25 results on '"*ORIFICIAL surgery"'
Search Results
2. Homeopathy, Orificial Surgery, and the Clitoris in the United States, 1880-1920 - an Eclectic Approach?
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Hulverscheidt, Marion
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ORIFICIAL surgery ,HYSTERECTOMY ,MASTURBATION - Abstract
This article focuses on a hitherto unknown surgical practices performed around the vulva. At the turn from the 19
th to the 20th century, a group of Chicago-based surgeons performing orificial surgery expounded on the curing and helpful aspects of surgical practices performed on mouth and nose and the bodily orifices below the waist. This association was founded by Edwin Pratt, a trained physician and homeopath. In 1887 he had published a monograph on Orificial Surgery, between 1892 and 1901 he edited the Journal of Orificial Surgery. Although the majority of the articles were contributions of him, other practitioners also gave examples of their treatment activities. Orificial surgery fits in well with the idea of reflex neuroses, which was an accepted explanation for disease at that time. Pratt recommended surgical interventions on the rectum, circumcision as well as the removal of the hood of the clitoris and even hysterectomy to cure masturbation and insanity, and other so-called chronic diseases. This paper attempts to contextualize the era of Orificial Surgery and their protagonists in the medical and social realm. [ABSTRACT FROM AUTHOR]- Published
- 2018
3. Current management options for displaced intra-articular calcaneal fractures: Non-operative, ORIF, minimally invasive reduction and fixation or primary ORIF and subtalar arthrodesis. A contemporary review.
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Sharr, P.J., Mangupli, M.M., Winson, I.G., and Buckley, R.E.
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HEEL bone fractures , *ORIFICIAL surgery , *SURGEONS , *MINIMALLY invasive procedures , *FRACTURE fixation , *ARTHRODESIS , *TREATMENT of fractures , *HEEL bone injuries , *FOOT injuries , *SUBTALAR joint , *WOUNDS & injuries , *SURGERY , *THERAPEUTICS - Abstract
Background: Management of Displaced Intra-articular Calcaneal Fractures (DIACFs) continues to be technically demanding. The literature has not been definitive in its guidance for surgeons dealing with these injuries. Recent publications have further added to the lack of clarity. This review is intended to summarise the present state of knowledge, and provide some genuine guidance for clinicians.Objectives: To review previous research, focussing on articles published within the last fifteen years, and summarise the findings to aid surgeons in managing DIACFs with choosing best management for patients.Methods: We reviewed the best evidence and literature, focussing on articles published within the last fifteen years, and summarised findings into workable recommendations. Variables of (1) patient, (2) the associated soft tissue injury and (3) the fracture characteristics were used to aid surgeons in choosing the best of the available options for each patient that presents with a DIACF.Authors Summary: Management of DIACFs can best be divided into four broad categories: (i) non-operative management, (ii) open reduction and internal fixation, (iii) minimally invasive reduction and fixation, and (iv) primary subtalar arthrodesis. The evolution of the literature would suggest orthopaedic surgeons managing calcaneus fractures should have an expert's knowledge, surgical expertise and the latest techniques to cover these four options, to tailor the treatment of DIACFs to the individual patient. [ABSTRACT FROM AUTHOR]- Published
- 2016
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4. The Ilizarov external fixator - a useful alternative for the treatment of proximal tibial fractures A prospective observational study of 30 consecutive patients.
