Autologous platelet-rich plasma versus conventional therapy for the treatment of chronic venous leg ulcers: A comparative study

Summary

Background

Chronic venous leg ulcers drastically reduce the quality of life of affected patients. There is heightened interest in autologous platelet-rich plasma (PRP) as one of the promising therapies for leg ulcers.

Aim

Our aim was to compare the clinical efficacy of PRP in the management of chronic venous leg ulcers vs conventional treatment.

Patients/Methods

In total, 40 patients with chronic venous leg ulcers were included in the study. Twenty patients were treated with autologous PRP weekly for 6 weeks (Group A), and 20 patients were treated with conventional treatment (compression and dressing) for 6 weeks (Group B). Treatment results were calculated by percentage of improvement in area of the ulcer.

Results

Compared to conventional therapy, a highly significant improvement in the ulcer size was observed post-PRP therapy (P-value = .0001). The mean change in the area of the ulcer post-PRP and conventional therapy was 4.92 ± 11.94 cm and 0.13 ± 0.27 cm, respectively, while the mean percentage improvement in the area of the ulcer post-PRP and conventional therapy was 67.6% ± 36.6% and 13.67% ± 28.06%, respectively. Subjective improvement in pain associated with the ulcer was noted by all patients.

Conclusions

Platelet-rich plasma is a safe nonsurgical procedure for treating chronic venous leg ulcers. Additional studies with larger sample size and longer follow-up periods are required to confirm or refute our findings.

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Effect of different dental burs for experimental induction of pulpitis in mice

Publication date: November 2017
Source:Archives of Oral Biology, Volume 83
Author(s): Xilin Shi, Zhengmao Li, Ying He, Qianzhou Jiang, Xuechao Yang
ObjectiveTo evaluate the effect of using different dental burs on the development of pulpal inflammation after pulpal exposure in mice.DesignEighty-eight C57BL/6 mice were randomly assigned to group A (n=40), group B (n=40) and control group (n=8). The pulps of the maxillary first molars were occlusally exposed using ¼ round burs and polishing burs in group A and B respectively. Animals were sacrificed randomly at 0h, 4h, 8h, 12h and 24h after pulpal exposure. Micro-CT scanning was used to determine the success rate of sample preparation. Pulpal tissue changes were evaluated by histopathologic and immunohistochemical analyses.ResultsThe success rates of sample preparations were 85% in group A and 90% in group B. The mean maximum diameter of pulpal exposure area was 625.6±30.6μm in group A and 402.7±18.0μm in group B (p<0.05). In addition, the mean of the minimum remaining dentine thickness at the marked region of interest was 133.2±29.9μm in group A and 261.4±16.3μm in group B (p<0.05). Histopathologic staining demonstrated more signs of inflammation in both groups, as the duration of pulpal exposure increases. However, the rate of inflammatory progress was higher in group A, even spreading to the root pulp tissue within a few hours. For group B, the progress was relatively slow.ConclusionsPulpal exposure with different sizes of dental burs affects changes in the development of pulpal inflammation in mice.



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Breast cancer subtype discrimination using standardized 4-IHC and digital image analysis

Abstract

Breast cancer is a heterogeneous disease. Surrogate classification of intrinsic subtypes of invasive carcinomas by combined immunohistochemistry for estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67 (4-IHC) has increased steadily since the 2011 St Gallen symposium, due to its rapid subtyping of tumors at a reasonable cost. An important step in improving 4-IHC reproducibility and reliability will be to provide reference values from the routine use of standardized 4-IHC followed by image analysis. The aims of the current study were (1) to analyze invasive breast carcinomas using standardized 4-IHC and quantitative image analysis and (2) to compare the results obtained in the classification of biological subtypes using current Ki67 and PR threshold values proposed by different authors to sub-classifying the luminal A-like and the luminal B-like (HER2-negative) subtypes. Five hundred twenty-one tumors were analyzed by standardized immunohistochemistry, with automatic image analysis, and HER2 FISH technique. Positivity for ER was found in 82.7% and for PR in 70.1% of cases. Using the Allred scoring system, hormone receptor results showed a bimodal distribution, particularly for ER. HER2 positivity was found in 15.7% of cases, and the mean Ki67 score was 32.3%. Using the most recently proposed surrogate definitions for the classification of luminal breast cancer subtypes, the percentages of different subtypes that we found were similar to those published with genomic platforms: 40.7% luminal A-like, 32.4% luminal B-like/HER2-negative, 9.8% luminal B-like/HER2-positive, 6.0% HER2-positive, and 11.1% triple negative. Standardized 4-IHC with automatic image analysis constitutes a low-cost method for surrogate definitions of biological subtypes of breast cancer that delivers accurate results in a day.

