This article introduces the slide crown lengthening procedure (SCLP), which incorporates surgical design features to overcome present crown lengthening procedure (CLP) shortcomings. The result is a 75% decrease in required surgery on adjacent teeth and a corresponding 75% reduction in surgical time. Other advantages include a reduction in surgical morbidity, ...

In the setting of the hypovolaemic patient with a thoraco-abdominal stab wound and potential injuries in both the chest and abdomen, deciding which cavity to explore first may be difficult.Opening the incorrect body cavity can delay control of tamponade or haemorrhage and exacerbate hypothermia and fluid shifts. This situation has ...

Introduction : Having long experience of open upper abdominal surgery under spinal anesthesia and laparoscopic cholecystectomy under general anesthesia, we performed this study of laparoscopic cholecystectomy with low-pressure pneumoperitoneum under spinal anesthesia to assess its safety and feasibility. Materials and Methods : In a private rural health set-up, 300 patients ...

Object Neurological deterioration due to spinal epidural hematoma (SEH) is a rare but significant complication of spinal surgery. The frequency of hematoma evacuation after spinal surgery is reportedly 0.1%-3%. The objective of this study was to investigate the symptomatology of SEH and the frequency of evacuation for each surgical procedure ...

The pedicle screw instrumentation represents the most rigid construct of the cervical and cervicothoracic spine and in spite of the risks to neurovascular structures clinical relevant complications do not occur frequently. The steep angles of the cervical pedicles result in a wide surgical exposure with extensive muscular trauma. The objective ...

The endoscopic approach is a technical innovation for release of the sternocleidomastoid (SCM) fibrosis in muscular torticollis, where operation scars can be hidden at less conspicuous areas, for example, at the axilla and hair-bearing scalp. As the SCM muscle is located beneath the investing layer of deep cervical fascia which ...

The purpose of this study was to describe a simplified arytenoid rotation technique and to test its applicability in excised human larynges. A non-absorbable monofilament thread is slung around the muscular process of the arytenoid cartilage through an external approach. During visual control through flexible endoscopy, two needles and a ...

The study design is retrospective. The aim is to describe our experience about the treatment of patients with neuromuscular scoliosis (NMS) using Cotrel-Dubousset instrumentation. Neuromuscular scoliosis are difficult deformities to treat. A careful assessment and an understanding of the primary disease and its prognosis are essential for planning treatment which ...

While the pharmacology of sugammadex has been extensively reviewed, there is limited literature regarding its use in specific clinical settings. Several case reports describe its use in patients with the potential for postoperative respiratory dysfunction; in the settings of myasthenia gravis, Duchenne muscular dystrophy and myotonic dystrophy. We describe the ...

The management of paediatric mandibular fractures using an acrylic splint is a time-tested procedure. Traditionally, an awl is used to place wires to secure such splints. In this article, we have designed prospective study to compare a new technique of using intravenous cannula stillete (IVCS) as against conventional awl in ...

The swinging eyelid procedure, which was first described by C. D. McCord, Jr in 1981 ( McCord, 1981 ), is now the first-line approach to reach the inferior and lateral orbits ( Mourits et al., 2009 ). Although few complications are reported in relation to this approach, a chemosis is ...

We report the case of a 76-year-old man who developed a late-onset Descemet's membrane detachment (DMD) 5 months after uncomplicated cataract surgery. Despite two air tamponade procedures that initially appeared successful, the DMD continued to return. After careful examination it was found that a surgical entry wound may have been scarred ...

Background. Lumbar hernia is a rare hernia arising through posterolateral abdominal wall defects. Different techniques of repair are reported in the literature. Methods. The authors present their experience of 4 lumbar hernias during a short span of 9 months. All surgical repairs were performed using synthetic mesh placed in the ...

ABSTRACT: Study Design. Retrospective study.Objectives. To evaluate the prognostic value of preoperative pulmonary function test for postoperative pulmonary complications and to identify the operability associated with severely decreased forced vital capacity (< 30% FVC) status in flaccid neuromuscular scoliosis.Summary of Background Data. The preoperative pulmonary function test, especially > 30% ...

Although Harvey Cushing played a central role in the establishment of neurosurgery in the United States, his work on the spine remains largely unknown. This article is not only the first time that Cushing's spinal cases while he was at Johns Hopkins have been reported, but also the first time ...

STRUCTURED ABSTRACT: Study Design. A retrospective review of coronal spine balance after tethered cord release for children with tight filum terminale.Objective. To understand the effects of untethering on coronal spine balance for these patients.Summary of Background Data. In patients with tight filum terminale, the spinal cord is tethered by a ...

Abstract  The surgical management of multiple muscular ventricular septal defects (mVSDs) in the infant remains a challenging problem because of the presence of residual shunts and postoperative myocardial dysfunction. We present a case of successful repair of multiple mVSDs with a unique hybrid procedure combining both the perventricular closure and ...