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Ramos, Telmo, Ekholm, Carl, Eriksson, Bengt I., Karlsson, Jón, and Nisto, Lars
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ORIFICIAL surgery , *TIBIA injuries , *BONE fractures , *BONE injuries , *SCIENTIFIC observation - Abstract
Background: In dislocated proximal tibial fractures, the most frequently used treatment is ORIF with screws and plates. Minimally-invasive techniques using external fixation are an alternative. The aim of this study was to analyse the clinical and radiological results using the Ilizarov technique in both uni- and bicondylar tibial fractures. Methods: Thirty consecutive patients with isolated fractures of the proximal tibia were treated with the Ilizarov technique, 11 Schatzker I-IV with 2-3 rings and 19 Schatzker V-VI with 3-4 tibial rings and a femoral, hinged, two-ring extension. Unrestricted weight-bearing was allowed. Pre and post-operatively, conventional radiographs, computerized tomography scans, post-operative pain assessments and complications were evaluated. The knee function was evaluated with the EQ-5D, NHP and KOOS scores, as well as self-appraisal. Results: All the fractures healed. Twenty-five patients achieved a range of motion better than 10-100°. The type I-IV fractures had a shorter operating time and hospital stay, as well as better knee flexion, and the self-appraisal indicated that they tolerated the treatment better. Pin infections occurred in 4% of the pin sites, but only two patients required debridement. Two patients developed compartment syndrome and underwent fasciotomy. No patient complained of functional knee instability. Two patients underwent a total knee arthroplasty because of residual pain. The overall result was judged as satisfactory in twenty-seven patients. Conclusions: The Ilizarov method produces a good clinical outcome and is a valuable treatment alternative in proximal tibial fractures of all types. [ABSTRACT FROM AUTHOR]
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- 2013
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5. Free Vascularized Iliac Crest Bone Graft for the Treatment of a Pediatric Lateral Humeral Condyle Fracture Nonunion.
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Chubb, Paul, Oishi, Scott, and Lattanza, Lisa
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ELBOW fractures , *ILIAC artery , *INTERNAL fixation in fractures , *BONE grafting , *ORIFICIAL surgery - Abstract
The article presents a case study of a 10-year-old woman admitted with symptoms of increasing pain and valgus deformity in the left elbow. She had a history of a lateral humeral condyle fracture that was treated nonoperatively. She had undergone a tradition in situ open reduction and internal fixation (ORIF) with iliac crest-bone grafting. The option for providing union of the lateral humeral condyle in a patient with continued nonunion following ORIF and bone-grafting is discussed.
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- 2012
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6. Preliminary investigation to achieve patency of MB2 canal in maxillary molars.
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de Souza Coutinho-Filho, Tauby, Gurgel-Filho, Eduardo Diogo, Souza-Filho, Francisco José, and Nogueira Leal da Silva, Emmanuel João
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MAXILLA ,MOLARS ,DENTAL pulp cavities ,OPERATING microscopes ,ORIFICIAL surgery ,ORAL surgery - Abstract
Aim: To establish a preliminary investigation about the possibility to achieve patency of second mesiobuccal canal (MB2) in mesiobuccal roots of maxillary molars. Methods: Three hundred and five first maxillary molars were examined with direct vision and with magnification. The root canal configurations were classified according to the possibility to achieve patency in MB2 canals. Clearing technique was also performed to illustrate root canal anatomy and verify the presence of extra canals not identified with magnification. Results: The prevalence of MB2 canals detected only with direct vision was 53.4% and the use of the surgical operating microscope increased rate detection to 90.7%. The clearing technique revealed the presence of MB2 canal in 12 more teeth (94.7%). In 49.1% of the localized MB2 canals, it was not possible to achieve patency. Conclusions: The findings of the presented study revealed that it was only possible to achieve patency in 50.9% of the MB2 canals, showing that achieve patency in the MB2 canal is much more challenging than locating them. [ABSTRACT FROM AUTHOR]
- Published
- 2012
7. Labyrinthine window rupture as a cause of acute sensorineural hearing loss.
- Author
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Nagai, Tomoyuki and Nagai, Midori
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ORGAN rupture , *DIAGNOSIS of deafness , *ORIFICIAL surgery , *SENSORINEURAL hearing loss , *TREATMENT of ear diseases , *DISEASE risk factors ,RISK factors - Abstract
Labyrinthine window rupture (LWR) is one cause of acute sensorineural hearing loss and need for early exploration is clear for good improved hearing. Acute sensorineural hearing loss of 60 dB or more treated from May 2006 to May 2010 were retrospectively analyzed. There were 21 ears of severe deafness, 18 ears of profound deafness, and 10 ears of total deafness. All patients were examined with temporal bone CT. Space-occupying lesions around the labyrinthine windows were suggestive images of LWR. Thirty-five ears were operated for LWR while 14 ears of SHL received conservative treatments. Fifty-seven percent of LWR improved 30 dB or more after sealing of both labyrinthine windows. Of the 15 markedly recovered ears, 14 ears were operated within 2 weeks from the onset. Of the five cured ears, four ears were operated within a week from the onset. As for the hearing prognosis of SHL, 88% of severe and profound deafness improved 30 dB or more but total deafness did not improve more than 30 dB. Exclusion of LWR from SHL and early surgical intervention in LWR will bring about good hearing prognosis to both LWR and SHL. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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8. An alternative subcoronary implantation technique decreases the risk of complete heart block after stentless aortic valve replacement.
