Does Hearing Improve Following Primary Cleft Palate Repair?

Objective: To establish the effect of cleft palate repair on hearing outcomes in children with glue ear and conductive hearing loss undergoing elective primary palatoplasty.

Methods: A retrospective chart review of all patients who underwent cleft palate repair (isolated cleft palate [CPO], unilateral cleft lip and palate [UCLP], and bilateral CLP [BCLP]) between 2020 and 2022 in a single institution. Patient demographic data and cleft type were recorded.

Principal diagnostic features of paediatric foreign body aspiration.

Objectives: The aim of this study is to identify the most common and important features within the presenting history, clinical examination and chest radiograph that are associated with foreign body (FB) aspiration in the paediatric population, to support rationalised decision making in regards to proceeding with diagnostic bronchoscopy.

Methods: A retrospective notes review was conducted of 70 patients over a 12-year period at our tertiary referral centre. Their presenting history, clinical and radiographic signs were documented and univariate logistic regression model used to calculate odds ratios.

A systematic review of left ventricular cardio-endoscopic surgery.

Better visualisation, accurate resection and avoidance of ventriculotomy associated with use of endoscopic devices during intracardiac surgery has led to increasing interest in their use. The possibility of combining a cardio-endoscopic technique with either minimally invasive or totally endoscopic cardiac surgery provides an incentive for its further development. Several devices have been used, however their uptake has been limited due to uncertainty around their impact on patient outcomes.

A systematic review of the safety and efficacy of distal coronary artery anastomotic devices in MIDCAB and TECAB surgery.

Background: Minimally invasive direct coronary artery bypass (MIDCAB) and totally endoscopic coronary artery bypass (TECAB) techniques may improve recovery and reduce hospital stay following coronary artery bypass surgery (CABG). However, working in a limited space with indirect visualisation would greatly benefit from a simple, high-quality and reproducible automated distal anastomotic method. Several devices have been developed; however, their uptake has been limited due to uncertainty around their impact on patient outcomes.

Vivien Theodore Thomas (1910-1985): An African-American laboratory technician who went on to become an innovator in cardiac surgery.

Vivien Theodore Thomas (1910-1985) was an African-American laboratory technician and instructor of surgery at Johns Hopkins University, Baltimore. He was born as the grandson of a slave in Lousiana, working as a carpenter and subsequently as a laboratory technician after the great depression and the loss of his savings derailed his plans to become a doctor. In his role as a laboratory technician, he overcame challenging personal circumstances to become an innovator in paediatric cardiac surgery, despite having no formal college education.

A systematic review of the safety and efficacy of distal coronary artery anastomotic devices.

Interest in minimally invasive and off-pump cardiac surgical techniques has promoted the development of automated distal anastomotic devices (DADs) to facilitate construction of coronary artery anastomosis. Several DADs have been proposed for potential use in coronary surgery. However, a number of technical failures and uncertainty around both short-term morbidity and long-term patency have limited the generalized uptake of these devices.

Does coronary endarterectomy technique affect surgical outcome when combined with coronary artery bypass grafting?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether open coronary endarterectomy (CE) and coronary artery bypass grafting (CABG) compares favourably with closed endarterectomy and CABG in the myocardial revascularization of patients presenting with diffuse coronary artery disease (DCAD). One hundred and fifty-five articles were identified by a systematic search, of which 10 best answered the clinical question incorporating a total of 1203 patients (915 open-CE, 288 closed-CE).

Adjunct coronary endarterectomy increases myocardial infarction and early mortality after coronary artery bypass grafting: a meta-analysis.

Coronary endarterectomy (CE) may provide a useful adjunct to coronary artery bypass grafting (CABG) in patients with extensive, diffuse coronary atheroma. However, concerns regarding its morbidity and mortality have created uncertainty as to the role of CE in the current era. The aim of this study was therefore to quantitatively summarize the short- and long-term outcomes of CE.

Should we consider off-pump coronary artery bypass grafting in patients undergoing coronary endarterectomy?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether off-pump coronary artery bypass grafting with coronary endarterectomy (OPCAB-CE) is a safe and feasible method of myocardial revascularization in patients presenting with diffuse coronary artery disease. Seventy-one papers were identified by a systematic search, of which nine were judged to best answer the clinical question.

Surgical treatment of innominate artery and aortic aneurysm: a case report and review of the literature.

Innominate artery (IA) aneurysms represent 3% of all arterial aneurysms. Due to the risk of thromboembolic complications and spontaneous rupture, surgical repair is usually recommended on an early elective basis. We present the case of 81-year-old Caucasian male presenting with atypical anterior chest pain secondary to a large innominate artery aneurysm who underwent successful open surgical repair at our institution.

Imbalance of desmoplastic stromal cell numbers drives aggressive cancer processes.

Epithelial tissues have sparse stroma, in contrast to their corresponding tumours. The effect of cancer cells on stromal cells is well recognized. Increasingly, stromal components, such as endothelial and immune cells, are considered indispensable for cancer progression.

Recurrent indigestion in a young adult.

Bochdalek hernias (BHs) arise due to congenital diaphragmatic defect and can result in gross displacement of abdominal tissues into the thorax. Although they are uncommon in occurrence, they usually present as serious respiratory distress in infants. In the adult population, they are asymptomatic and only detected incidentally.