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Conchal contractility after inferior turbinate hypertrophy treatment: A prospective, randomized clinical trial

The aim of this study is to evaluate the effects of these two methods (Nasal corticosteroids (NCS) and radiofrequency (RF) application) on conchal contractility utilizing objective rhinologic measurement parameters.

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Diagnostic implications of TERT promoter mutation status in diffuse gliomas in a routine clinical setting

Abstract

IDH (isocitrate dehydrogenase) gene mutations are present in most diffuse low-grade gliomas and define the clinico-pathological core of the respective morphologically defined entities. Conversely, according to the 2016 WHO classification, the majority of glioblastomas belong to the IDH-wildtype category, which is defined by exclusion. TERT (telomerase reverse transcriptase gene) promoter mutations have been suggested as a molecular marker for primary glioblastomas. We analyzed molecular, histopathological, and clinical profiles of a series of 110 consecutive diffuse gliomas (WHO grades II-IV) diagnosed at our institution, in which TERT promoter mutation analysis had been performed as part of diagnostic work-up. A diagnostic algorithm based on IDH, TERT, ATRX, H3F3A, and 1p19q co-deletion status resulted in a consistent molecular classification with only 14 (13%) marker-negative tumors. TERT promoter mutations were present in 77% of IDH-wildtype tumors. The TERT/IDH-wildtype category was highly enriched for tumors with unconventional clinical or histological features. Molecular classes were associated with distinct rates of MGMT promoter methylation. We conclude that, in a routine diagnostic setting, TERT promoter mutations define a relatively homogeneous core group among IDH-wildtype diffuse gliomas that includes the majority of primary glioblastomas as well as their putative precursor lesions.

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Guía de Práctica Clínica Para el Diagnóstico y Tratamiento del Vértigo Posicional Paroxístico Benigno. Documento de Consenso de la Comisión de Otoneurología Sociedad Española de Otorrinolaringlogía y Cirugía de Cabeza y Cuello

Publication date: Available online 19 August 2017
Source:Acta Otorrinolaringológica Española
Author(s): Paz Pérez-Vázquez, Virginia Franco-Gutiérrez, Andrés Soto-Varela, Juan Carlos Amor-Dorado, Eduardo Martín-Sanz, Manuel Oliva-Domínguez, Jose A. Lopez-Escamez
El vértigo posicional paroxístico benigno (VPPB) es la causa más frecuente de vértigo vestibular episódico. EL propósito de esta guía, encomendada por la Comisión de Otoneurología de la SEORL CCC, es disponer de un documento de consenso que sirva de guía práctica para el manejo del VPPB en la clínica diaria. El punto de partida es la clasificación elaborada por la Barany Society, con sus variantes clínicas. Incluye una descripción de las pruebas diagnósticas y de las maniobras terapéuticas para cada una de las variantes establecidas, habiéndose seleccionado aquellas con estudios con nivel adecuado de evidencia o con suficientes series de soporte. Se ha incluido también un capítulo de diagnóstico diferencial, así como un apartado de aspectos generales básicos en el manejo de los pacientes con VPPB.Benign Paroxysmal Positional Vertigo is the most frequent episodic vestibular disorder. The purpose of this guide, requested by the committee on otoneurology of the Spanish Society of Otolaryngology and Head and Neck Surgery, is to supply a consensus document providing practical guidance for the management of BPPV. It is based on the Barany Society criteria for the diagnosis of BPPV. This guideline provides recommendations on each variant of BPPV, with a description of the different diagnostic tests and the therapeutic manoeuvres. For this purpose, we have selected the tests and manoeuvres supported by evidence-based studies or extensive series. Finally, we have also included a chapter on differential diagnosis and a section relating to general aspects in the management of BPPV.



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Coexistence of congenital left ventricular aneurysm and prominent left ventricular trabeculation in a patient with LDB3 mutation: a case report

The coexistence of congenital left ventricular aneurysm and abnormal cardiac trabeculation with gene mutation has not been reported previously. Here, we report a case of coexisting congenital left ventricular ...