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Zhigang Song, Lehr, Eric J., and Shaohua Wang
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HEART block , *POSTOPERATIVE care , *HEMODYNAMICS , *CHI-squared test , *PARTIAL left ventriculectomy , *PROSTHETICS , *ORIFICIAL surgery ,AORTIC valve surgery - Abstract
Context: Stentless aortic valve prostheses have excellent hemodynamic profiles, but may be associated with an increased postoperative heart block when compared to conventional prostheses. Aims: To assess the effect of an alternative subcoronary implantation technique on postoperative complete heart block (CHB) and permanent pacemaker implantation (PPI) following aortic valve replacement (AVR) with stentless tissue valves. Settings and Design: A total of 130 consecutive patients undergoing AVR with stentless tissue valves by a single surgeon were studied retrospectively. Materials and Methods: A stentless tissue valve was implanted into 80 patients using the conventional modified subcoronary implantation technique, and 50 patients received a stentless tissue valve by an alternative subcoronary technique in which the inflow suture line is raised at the level of right-non coronary commissure. Data were collected at the time of hospital discharge and at 6-12 months postoperatively. Statistical Analysis Used: Independent samples t-test was used to compare continuous variables, and categorical variables were compared with the chi-square test. Results: Use of this new method reduced postoperative CHB (4.0% vs. 16.3%, P = 0.033), with fewer patients requiring PPI in the early postoperative period (6.0% vs. 18.8%, P = 0.041). Echocardiographic examination showed no differences in the effective orifice area, peak and mean aortic valve gradients, or left ventricular mass index between groups. Trivial or mild aortic regurgitation was found in 3.9% of patients with the conventional modified technique and 4.0% of patients undergoing the alternative technique, during follow-up (P > 0.05). Conclusions: Compared to the conventional subcoronary implantation technique, the alternative subcoronary implantation technique reduces the incidence of new CHB and the requirement of PPI following AVR with stentless tissue valves while preserving mid-term hemodynamic function. [ABSTRACT FROM AUTHOR]
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- 2012
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9. Functional and structural effects of percutaneous edge-to-edge double-orifice repair under cardiac cycle in comparison with suture repair.
- Author
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Avanzini, A, Donzella, G, and Libretti, L
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HEART beat ,MITRAL valve surgery ,CARDIAC surgery ,ORIFICIAL surgery ,SUTURING ,FINITE element method - Abstract
Percutaneous procedures for double-orifice mitral valve repair using the MitraClip® device (clip) have been recently introduced as new treatment options as alternatives to medical management and open-heart surgery, especially for patients with high estimated operative risk. Similarly to the open-heart surgical technique, where suturing is used, the clip creates a double-orifice configuration that not only improves the closing function of the valve, but also significantly modifies its behaviour, particularly in the diastolic phase. While several clinical trials have been conducted, and are ongoing, in order to assess the safety and effectiveness of this technique, a deeper knowledge of the structural and functional effects on the valve, and of the cyclic loads transmitted to the clip itself, would allow a comparison with other repair techniques, and could serve as a foundation for possible further optimization of the clip design. The effects of the MitraClip® device developed by Evalve Inc. were studied by means of a finite element model of the mitral valve, specifically developed to study the structural effects of the original, suture-based, edge-to-edge technique. A second model was developed in order to simulate the effects of a suture with similar extension from the leaflet edge in a direction to the annulus, in order to compare the two repair techniques. The mitral valve area and transvalvular pressure gradient predicted by the models for the clip and the suture are quite similar. Similar leaflet cyclic stresses, both in value and in location, were noted for the two mechanisms of linking the leaflets, while minor differences were found in the load transmitted to the suture and the clip, with slightly higher values for the clip. The model satisfactorily allowed functional parameters (valve area and transvalvular pressure gradient) and structural parameters (load, leaflet stress) to be determined. Overall, the structural effects of the clip and the suture are quite similar under the cyclic loading conditions imposed by the cardiac cycle. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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10. Intraperitoneal virtual biopsy by fibered optical coherence tomography (OCT) at natural orifice transluminal endoscopic surgery (NOTES).
