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Ablative Surgery (ablative + surgery)
Selected AbstractsReview of the functional surgical treatment of dystoniaEUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2001Paul Krack A review of functional surgery for dystonia is presented. Recently renewed interest in stereotaxy for dystonia has followed the resurgence of pallidotomy and the introduction of deep brain stimulation (DBS) in Parkinson's disease (PD) in the early 1990s. However, even since the 1950s, small series of patients treated with ablative surgery have been carefully studied, providing useful information, notably regarding the tolerability of surgery. In the setting of dystonia, thalamotomy was first performed with substantial benefits, but some authors outlined the great variability in outcome, and the high incidence of operative side-effects. In the ,modern' era of functional surgery for movement disorders, the globus pallidus internus (GPi) has emerged to be currently the best target for dystonia, based on small series of patients published in the last few years. Both bilateral posteroventral pallidotomy (PVP) and bilateral pallidal stimulation, performed by several teams, have benefited a variety of patients with severe dystonia, the most dramatic improvements being seen in primary dystonia with a mutation in the DYT1 gene. Whereas patients with secondary dystonia have often shown a lesser degree of improvement, some publications have nevertheless reported major benefit. There is today a strong need for carefully controlled studies comparing secondary and primary dystonia, DYT1 and non-DYT1 dystonia, ablative surgery and DBS, with additional assessment of neuropsychological changes, especially in children treated with bilateral pallidal procedures. [source] Reconstruction with radial forearm flaps after ablative surgery for hypopharyngeal cancerHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2003Joseph Scharpf MD Abstract Background. Patients afflicted with advanced hypopharyngeal cancer must contend with both potentially poor survival prognosis and a compromised quality of remaining life. After extensive ablative surgery, it is imperative to use a reliable, low morbidity reconstructive strategy that will allow for an expedient reconstitution of speech and swallowing. Methods. Retrospective review of the records of 28 patients who underwent pharyngoesophageal reconstruction with radial forearm free flaps (RFFF) between 1996 and 2001 by a single surgeon (RE). Analysis was confined to patients requiring complete tubulation of the RFFF. Perioperative mortality, morbidity, and functional evaluation based on the parameters of speech and swallowing were analyzed. Results. Completely tubulated RFFF were required in 25 patients. There was 100% RFFF survival with no perioperative mortalities. The median hospital stay was 8.0 days. All patients acquired a reconstitution of oral alimentation; median time to swallowing was 18.0 days. Fourteen of 16 patients (93%) were able to rely on TEP speech as their main modality of communication. Two patients (8%) had early fistulas develop, and 5 (20%) had late fistulas develop. Nine patients (36%) required mechanical dilatation; five of the nine patients required only one dilatation. Conclusion. Review of our experience has confirmed the reliability and excellent functional outcome associated with this flap. © 2003 Wiley Periodicals, Inc. Head Neck 25: 261,266, 2003 [source] Head and neck reconstruction using cephalic vein transposition in the vessel-depleted neckMICROSURGERY, Issue 8 2009M.B.B.S., Vasileios Vasilakis B.Sc. In microvascular reconstructive surgery the patency of the recipient vessels is the key to successful outcome. In head and neck surgery there is often a lack of adequate recipient vessels as a result of chemoradiation therapy and ablative surgery. To overcome this it is crucial to identify vessels of adequate length and diameter outside the field of injury. We report our experience with cephalic vein transposition for drainage of seven free flaps,six intestinal and one osteocutaneous,for head and neck reconstruction. In five cases the cephalic vein was used during the free flap transfer and in two cases in salvage re-exploration surgery. All flaps survived completely. The anatomical course and location of the cephalic vein allow good patency and straightforward harvesting. Its vascular properties are predictive of reduced incidence of complications such as flap congestion and failure. We suggest that the cephalic vein offers a high venous flow drainage system for large free flaps and advocate its use in free intestinal transfer in the vessel-depleted neck as well as in re-exploration surgery. © 2009 Wiley-Liss, Inc. Microsurgery 2009. [source] Bone marrow-derived mesenchymal stem cells for regenerative medicine in craniofacial regionORAL DISEASES, Issue 6 2006M Miura The craniofacial region contains many specified tissues including bone, cartilage, muscle, blood vessels and neurons. Defect or dysfunction of the craniofacial tissue after post-cancer ablative surgery, trauma, congenital malformations and progressive deforming skeletal diseases has a huge influence on the patient's life. Therefore, functional