Lamb larynx model for training in endoscopic and CO 2 laser-assisted surgeries for benign laryngotracheal obstructions

Abstract

Purpose

With adequate indication and meticulous execution, endoscopic procedures can efficiently treat a subset of adult and pediatric benign laryngotracheal stenosis and obstructions, but these procedures are precise and very demanding. The difference between a successful and a failed surgery, with potentially debilitating side effects, resides in small details. The learning curve is long and very few centers worldwide have a sufficient case load making adequate training difficult. While indications and concepts of endoscopic procedures can be learned in books and by observing trained colleagues, the dexterity and the precise realization need to be practiced, ideally not initially on patients.

Methods

We describe here the lamb model system for the initial training in such procedures. We provide a step-by-step guide for endoscopic approaches intended to treat pathologies such as laryngomalacia, bilateral vocal fold paralysis, posterior glottic stenosis, and laryngotracheal clefts.

Conclusions

The lamb model system does not pose ethical issues, and it is easy to obtain and to handle. It was used during an international training course for laryngotracheal stenosis by novice and advanced airway surgeons. It was unanimously judged as relevant and useful by the participants.

https://ift.tt/2xGkFn0

Orbital infections: a complete cycle 7-year audit and a management guideline

Abstract

Objectives

Orbital infections are regularly encountered and are managed by various healthcare disciplines. Sepsis of the orbit and adjacent tissues can be associated with considerable acute complication and long-term sequelae. Therefore, prompt recognition and management of this condition are crucial. This article presents the outcomes of a 7-year complete cycle audit project and describes the development of the new local guideline on the management of orbital infections in our tertiary centre.

Methods

(1) A retrospective 5-year audit cycle on patients with orbital infections. (2) A review of available evidence on the management of orbital infections. (3) A new local multidisciplinary guideline on the management of orbital infections. (4) A retrospective 2-year second audit cycle to assess the clinical outcomes.

Results

Various disciplines intersect in the management of orbital infections. Standardising the management of this condition proved to be achievable through the developed guideline. However, room for improvement in practice exists in areas such as the promptness in referring patients to specialist care, the multidisciplinary assessment of patients on admission, and the improvement of scanning requests of patients.

https://ift.tt/2LYE59B

Accelerated subcutaneous nodulosis in patients with rheumatoid arthritis treated with tocilizumab: a case series

Tocilizumab is a monoclonal antibody directed against the interleukin-6 receptor, which is approved for the treatment of moderate-to-severe rheumatoid arthritis. Authors have found that it prevents lung and su...

https://ift.tt/2kJrlHv

Complexity, Variation, and the Ever-moving Cheese

No abstract available

https://ift.tt/2xBk6uo

The 2018 AAAAI Foundation Faculty Development Awardees

Publication date: Available online 2 June 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Zuhair K. Ballas




https://ift.tt/2Jv2uoK

The use of honey in cochlear implant associated wounds in pediatric patients

Publication date: August 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 111
Author(s): Anya Costeloe, Nathan Douglas Vandjelovic, Michel Anthony Evans, Sonal S. Saraiya
IntroductionThe use of honey in wound care is becoming more common due to the proven benefit in all three phases of wound healing, as well as the antibacterial and antibiofilm properties. We present our experience using TheraHoney gel, a medical grade honey, for the successful treatment of cochlear implant associated skin breakdown.ObjectiveTo describe the role of TheraHoney gel in the management of cutaneous infection and ulceration associated with cochlear implants.MethodsThree cases of wounds treated traditionally with antibiotics, plus the addition of TheraHoney, were retrospectively reviewed. The first patient had a superficial 1 × 1 cm ulcer, the second patient had bilateral ulcers: one superficial 1.5 × 1.5 cm ulcer and the other a 1.5 × 2 cm stage III pressure ulcer with an exposed receiver stimulator, and the third patient with a 3 × 3.5 cm stage III ulcer with an exposed receiver stimulator.ResultsWith the addition of TheraHoney gel, complete wound closure was achieved at all three patients without the need for surgical reconstruction.ConclusionCutaneous infection with or without skin breakdown is a common delayed complication after cochlear implantation. We demonstrate the efficacy of adding medical grade honey in promoting healing in infected scalp pressure ulcers overlying the cochlear implant site.



https://ift.tt/2Jp65EZ

TAILORx trial finds most women with early breast cancer do not benefit from chemotherapy

Findings from the TAILORx clinical trial show chemotherapy does not benefit most women with early breast cancer. The new data, released at the 2018 ASCO annual meeting, will help inform treatment decisions for many women with early-stage breast cancer.

https://ift.tt/2HfzhZZ

Metabolic signature of squamous cell carcinoma of the head and neck: Consequences of TP53 mutation and therapeutic perspectives

Publication date: August 2018
Source:Oral Oncology, Volume 83
Author(s): Mark D. Wilkie, Andrew S. Lau, Nikolina Vlatkovic, Terence M. Jones, Mark T. Boyd
There is a pressing need to identify ways of sensitising squamous cell carcinomas of the head and neck (SCCHN) to the effects of current treatments, both from oncological and functional perspectives. Alteration to cellular metabolism is now widely considered a hallmark of the cancer phenotype; presents a potentially attractive therapeutic target in this regard; and as such has received renewed research interest in recent years. However, whilst metabolic disruption may occur to some degree in all tumours, there is undoubtedly heterogeneity and detailed study of individual tumour types is paramount if effective therapeutic strategies targeting metabolism are to be developed and effectively deployed. In this review we outline current understanding of altered tumour metabolism and how these adaptations promote tumorigenesis generally. We relate this specifically to SCCHN by focusing on several recent key studies specific to SCCHN, and by discussing the role TP53 mutation may play in this metabolic switch, given the fundamental role of this oncogenic event in SCCHN tumorigenesis. Finally, we also offer insight into the potential therapeutic implications this may have in the clinical setting and make recommendations for future study.



https://ift.tt/2xBOp4m