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Cahill, Ronan A., Asakuma, Mitsuhiro, Trunzo, Joseph, Schomisch, Steven, Wiese, David, Saha, Sukamal, Dallemagne, Bernard, Marks, Jeff, and Marescaux, Jacques
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OPTICAL coherence tomography , *BIOPSY , *ORIFICIAL surgery , *ENDOSCOPIC surgery , *TOMOGRAPHY , *SENTINEL lymph nodes , *PERITONEUM surgery , *GASTROSCOPY , *ANIMAL experimentation , *BIOLOGICAL models , *COMPARATIVE studies , *FIBER optics , *RESEARCH methodology , *MEDICAL cooperation , *RESEARCH , *SWINE , *PILOT projects , *EVALUATION research , *SENTINEL lymph node biopsy , *IN vitro studies , *EQUIPMENT & supplies - Abstract
Introduction: Fibered optical coherence tomography (OCT) in conjunction with natural orifice transluminal endoscopic surgery (NOTES) could provide a facility for rapid, in situ pathological diagnosis of intraperitoneal tissues in a truly minimally invasive fashion.Materials and Methods: A large porcine model was established to test this hypothesis. A standard double channel gastroscope (Olympus) was used to achieve a transgastric access to the peritoneum and initiate the pneumoperitoneum. Magnetic retraction was used to display the sigmoid colon along with its mesentery. A commercially available fibered OCT probe (NIRIS system, Imalux) was inserted via a working channel of the gastroscope and used to assess intraperitoneal tissues. Separately, OCT images of human tissue specimens ex vivo were contrasted with representative standard histopathological slides.Results: Intraperitoneal OCT provided clear real-time images of both the serosal and muscularis propria mural layers as well as the submucosal-muscularis interface. Examination of mesenteric lymph nodes (including sentinel nodes) allowed visualization of their subcapsular sinus. Comparison of representative cross-sections however failed to evince sufficient resolution for confident diagnosis.Conclusion: This approach is technically feasible and, if the technology is advanced and proven accurate in human patients, could potentially be used to individualize operative extent prior to definitive resection. [ABSTRACT FROM AUTHOR]- Published
- 2010
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11. Transumbilical Single-Port Laparoscopic Adjustable Gastric Band Placement with Liver Suture Retractor.
- Author
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De la Torre, Roger A., Satgunam, Shean, Morales, Mario P., Dwyer, C. Liam, and Scott, J. Stephen
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BARIATRIC surgery ,LAPAROSCOPIC surgery ,ORIFICIAL surgery ,ENDOSCOPIC surgery ,GASTRIC banding - Abstract
The article details a study which described a technique in placing an adjustable band via a single incision using three ports in a small transumblical incision. A comparison between single-incision laparoscopic surgery (SILS) and natural orifice transluminal endoscopic surgery (NOTES) is presented. The study demonstrated the safety and technical feasibility of single-incision transumbilical placement of gastric band.
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- 2009
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12. A new technique during septoplasty to prevent saddle nose.
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Raeessi, M. A., Farhadi, M., Shirazi, A., Ajalloueyan, M., and Karimi Yazdi, A. R.
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OPERATIVE otolaryngology , *ORIFICIAL surgery , *OPERATIVE surgery , *NOSE abnormalities , *SURGICAL complications - Abstract
Keypoints • During septoplasty, especially in patients with severe deviation of the nasal septum, there is the risk of septal instability, which may result in a saddle nose deformity. Therefore, prevention of this unwanted outcome is very important and removes surgeon’s anxieties. • This article describes a simple technique during septoplasty to prevent the development of this serious complication. • In this surgical technique, the dislocated nasal septum is lifted and stabilised with a temporary traction suture. This traction suture holds the mobile septal cartilage in the proper position to restore and support the nasal dorsum and provides it with a normal contour. • The advantages of this technique are that it is (i) easy to perform, (ii) not time-consuming, (iii) is less traumatic compared to other methods, (iv) is comfortable for the patient and (v) provides long-term stability. [ABSTRACT FROM AUTHOR]
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- 2008
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13. Natural orifice surgery with an endoluminal mobile robot.