reconstruction of damaged tissues is highly expected. Bone marrow-derived mesenchymal stem cells (BMMSCs) are one of the most well characterized postnatal stem cell populations, and considered to be utilized for cell-based clinical therapies. Here, the current understanding and the potential applications in craniofacial tissue regeneration of BMMSCs are reviewed, and the current limitations and drawbacks are also discussed. [source] The economic consequences of introducing deep brain stimulation for the treatment of advanced Parkinson's disease in AustraliaAUSTRALASIAN JOURNAL ON AGEING, Issue 3 2003Bruce P. Hollingsworth Objectives: Parkinson's disease is a debilitating condition, which is increasing in prevalence as elderly populations increase in the developed world. As such, resource consumption will also increase. For advanced Parkinsons, where drug therapy is no longer effective, there are two surgical options - ablative surgery, a one-off procedure which destroys part of the brain, and deep brain stimulation (DBS), which uses electrodes to stimulate part of the brain. The specific question to be answered here is what the costs to the community of DBS are compared to ablative surgery (thalmotomy or pallidotomy) in potentially relieving the symptoms of advanced Parkinson's disease, and if there is any improvement in patients' quality of life. Design: A cost effectiveness study is undertaken. UK and Australian data are made use of and cost-effectiveness estimated in terms of cost per change in functional ability. Setting: Hospital, community and home care. Patients: Those with advanced Parkinson's Disease. Main outcome measures: Frenchay index of functional ability. Results: It is estimated that the incremental extra cost for a small change in ability to undertake daily tasks is at least 23,559. Conclusions: As outcomes evidence is of low quality, at this stage it is not possible to establish that Deep Brain Stimulation offers substantial improvements in quality of life. Extra costs over ablative surgery are estimated to be in the range of 17,830 to 51,385 per patient over a five year period. [source] Application of imiquimod by suppositories (anal tampons) efficiently prevents recurrences after ablation of anal canal condylomaBRITISH JOURNAL OF DERMATOLOGY, Issue 4 2002M. Kaspari SummaryBackground After surgical removal, anal canal condyloma (ACC) has a higher risk of recurrence compared with extragenital warts. Objectives To reduce local recurrences of ACC using follow-up treatment with imiquimod-containing suppositories (anal tampons). Methods After ablation of ACC, 10 male patients received treatment with imiquimod suppositories three times weekly for 3,4 months. Results Treatment with imiquimod anal tampons was well tolerated. Early initial recurrences in some patients cleared after treatment with the imiquimod suppositories. Within a mean follow-up of 9 months no patient demonstrated recurrence of ACC. Conclusions These data suggest that imiquimod anal tampons may represent a new therapeutic option to prevent recurrences of ACC following ablative surgery. [source] Benefits of dental implants installed during ablative tumour surgery in oral cancer patients: a prospective 5-year clinical trialCLINICAL ORAL IMPLANTS RESEARCH, Issue 9 2010Anke Korfage Abstract Objective: This prospective study assessed treatment outcome and patient satisfaction of oral cancer patients with a mandibular overdenture on implants up to 5 years after treatment. Materials and methods: At baseline, 50 consecutive edentulous oral cancer patients, in whom prosthetic problems were expected after oncological treatment, were evaluated by standardized questionnaires and clinical assessments. All implants were installed during ablative tumour surgery in native bone in the interforaminal area. About two-thirds of the patients (n=31) had radiotherapy post-surgery (dose >40 Gy in the interforaminal area). Results: At the 5-year evaluation, 26 patients had passed away and four patients had to be excluded from the analyses, because superstructures were not present, due to persistent local irritation (n=2), loss of three implants (n=1) and the impossibility of making an overdenture related to tumour and oncological surgery-driven anatomical limitations (n=1). In the remaining 20 patients, the prosthesis was still in function (76 implants). During the 5-year follow-up, total 14 implants were lost, 13 in irradiated bone (survival rate 89.4%, dose >40 Gy) and one in non-irradiated bone (survival rate 98.6%). Peri-implant tissues had a healthy appearance and remained healthy over time. Patients were satisfied with their dentures. Conclusions: It was concluded that oral cancer patients can benefit from implants installed during ablative surgery, with a high survival rate of the implants, a high percentage of rehabilitated patients and a high denture satisfaction up to 5 years after treatment. To cite this article: Korfage A, Schoen PJ, Raghoebar GM, Roodenburg JLN, Vissink A, Reintsema H. Benefits of dental implants installed during ablative tumour surgery in oral cancer patients: a prospective 5-year clinical trial. Clin. Oral Impl. Res. 21, 2010; 971,979. doi: 10.1111/j.1600-0501.2010.01930.x [source] | ||||||||||