Vein; Stents; Treatment Outcome; Vascular Patency
PubMed: 32621412
DOI: 10.3785/j.issn.1008-9292.2020.02.15 -
Radiologia 2022Vascular compression syndromes arise when a vessel in a tight anatomic space is entrapped by another structure, resulting in diverse symptoms for which different imaging... (Review)
Review
Vascular compression syndromes arise when a vessel in a tight anatomic space is entrapped by another structure, resulting in diverse symptoms for which different imaging tests are used to diagnose. Radiologists need to be familiar with vascular compression syndromes and to be able to identify their most representative findings. This paper aims to review the principal symptoms of vascular compression, describing and illustrating the key findings on Doppler ultrasonography that enable accurate diagnosis and guide further workup, avoiding unnecessary invasive tests and pointing to the appropriate treatment.
Topics: Angiography; Celiac Artery; Constriction, Pathologic; Humans; Median Arcuate Ligament Syndrome; Ultrasonography, Doppler
PubMed: 35180983
DOI: 10.1016/j.rxeng.2021.08.001