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Rentschler, Mark, Dumpert, Jason, Platt, Stephen, Farritor, Shane, Oleynikov, Dmitry, Rentschler, Mark E, Platt, Stephen R, and Farritor, Shane M
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ORIFICIAL surgery , *SURGICAL robots , *ENDOSCOPIC surgery , *SURGICAL complications , *GASTROINTESTINAL surgery , *LAPAROSCOPY , *ESOPHAGUS examination , *ROBOTICS equipment , *ANIMAL experimentation , *BIOLOGICAL models , *GASTROSCOPY , *MINIATURE electronic equipment , *SWINE , *MEDICAL equipment safety measures , *PRODUCT design - Abstract
Natural orifice transgastric endoscopic surgery promises to eliminate skin incisions and reduce postoperative pain and discomfort. Such an approach provides a distinct benefit as compared with conventional laparoscopy, in which multiple entry incisions are required for tools and camera. Endoscopy currently is the only method for performing procedures through the gastrointestinal tract. However, this approach is limited by instrumentation and the need to pass the entire scope into the patient. In contrast, an untethered miniature robot inserted through the mouth would be able to enter the abdominal cavity through a gastrotomy for exploration of the entire peritoneal cavity. In this study, the authors developed an endoluminal robot capable of transgastric abdominal exploration under esophagogastroduodenoscopic (EGD) control. Under EGD control, a gastrotomy was created, and the miniature robot was deployed into the abdominal cavity under remote control. Ultimately, future procedures will include a family of robots working together inside the gastric and abdominal cavities after their insertion through the esophagus. Such technology will help to reduce patient trauma while providing surgical flexibility. [ABSTRACT FROM AUTHOR]
- Published
- 2007
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14. Management of the Thick-Skinned Nose: A More Effective Approach.
- Author
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Hafezi, Farhad, Naghibzadeh, Bijan, and Nouhi, Amirhossein
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RHINOPLASTY , *NASAL surgery , *PLASTIC surgery , *OPERATIVE otolaryngology , *ORIFICIAL surgery - Abstract
A bulky nose is a challenging issue to manage, and surgeons have not found the ultimate solution to this problem in the evolution of rhinoplastic surgery. Because of the multiplicity of techniques and controversies published in the literature, it has become confusing for the operating surgeon to find the most appropriate and effective way of solving this frustrating dilemma. The subcutaneous fat is the thickest in the supratip area, and the soft tissue thickness over the tip of the nose varies considerably from patient to patient. The focus of this study was to find a method for reducing the overlying soft tissue of the tip for better re-draping of skin over the nasal skeleton. The hallmark of this technique is to undermine the nasal skin in two layers. We believe that soft tissue trimming in biplane dissection can minimize the thickness of the tip skin in a relativelv safe and homogeneous way. With this report we introduce a new method of dissection of nasal soft tissue and of trimming it in different areas of the nose for different purposes. In the authors' opinion, this approach is one of the most effective ways of handling unpliable, thick nasal skin. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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15. Computer-Assisted Oral and Maxillofacial Reconstruction.
- Author
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Schramm, Alexander, Schön, Ralf, Rücker, Martin, Barth, Enno-Ludwig, Zizelmann, Christoph, and Gellrich, N.-C.
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FACIAL reconstruction (Anthropology) ,LIP surgery ,MAXILLOFACIAL surgery ,ORIFICIAL surgery ,SKULL base ,MAGNETIC resonance imaging ,TOMOGRAPHY ,TISSUE remodeling ,TRANSPLANTATION of organs, tissues, etc. ,SURGERY - Abstract
Ablative tumor surgery, orbital and mid face reconstruction as much as skull base surgery requires detailed planning using CT or MRI. Reconstruction is depending on reliable information to choose correct type of grafts and to predict the outcome. Benefits and indications of computer-assisted surgery in the treatment of cranio- maxillofacial surgery are demonstrated. Based on a CT or MR1 data set, an optical navigation system was used for preoperative planning, intraoperative navigation and postoperative control. Surgery was preoperatively planned and intraoperatively navigated. Preoperatively, required soft and hard tissue was measured using the mirrored data set of the unaffected side; size and location of the graft were chosen virtually. lntraoperatively, contours of transplanted tissues were navigated to the preoperatively simulated reconstructive result. Pre- operatively outlined safety margins could be exactly controlled during tumor resection. Reconstruction was designed and performed precisely as virtually planned. Image-guided treatment improves preoperative planning by visualization of the individual anatomy, intended reconstructive outcome and by objectivation the effect of adjuvant therapy. lntraoperative navigation makes tumor and reconstructive surgery more reliable by showing the safety margins, saving vital structures and leading reconstruction to preplanned objectives. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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16. Treatment of Nasal Obstruction From Nasal Valve Collapse with Alar Batten Grafts.