Salvage abdomino-perineal resection is justified in case of failure of the conservative treatment of a cancer of the anal canal. This surgery must be offered if surgery could be complete. In case of R0 resection, more than a patient on two will be alive after 5 years. The rate of perineal ...

Patients with neurogenic disorders and voiding dysfunction have been reported to respond poorly to sacral neuromodulation. We report on our experience in treating voiding symptoms with sacral neuromodulation after spinal surgery. The medical charts of patients evaluated for sacral neuromodulation from 2000-2008 were retrospectively reviewed. Indications, need for explantation, and ...

Tracheal reconstructions are aimed at rearranging or replacing parts of the tracheal tissue by different techniques. Here we introduce a new technique for tracheal reconstruction. In 10 adult dogs, after intubation with an endotracheal tube, a segment of trachea including seven tracheal rings was resected circumferentially. A submuscular tunnel was ...

Myotonic dystrophy (MD) is a rare genetic disorder with multisystem involvement characterised by myotonia and progressive muscle weakness and wasting. These patients pose significant challenges to the anaesthesiologist in view of the muscular and extramuscular involvement and sensitivity to anaesthetic drugs. The literature is replete with reports of postanaesthetic respiratory ...

The aim of this study was to assess retrospectively the clinical presentation, management and outcome of three patients with isolated SMA dissection encountered at Okinawa Prefectural Chubu Hospital, Japan from 2005 to 2006, along with a review of the literature. We follow up the patient's clinical symptoms and the image ...

It is generally accepted that neuraxial anesthesia is difficult to establish in patients with ankylosing spondylitis. General anesthesia also has some disadvantages, especially with respect to airway control in patients with ankylosing spondylitis. We present herein a gravida with ankylosing spondylitis who had a cesarean delivery performed under spinal anesthesia. ...

The nonoperative management (NOM) of abdominal gunshot injuries is gradually becoming the standard of care. Patients with pelvic gunshot injuries constitute a subgroup of patients at high risk of visceral injury. The aim of this study was to assess the feasibility and safety of the selective NOM of pelvic gunshot ...

Transorbital penetrating injury (TPI), an uncommon subset of head trauma, requires prompt multidisciplinary surgical intervention. While numerous case reports appear in the literature, there is a lack of discrete recommendations for initial evaluation, surgical intervention, and postoperative care of patients with TPI. A retrospective review of 4 cases of TPI ...

PURPOSE OF REVIEW: Patients with penetrating abdominal trauma are at risk of harboring life-threatening injuries. Many patients are in need of emergent operative intervention. However, there are clearly patients who can be safely managed nonoperatively. This review evaluates the literature to identify management guidelines for patients with penetrating abdominal trauma. ...

The inadvertent loss of surgical sponges remains a dreadful hazard of surgery. We report the case of a patient with a medical history of myotonic dystrophy type 1 who had received a right upper lobectomy for the treatment of a stage IIA (pT1N1M0) well differentiated neuroendocrine carcinoma. In the early ...

Thoracic wounding has been a relatively common presentation of military wounds throughout modern conflict. When civilian casualties are included the incidence has remained constant at around 10%, although the frequency and severity of wounds to combatants has been altered by modern body armour. Whilst thoracic injury has a high initial ...

An ideal vasovasostomy procedure requires precise mucosal approximation with a watertight anastomosis. The standard two-layer microdot technique requires multiple sutures within each layer and is a technically difficult operation to perform. We describe a two-layered technique which adheres to the principles of tubular anastomosis, but is simpler and provides excellent ...

The retained knife blade is an unusual and spectacular injury. The aim of this study was to review our experience with the management of such injuries. A retrospective chart review of patients with retained knife blades treated at Groote Schuur Hospital Trauma Centre from January 1996 to December 2007 was ...

A young boy presented in emergency with history of being hit by a stray bullet injuring the right hypochondrium. Ultrasound of abdomen showed hemoperitoneum and the radiograph showed bullet in the pelvis. Exploratory laparotomy showed injuries to liver and cystic duct with tract leading retroperitoneally into the inferior vena cava. ...

OBJECTIVE: To determine pattern and presentation in terms of site of injury, airway, associated injuries; and management of facial gunshot wounds. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Oral Surgery Department, Armed Forces Institute of Dentistry, Rawalpindi, between January 2001 and December 2008. METHODOLOGY: All patients with gunshot ...

OBJECT: Penetrating spinal injury (PSI), although an infrequent injury in the civilian population, is not an infrequent injury in military conflicts. Throughout military history, the role of surgery in the treatment of PSI has been controversial. The US is currently involved in 2 military campaigns, the hallmark of both being ...