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Prevalence of high-risk human papillomavirus infection and cancer gene mutations in nonmalignant tonsils

Publication date: October 2017
Source:Oral Oncology, Volume 73
Author(s): Taru Ilmarinen, Pauliina Munne, Jaana Hagström, Caj Haglund, Eeva Auvinen, Elina I. Virtanen, Annick Haesevoets, Ernst J.M. Speel, Leena-Maija Aaltonen
ObjectivesTo analyze the prevalence of high-risk HPV (human papillomavirus) and genetic alterations in nonmalignant tonsils.MethodsWe collected benign fresh tonsillar tissue specimens from 477 patients undergoing tonsillectomy because of chronic tonsillitis or tonsillar hypertrophy in 2012 (Group A, n=237) and in 2015 (Group B, n=240). Luminex xMAP technique served to detect E6/E7 DNA from 16 different high-risk HPV types. Tonsillar DNA and peripheral blood leukocyte DNA from the infected individuals were analyzed using Nimblegen SeqCap EZ Comprehensive Cancer Design panel. The panel targets 578 different genes that are relevant in carcinogenesis. HPV negative tonsillar specimens from age- and gender matched individuals were used as controls. All specimens harboring high-risk HPV were analyzed using fluorescence in situ hybridization (FISH).ResultsFive of 477 (1.0%) patients tested positive for the following HPV types: HPV16 (two cases), HPV52 (one case), HPV66 (one case), HPV52 and HPV68 (coinfection, one case). FISH analyses showed that the appearance of HPV in specimens infected with HPV 16 was episomal. Benign tonsils infected with high-risk HPV harbored mutations in EP300, NF1, PIK3CA, and RB1 which are considered relevant in the development of HPV-associated head and neck squamous cell carcinoma (SCC).ConclusionsThe prevalence of high-risk HPV in nonmalignant tonsils is low. High-risk HPV positive tonsils harbored mutations in genes that are commonly altered in HPV-associated head and neck SCC. The role of these mutations in tonsillar carcinogenesis is an interesting target for future research.



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Rescue of T-cell function during persistent pulmonary adenoviral infection by TLR9 activation

Publication date: Available online 19 August 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Tristan Holland, Dirk Wohlleber, Samira Marx, Thomas Kreutzberg, Salvador Vento-Asturias, Christine Schmitt-Mbamunyo, Meike Welz, Marianne Janas, Karl Komander, Sarah Eickhoff, Anna Brewitz, Mike Hasenberg, Linda Männ, Matthias Gunzer, Christoph Wilhelm, Wolfgang Kastenmüller, Percy Knolle, Zeinab Abdullah, Christian Kurts, Natalio Garbi

Teaser

Pulmonary persistent adenoviral infections induce an immunosuppressive environment in the lung that renders CD8 T-cells dysfunctional. Innate cell activation during persistent infection re-invigorates effector T cell function leading to viral clearance and immune homeostasis.


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Combined immunodeficiency and atopy caused by a dominant negative mutation in CARD11

Publication date: Available online 19 August 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Harjit Dadi, Tyler A. Jones, Daniele Merico, Nigel Sharfe, Adi Ovadia, Yael Schejter, Brenda Reid, Mark Sun, Linda Vong, Adelle Atkinson, Sasson Lavi, Joel L. Pomerantz, Chaim M. Roifman
BackgroundCombined immunodeficiency is a T cell defect frequently presenting with recurrent infections as well as associated immune dysregulation manifesting as autoimmunity or allergic inflammation.ObjectiveWe sought to identify the genetic aberration in four related patients with combined immunodeficiency, early onset asthma, eczema and food allergies, as well as autoimmunity.MethodsWhole exome sequencing (WES) followed by Sanger confirmation, assessment of the genetic variant impact on cell signaling and evaluation of the resultant immune function.ResultsA heterozygous novel c.C88T one base pair substitution resulting in the amino acid change R30W in CARD11 was identified by WES and segregated perfectly to family members with severe atopy only, but was not found in healthy individuals. We demonstrate that the R30W mutation results in a loss of function while also exerting a dominant negative effect on wild-type CARD11. The CARD11 defect altered the classical Nuclear Factor-κB (NF-κB) pathway, resulting in poor in vitro T cell responses to mitogens and antigens caused by reduced secretion of IFNγ and IL-2.ConclusionUnlike patients with biallelic mutations in CARD11 causing severe combined immunodeficiency, the R30W defect results in a less profound yet prominent susceptibility to infections as well as multi-organ atopy and autoimmunity.