- Author
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Becket, Daniel G. and Becket, Samuel S.
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NASAL surgery ,RHINOPLASTY ,OPERATIVE otolaryngology ,ORIFICIAL surgery ,OPERATIVE surgery ,PATIENTS - Abstract
Nasal obstruction may require treatment with rhinoplasty techniques. One cause of nasal obstruction is known as nasal-valve collapse. This refers to narrowness and weakness at the nasal valve, the narrowest part of the nasal airway. There are a number of surgical approaches available to treat nasal valve collapse. Selection of the appropriate surgical intervention depends on proper identification of the anatomic cause of the collapse. Alar batten grafts are especially useful for addressing nasal valve collapse caused by a weak nasal sidewall. In this report, we review the senior author's experience with the use of alar batten grafts for nasal valve collapse. Twenty-one patients had septoplasty with placement of alar batten grafts; all patients noted improvement in their nasal breathing. Seven patients underwent ear cartilage harvest with alar batten grafts, and five of them noted improvement, one noted partial improvement, one noted no improvement. Six patients underwent revision septorhinoplasty with alar batten grafting, and ten patients underwent revision septorhinoplasty with ear cartilage harvest and alar batten grafting. These patients all reported improvement in their nasal breathing postoperatively. Six patients underwent revision rhinoplasty (no septoplasty) with ear cartilage and battens. These patients hold special interest because no other intranasal procedures were performed that affected nasal breathing. All six of these patients reported significant improvement of their nasal breathing and all patients were satisfied with their postsurgical cosmetic appearance. The nasal valve area is considered to be the location of the least cross-sectional area in the nose. When narrowing of the nasal valve is a result of collapse of the nasal sidewall, alar batten grafts are a useful technique to address the patient's nasal obstruction. [ABSTRACT FROM AUTHOR]
- Published
- 2003
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17. Fundamental considerations of the design and function of intranasal antrostomies.
- Author
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Lund, Valerie J.
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NASAL surgery ,NASAL bone ,OPERATIVE otolaryngology ,OPERATIVE surgery ,ORIFICIAL surgery - Abstract
The article focuses on the factors to consider in the design and function of intranasal antrostomies. One factor that limits the potential inferior meatal antrostomy is the thickness of the bone in the nose. Antrostomies tend to close more in patients under 16 years old at the time of the operation. Patency does not guarantee the success of the operation.
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- 1986
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18. How we do it: the Bradford grommet trainer: a model for training in myringotomy and grommet insertion.
- Author
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Jesudason, W. V. and Smith, I.
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MYRINGOPLASTY , *EAR surgery , *TYMPANIC membrane surgery , *PLASTIC surgery , *OPERATIVE otolaryngology , *OPERATIVE surgery , *ORIFICIAL surgery - Abstract
• Myringotomy and grommet insertion is the most common operative procedure in otological practice. • We describe a simple, cheap and effective model for the junior trainee to develop the skills required for myringotomy and grommet insertion without compromising patient safety. • As the materials required for our model are more readily available, it is more likely to gain widespread acceptance in ENT training. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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19. É o exame anatomopatológico de rotina indispensável em cirurgias orificiais? Is the histopathologic examination essential in orificial sugeries?
