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This study analyzed patients undergoing multiple surgeries for velopharyngeal insufficiency (VPI) and reviewed their preoperative evaluations and techniques selected for subsequent surgeries. A retrospective chart review was performed including patients having undergone multiple surgeries for VPI at the authors' institution between 2012 and 2022. All patients were evaluated and managed at the author's institution under the direction of 4 senior surgeons. The objective of this study was to provide insight into preoperative evaluation, surgical technique selection, and other factors that may contribute to patients who require multiple VPI surgeries. Of 71 patients having undergone surgery for VPI, 8 required at least 1 additional operation for persistent VPI following the initial intervention. Six patients who initially underwent a superiorly based posterior pharyngeal flap (PPF) required additional surgery, and for those patients' subsequent operations, 5 different techniques were used throughout their treatment. Of the remaining 2 patients who had multiple VPI surgeries, 1 initially received autologous fat transfer and 1 initially underwent a furlow palatoplasty. Finally, 0 patients that initially underwent buccal flaps or collagen injection required further unplanned surgical intervention. This study demonstrates the importance of selecting an appropriate surgical approach when operating on patients following a failed VPI surgery. The algorithm developed from these findings emphasizes the importance of properly identifying the anatomical deficiency resulting from the failed intervention. A review of the advantages of nasopharyngoscopy as a preoperative evaluative technique of velopharyngeal form and function when compared to lateral barium video fluoroscopy was also included.
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http://dx.doi.org/10.1097/SCS.0000000000010213 | DOI Listing |
Improved surgical skill is generally associated with improved patient outcomes, although assessment is subjective, labour intensive, and requires domain-specific expertise. Automated data-driven metrics can alleviate these difficulties, as demonstrated by existing machine learning instrument tracking models. However, these models are tested on limited datasets of laparoscopic surgery, with a focus on isolated tasks and robotic surgery.
View Article and Find Full Text PDFHealthc Technol Lett
December 2024
Ecole Supérieure Polytechnique Dakar Senegal.
Percutaneous nephrostomy can be an effective means of preventing irreparable renal damage from obstructive renal disease thereby providing patients with more time to access treatment to remove the source of the blockage. In sub-Saharan Africa, where there is limited access to treatments such as dialysis and transplantation, a nephrostomy can be life-saving. Training this procedure in simulation can allow trainees to develop their technical skills without risking patient safety, but still requires an ex-pert observer to provide performative feedback.
View Article and Find Full Text PDFMol Ther Nucleic Acids
December 2024
Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA.
There is an urgent need for agents that promote health and regeneration of cells and tissues, specifically to treat diseases of the aging nervous system. Age-associated nervous system degeneration and various diseases are driven by many different biochemical stresses, often making it difficult to target any one disease cause. Our laboratory has previously identified DNA aptamers with apparent regenerative properties in murine models of multiple sclerosis by selecting aptamers that bind oligodendrocyte membrane preparations.
View Article and Find Full Text PDFInt J Womens Health
December 2024
Department of Reproductive Endocrinology, Hangzhou Women's Hospital, Hangzhou, People's Republic of China.
Objective: To report a rare case of multiple subserous uterine adenomyomas diagnosed and treated by laparoscopy.
Case Report: A premenopausal 55-year-old woman was admitted presenting with bilateral adnexal cysts. Preoperative ultrasound and magnetic resonance imaging both indicated a right ovarian cyst.
Front Med (Lausanne)
December 2024
School of Nursing, Southwest Medical University, Luzhou, China.
Objective: This study aimed to analyze the characteristics of surgical litigation cases and the risk factors that contribute to catastrophic compensation.
Methods: We downloaded and retrieved all cases related to surgical litigation cases from the China Jufaanli Database between 2008 and 2023. Multivariate logistic regression analysis was employed to identify independent risk factors that may contribute to catastrophic compensation.
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