Teaser

We show here for the first time that a novel R30W dominant negative mutation in CARD11 can cause a familial autosomal dominant disorder encompassing combined immunodeficiency, severe multi-system atopy and autoimmunity.


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Advances in Basic and Clinical Immunology 2016

Publication date: Available online 19 August 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Javier Chinen, Yousef Badran, Raif S. Geha, Janet S. Chou, Ari J. Fried
Advances in basic immunology in 2016 included studies that further characterized the role of different proteins in the differentiation of effector T cells and B cells, including cytokines and proteins involved in actin cytoskeleton. The regulation of granule formation and secretion in cytotoxic cells was also further described by examining patients with familial hemophagocytic lymphohystiocytosis. The role of prenylation in mevalonate kinase deficiency leading to inflammation has been established. We reviewed advances in clinical immunology as well as new approaches of whole genome sequencing and genes newly reported to be associated with immunodeficiency, such as linker of activation of T cells (LAT), B cell lymphoma 11B (BCL11B), RLTPR, moesin and JAK1. Trials of Hematopoietic stem cells transplantation and gene therapy for primary immunodeficiency have had relative success; the use of autologous viral specific cytotoxic T cells has proven effective. New medications are being explored, such as pioglitazone and its role in enhancing the oxidative burst in chronic granulomatous disease. Development of vaccines for HIV infection continues to provide insight into the immune response against a virus with an extraordinary mutation rate.



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A flow cytometry–based diagnosis of eosinophilic esophagitis

Publication date: Available online 19 August 2017
Source:Journal of Allergy and Clinical Immunology
Author(s): Ting Wen, Jonathan Kuhl, Philip Putnam, Vincent Mukkada, Michael Farrell, Ajay Kaul, Conrad Cole, Marc E. Rothenberg




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18 Royal Jelly in Medicinal to Functional Energy Drinks

Publication date: 2017
Source:Sustained Energy for Enhanced Human Functions and Activity
Author(s): Hiroyoshi Moriyama, Manashi Bagchi, Debasis Bagchi
Royal jelly (RJ), which is secreted by the hydropharyngeal gland of worker bees, has a broad spectrum of beneficial physiological properties. It is primarily used to nourish worker bees as well as queen bees. The antioxidant properties of RJ are attributed to proteins and/or peptides, which are potentially associated with the amelioration of fatigue. Muscle-enhancing performance can also be increased with the supply of oxygen in conjunction with RJ. RJ has also been demonstrated to improve erythropoiesis. These results have been confirmed in clinical trial results. However more clinical evidence is required to confirm its efficacy. Overall, RJ is safe and efficacious in a variety of functional beverages to boost energy and performance.



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Biofeedback in dysphonia – progress and challenges

Publication date: Available online 19 August 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Geová Oliveira de Amorim, Patrícia Maria Mendes Balata, Laís Guimarães Vieira, Thaís Moura, Hilton Justino da Silva
IntroductionThere is evidence that all the complex machinery involved in speech acts along with the auditory system, and their adjustments can be altered.ObjectiveTo present the evidence of biofeedback application for treatment of vocal disorders, emphasizing the muscle tension dysphonia.MethodsA systematic review was conducted in Scielo, Lilacs, PubMed and Web of Sciences databases, using the combination of descriptors, and admitting as inclusion criteria: articles published in journals with editorial committee, reporting cases or experimental or quasi-experimental research on the use of biofeedback in real time as additional source of treatment monitoring of muscle tension dysphonia or for vocal training.ResultsThirty-three articles were identified in databases, and seven were included in the qualitative synthesis. The beginning of electromyographic biofeedback studies applied to speech therapy were promising and pointed to a new method that enabled good results in muscle tension dysphonia. Nonetheless, the discussion of the results lacked physiological evidence that could serve as their basis. The search for such explanations has become a challenge for speech therapists, and determined two research lines: one dedicated to the improvement of the electromyographic biofeedback methodology for voice disorders, to reduce confounding variables, and the other dedicated to the research of neural processes involved in changing the muscle engram of normal and dysphonic patients.ConclusionThere is evidence that the electromyographic biofeedback promotes changes in the neural networks responsible for speech, and can change behavior for vocal emissions with quality.