Exsanguination from penetrating torso injury is a major source of mortality on the battlefield. Advanced Life Support guidelines suggest 'on-scene' thoracotomy for patients in cardiac arrest following penetrating chest trauma. This requires significant resourcing and training. Experience from published series (31 pre-hospital thoracotomies with 3 survivors) suggests that when this ...

Vascular injury due to penetrating abdominal trauma is a major challenge for trauma teams. Arterial and venous injuries occur with equal frequency. Treatment depends on the hemodynamic status of the patient: under stable conditions, angiography can be envisioned, whereas instability is an indication for immediate surgery; damage control is the ...

The development of disease complications is poorly characterized in pediatric patients with Crohn's disease (CD). We retrospectively determined the cumulative incidence of stricturing and penetrating complications of CD prior to first surgery utilizing data from 989 consecutively enrolled CD patients (age 0-17 years at diagnosis) collected between January 2000 and ...

Although gunshot and stab wounds are a common cause of self-inflicted injury, very little is understood about this mechanism of injury. The aim of this study was to characterise the epidemiology and outcomes of patients who injured themselves with a gun or sharp object. After IRB approval, the LAC+USC Trauma ...

Gunshot wounds to the head are rare in Europe. They may be inflicted by low-velocity handguns, captive bolt guns and tear gas cartridges and mostly result from suicide attempts. The experience of neurosurgeons with this kind of traumatic injury is decreasing; the aim of this study was therefore to analyse ...

A 30-year-old male presented with accidental injury with an arrow which referred to us from a peripheral village hospital. It was found that the arrow was penetrating through the nasal bones. An xray skull lateral view showed the tip of the arrow penetrating into the posterior wall of the sphenoid ...

Gunshot wounds (GSWs) to the head are frequently fatal. Rarely, the bullet may lodge in the skull base and not cause significant brain injury. Typically, the bullet fragments are felt to be inert and do not require operative extirpation if they are within the bony confines of the skull base. ...

Stab wounds are often managed conservatively with simple wound assessment and closure. However, even apparently minor thoracic wounds can cause delayed pericardial effusions presenting as life-threatening tamponade sometimes days, weeks or months later. Patients suffering stab wounds to the chest should receive echocardiographic follow-up to exclude delayed pericardial effusions.

Left thoracoabdominal stab wounds (LTSWs) leading to diaphragmatic injuries can cause serious morbidity and mortality. The diagnosis and treatment of LTSWs are controversial. This study investigated the reliability of laparoscopy for the diagnosis and treatment of diaphragmatic lacerations in hemodynamically stable patients with an LTSW, hypothesizing that laparoscopy is sufficient ...

Penetrating knife injuries of the face are more common in South Africa than the rest of the world. These injuries can be life-threatening, especially where the major blood vessels of the face are involved. The approach to treatment should be multidisciplinary, beginning with the trauma unit to provide airway maintenance ...

A young adult male suffered a combat gunshot wound to his anterior trachea, which resulted in bullet migration, via aspiration, to the point of lodgment in the right upper lobe bronchus. He subsequently spontaneously expectorated the intact bullet, a first report of such events. A bronchoscopy was then performed confirming ...

The idea that traction on the subcutaneous musculoaponeurotic system (SMAS) deepens the nasolabial crease has been propagated through the plastic surgery literature. This notion is contrary to the senior author's experience. The purpose of the present study was to investigate the effects of mobilization of the SMAS on the nasolabial ...

BACKGROUND: Our aim was to express the importance of emergency diagnosis and surgical approach in penetrating cardiac trauma patients. METHODS: Ko?uyolu Heart and Research Hospital moved to its new location in Cevizli Kartal in June 2005. Due to its close proximity to the main roads of the city, the number ...

BACKGROUND: A prospective, longitudinal analysis of injuries sustained by a large combat-deployed maneuver unit has not been previously performed. METHODS: A detailed description of the combat casualty care statistics, distribution of wounds, and mechanisms of injury incurred by a U.S. Army Brigade Combat Team during "The Surge" phase of Operation ...

Interpersonal violence is a worldwide social reality which seems to increasingly affect even the safest of countries, such as Switzerland. In this country, road traffic accidents, as well as professional and recreational activities, are the main providers of trauma-related injuries. The incidence of penetrative trauma related to stab wounds seems ...

The United States forces in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) are primarily engaged in counterinsurgency operations within an irregular war. The US combat medical experience has reported new injury patterns secondary to the enemy's reliance on explosive mechanisms, particularly improvised explosive devices (IEDs), and the widespread use of individual ...

BACKGROUND: Gun violence is on the rise in some European countries, however most of the literature on gunshot injuries pertains to military weaponry and is difficult to apply to civilians, due to dissimilarities in wound contamination and wounding potential of firearms and ammunition. Gunshot injuries in civilians have more focal ...