- Author
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Juvenal da Rocha Torres Neto, Rodrigo Rocha Santiago, Ana Carolina Lisboa Prudente, Hugo Leito de Farias Brito, Felipe Augusto do Prado Torres, Júlio Augusto do Prado Torres, Fernanda Mendonça Ramos, and Raquel Matos de Santana
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lcsh:Internal medicine ,lcsh:Specialties of internal medicine ,Histopathologic examination ,cost-benefit analysis ,lcsh:R ,lcsh:Medicine ,orificial surgery ,lcsh:RC581-951 ,análise custo/benefício ,Exame anatomopatológico ,cirurgia orificial ,lcsh:Diseases of the digestive system. Gastroenterology ,lcsh:RC799-869 ,lcsh:RC31-1245 - Abstract
Introdução: O exame anatomopatológico é feito rotineiramente em cirurgias orificiais e é importante para diagnosticar doenças anais concomitantes, lesões malignas e doenças sexualmente transmissíveis não previstas anteriormente no exame clínico. O gasto com estes exames é bastante significativo para o serviço público o que evidencia a necessidade de avaliar o custo/benefício da sua utilização rotineira. Objetivos: Avaliar o tempo decorrido entre a entrega do material e a emissão do laudo, o nível de concordância entre a impressão diagnóstica e a conclusão do anatomopatológico, a importância clínica das patologias diagnosticadas secundariamente, o custo de realização dos exames e a relação custo/benefício dos mesmos. Metodologia: Estudo descritivo e retrospectivo de 173 exames anatomopatológicos de pacientes do Hospital Universitário de Aracaju realizados de 2005 a 2007, que foram submetidos à cirurgias orificiais. Resultados: O nível de concordância entre a impressão diagnóstica e a conclusão do anatomopatológico foi elevada e, dos laudos discordantes, poucos apresentaram relevância clínica, havendo somente um caso de neoplasia anorretal. Houve um atraso significativo na emissão dos laudos, sugerindo sobrecarga do serviço e o custo/benefício para realização dos exames foi desfavorável. Conclusão: Sugerimos triagem para um uso racional e criterioso do exame anatomopatológico em cirurgias orificiais baseada na história clínica e fatores de risco do paciente.Introduction: The histopathologic examination is repeatedly done in orificial surgeries and it's important to diagnose anal diseases associated, malign lesions and sexually transmitted diseases that weren't previously predicted on the clinic examination. The cost of the histopathologic examinations is very significant to the public health service, which shows the need to do a cost-benefit analysis of their routine use. Objectives: Evaluate the time between the surgical specimen's delivery and the emission of the histopathologic examination's report, the concordance level between the clinic impression and the histopathologic examination's report, the clinical relevance of the diseases secondarily diagnosed, the cost of the histopathologic examinations and the cost-benefit analysis of them. Methods: Descriptive and retrospective study of 173 histopathologic examinations from patients of the Hospital Universitário de Aracaju made from 2005 to 2007, that were submitted to orificial surgeries. Results: High concordance level between the clinic impression and the histopathologic examination's report; from the discordants reports, a few had clinical relevance and was only one case of anal cancer. There was a significant delay on the reports' emission, which suggests that the pathology service is overloaded; and the cost-benefit analysis was unfavorable. Conclusions: We suggest screening to a rational and judicious use of the histopathologic examination in orificial surgeries based on the patient's clinical history and risk factors.
- Published
- 2010
20. Open Wide. No, Wider.
- Author
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Peng, Tina
- Subjects
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SURGERY , *ORIFICIAL surgery , *MEDICAL technology - Abstract
This article discusses the development of natural orifice surgery, in which the surgeons enter through the mouth. It describes the reaction to the first natural orifice appendectomy to occur in the U.S. Christopher Thompson, from Brigham & Women's Hospital and the Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR), discusses the advantages. Ronald Bleday, also from Brigham & Women's expressed skepticism and suggested some of the dangers posed by orificial surgery.