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Epidural patch with autologous platelet rich plasma: a novel approach

Abstract

We aimed to perform an epidural patch using platelet rich plasma (PRP), which has the potential to regenerate and heal tissues via degranulation of platelets, in a 34-year-old parturient suffering from persistent post-dural puncture headache (PDPH) after failed epidural blood patch (EBP). After her admission to our unit, we reconfirmed the clinical and radiologic diagnosis of PDPH. Cranial MRI with contrast showed diffuse pachymeningeal thickening and contrast enhancement with enlarged pituitary consistent with intracranial hypotension. Clinical and radiological improvements were observed 1 week after the epidural patch using autologous PRP. Therefore, we recommend using autologous PRP for epidural patching in patients with incomplete recovery after standard EBP as a novel successful approach.

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Otitis Media with Effusion (OME) in Urban Pediatric Population in a Tertiary Care Centre: A Clinical Study

Abstract

Otitis media with effusion (OME) is a common condition affecting children. It is one of the most common causes for reduced hearing in pediatric age group leading to various learning disabilities including delayed speech development. The aim of this study was to find out various epidemiological characteristics and risk factors for developing OME and various treatment modalities depending on the clinical features and their outcomes in urban pediatric population. A prospective comparative study was done in 100 children taken 50 as cases and 50 as controls for a period of 2 years. The risk factors, common presenting features and the examination and investigational findings (tympanometry) of the study condition were compared among the cases and controls. Among the 50 cases, 28 children were treated medically and 22 underwent surgical treatment in the form of Myringotomy and Grommet insertion. The patients were followed up-to 6 months in both groups.

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Emotional and behaviour difficulties in teenagers with permanent childhood hearing loss

Publication date: October 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 101
Author(s): Jim Stevenson, Hannah Pimperton, Jana Kreppner, Sarah Worsfold, Emmanouela Terlektsi, Colin Kennedy
ObjectivesIt is known that during the middle childhood years those with permanent childhood hearing loss (PCHL) are at increased risk of showing emotional and behaviour difficulties (EBD). It has yet to be established whether this risk continues into the late teenage years. There is a paucity of longitudinal studies on the association between PCHL and EBD.MethodsThe Strengths and Difficulties Questionnaire (SDQ) was used to measure EBD based on parent, teacher and self-ratings in 76 teenagers with PCHL and 38 in a hearing comparison group (HCG) from a population sample of children that was followed up from birth to adolescence.ResultsOn parent-rated SDQ, the PCHL group had significantly higher Total Difficulties score than the HCG (Standardised mean difference (SMD) = +0.39, 95%CI 0.00 to 0.79). Amongst the PCHL group the presence of disabilities other than hearing loss had a substantial impact on the level of parent-rated EBD (SMD = +1.68, 1.04 to 2.33). There was a relationship between receptive language ability and EBD in both the HCG (r = −0.33, 95%CI −0.59 to −0.01) and the PCHI group (r = −0.33, 95%CI −0.53 to −0.02). The effect of PCHL on EBD became non-significant when receptive language was included as a covariate (F = 0.12, df = 1,95, p = 0.729). Early confirmation of hearing loss (i.e. before 9 months of age) did not have a significant effect on EBD scores (SMD = +0.31, 95%CI −0.15 to 0.77).ConclusionsPCHL continues to be associated with elevated EBD scores as measured by parent rated SDQ into the late teenage years but the degree of this elevation is less than in childhood and is not apparent on teacher or self-ratings. Poor receptive language ability appeared to account for these elevated EBD scores in the group with PCHL. Particular attention needs to be paid to the mental health of children and adolescents with PCHL that is accompanied by other disabilities and to those with poor receptive language ability. However, the majority of teenagers with PCHL do not show clinically significant elevated levels of EBD.