- Published
- 2008
21. Is the histopathologic examination essential in orificial sugeries?
- Author
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Fernanda Mendonça Ramos, Juvenal da Rocha Torres Neto, Rodrigo Rocha Santiago, Raquel Matos de Santana, Hugo Leito de Farias Brito, Felipe Augusto do Prado Torres, Júlio Augusto do Prado Torres, and Ana Carolina Lisboa Prudente
- Subjects
medicine.medical_specialty ,business.industry ,General surgery ,Concordance ,Histopathologic examination ,cost-benefit analysis ,Gastroenterology ,Retrospective cohort study ,Surgical specimen ,medicine.disease ,orificial surgery ,Surgery ,Public health service ,Clinical history ,análise custo/benefício ,medicine ,Anal cancer ,Clinical significance ,Exame anatomopatológico ,cirurgia orificial ,business - Abstract
Introdução: O exame anatomopatológico é feito rotineiramente em cirurgias orificiais e é importante para diagnosticar doenças anais concomitantes, lesões malignas e doenças sexualmente transmissíveis não previstas anteriormente no exame clínico. O gasto com estes exames é bastante significativo para o serviço público o que evidencia a necessidade de avaliar o custo/benefício da sua utilização rotineira. Objetivos: Avaliar o tempo decorrido entre a entrega do material e a emissão do laudo, o nível de concordância entre a impressão diagnóstica e a conclusão do anatomopatológico, a importância clínica das patologias diagnosticadas secundariamente, o custo de realização dos exames e a relação custo/benefício dos mesmos. Metodologia: Estudo descritivo e retrospectivo de 173 exames anatomopatológicos de pacientes do Hospital Universitário de Aracaju realizados de 2005 a 2007, que foram submetidos à cirurgias orificiais. Resultados: O nível de concordância entre a impressão diagnóstica e a conclusão do anatomopatológico foi elevada e, dos laudos discordantes, poucos apresentaram relevância clínica, havendo somente um caso de neoplasia anorretal. Houve um atraso significativo na emissão dos laudos, sugerindo sobrecarga do serviço e o custo/benefício para realização dos exames foi desfavorável. Conclusão: Sugerimos triagem para um uso racional e criterioso do exame anatomopatológico em cirurgias orificiais baseada na história clínica e fatores de risco do paciente. Introduction: The histopathologic examination is repeatedly done in orificial surgeries and it's important to diagnose anal diseases associated, malign lesions and sexually transmitted diseases that weren't previously predicted on the clinic examination. The cost of the histopathologic examinations is very significant to the public health service, which shows the need to do a cost-benefit analysis of their routine use. Objectives: Evaluate the time between the surgical specimen's delivery and the emission of the histopathologic examination's report, the concordance level between the clinic impression and the histopathologic examination's report, the clinical relevance of the diseases secondarily diagnosed, the cost of the histopathologic examinations and the cost-benefit analysis of them. Methods: Descriptive and retrospective study of 173 histopathologic examinations from patients of the Hospital Universitário de Aracaju made from 2005 to 2007, that were submitted to orificial surgeries. Results: High concordance level between the clinic impression and the histopathologic examination's report; from the discordants reports, a few had clinical relevance and was only one case of anal cancer. There was a significant delay on the reports' emission, which suggests that the pathology service is overloaded; and the cost-benefit analysis was unfavorable. Conclusions: We suggest screening to a rational and judicious use of the histopathologic examination in orificial surgeries based on the patient's clinical history and risk factors.
- Published
- 2010
22. Front & Back Matter.
- Subjects
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MAGAZINE covers , *OPERATIVE otolaryngology , *ORIFICIAL surgery - Abstract
The front and back covers of the January 2015 issue of the journal "ORL: Journal for Oto-Rhino-Laryngology, Head and Neck Surgery" are presented.
- Published
- 2015
- Full Text
- View/download PDF
23. Magnetically guided camera shows early promise.
- Author
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Guttman, Cheryl
- Subjects
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OPERATIVE surgery , *SURGICAL technology , *SURGICAL instruments , *ORIFICIAL surgery , *ENDOSCOPIC surgery - Abstract
The article discusses a study which examined the use of magnetic anchoring guidance systems (MAGS). The study found that MAGS is effective in facilitating single-port and natural orifice surgery. Chad R. Tracy, co-author of the study, explains that MAGS can also facilitate single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES).
- Published
- 2009
24. Turning surgery inside out.
- Subjects
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ENDOSCOPIC surgery , *SURGICAL instruments , *ORIFICIAL surgery , *MEDICAL technology equipment , *OPERATIVE surgery - Abstract
The article reports on the natural orifice translumenal endosurgery (NOTES) surgical procedure. The author describes the technique whereby surgical instruments are placed in through bodily orifices to perform surgical procedures. The article also discusses recovery times, various patient benefits, and the technological development necessary to allow the procedures to be more widespread.
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- 2007
25. Orificial Surgery.
- Author
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Rutkow, Ira M.
- Subjects
ORIFICIAL surgery ,HOMEOPATHY ,SURGERY practice - Abstract
Discusses the orificial surgery, the surgical practice under homeopathy developed by Edwin Pratt, an Illinois homeopathic general practitioner. Medical education of Pratt; Efforts of Pratt to promote orificial surgery; Popularity and decline of orificial surgery in the United States.
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- 2001
- Full Text
- View/download PDF
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