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HIV status and hearing loss among children between 6 and 12 years of age at a large urban health facility in south western Uganda

Publication date: October 2017
Source:International Journal of Pediatric Otorhinolaryngology, Volume 101
Author(s): Doreen Nakku, Victoria Nyaiteera, Evelyn Llowet, Dennis Nanseera, Gladys Nakalema, Brian Westerberg, Francis Bajunirwe
IntroductionPediatric HIV infection and treatment may increase the risk for hearing loss (HL), both sensorineural (SNHL) and conductive hearing loss (CHL). There is limited data on this subject, especially from sub Saharan Africa. The aim of this study was therefore to compare the prevalence of hearing loss among HIV positive and negative children, to determine the types of hearing loss and whether Nevirapine (NVP) based antiretroviral therapy (ART) is associated with HL.MethodsWe conducted a cross sectional study at two tertiary health facilities in south western Uganda. We consecutively enrolled 79 HIV negative and 148 HIV positive children aged between 6 and 12 years. Inclusion criteria were completion of written consent, ability to follow instructions to perform an audiogram and absence of congenital HL. We conducted hearing screening using the iPad Shoebox^® audiometer, and confirmatory assessments were conducted using pure tone audiometry. Hearing was classified as either normal hearing, CHL, SNHL or mixed.ResultsOf the 227 children enrolled, 115 (50.7%) were female. The mean age was 9.2 years (median = 9). Based on self-report, frequency of HL among HIV positive children was 6.8% and 20.3% among HIV negative children (p=<0.01). Using objective measures, prevalence of HL among the HIV positive children was 8.8% compared to 10.1% among the HIV negative children (p = 0.74). CHL was generally more frequent than SNHL but SNHL occurred more frequently among HIV positive (7.4%) compared to HIV negative children (3.8%). No association was found between NVP based ART and HL (p = 0.41). Logistic regression showed that older age of the child (p = 0.01), previous ear infection (p=<0.01), tuberculosis (TB) treatment (p=<0.01) and long term duration on ART (p=<0.01) were significantly associated with HL. Age (p = 0.02), previous ear infection (p = 0.01) and TB treatment (p = 0.005) remained significant in the multiple regression model.ConclusionPrevalence of HL is similar among HIV positive and negative children. Older age of the child, previous ear infection, use of TB drugs and long duration on ART among the HIV positive children increase the odds of having hearing loss among children. However, use of NVP was not associated with HL.



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Otitis Media with Effusion (OME) in Urban Pediatric Population in a Tertiary Care Centre: A Clinical Study

Abstract

Otitis media with effusion (OME) is a common condition affecting children. It is one of the most common causes for reduced hearing in pediatric age group leading to various learning disabilities including delayed speech development. The aim of this study was to find out various epidemiological characteristics and risk factors for developing OME and various treatment modalities depending on the clinical features and their outcomes in urban pediatric population. A prospective comparative study was done in 100 children taken 50 as cases and 50 as controls for a period of 2 years. The risk factors, common presenting features and the examination and investigational findings (tympanometry) of the study condition were compared among the cases and controls. Among the 50 cases, 28 children were treated medically and 22 underwent surgical treatment in the form of Myringotomy and Grommet insertion. The patients were followed up-to 6 months in both groups.

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3D-printed tracheoesophageal puncture and prosthesis placement simulator

Publication date: Available online 18 August 2017
Source:American Journal of Otolaryngology
Author(s): Samuel R. Barber, Elliott D. Kozin, Matthew R. Naunheim, Rosh Sethi, Aaron K. Remenschneider, Daniel G. Deschler
ObjectivesA tracheoesophageal prosthesis (TEP) allows for speech after total laryngectomy. However, TEP placement is technically challenging, requiring a coordinated series of steps. Surgical simulators improve technical skills and reduce operative time. We hypothesize that a reusable 3-dimensional (3D)-printed TEP simulator will facilitate comprehension and rehearsal prior to actual procedures.MethodsThe simulator was designed using Fusion360 (Autodesk, San Rafael, CA). Components were 3D-printed in-house using an Ultimaker 2+ (Ultimaker, Netherlands). Squid simulated the common tracheoesophageal wall. A Blom-Singer TEP (InHealth Technologies, Carpinteria, CA) replicated placement. Subjects watched an instructional video and completed pre- and post-simulation surveys.ResultsThe simulator comprised 3D-printed parts: the esophageal lumen and superficial stoma. Squid was placed between components. Ten trainees participated. Significant differences existed between junior and senior residents with surveys regarding anatomy knowledge(p<0.05), technical details(p<0.01), and equipment setup(p<0.01). Subjects agreed that simulation felt accurate, and rehearsal raised confidence in future procedures.ConclusionsA 3D-printed TEP simulator is feasible for surgical training. Simulation involving multiple steps may accelerate technical skills and improve education.



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