MedWorm: Cervical Discectomy

Antidepressants and the risk of abnormal bleeding during spinal surgery: a case–control study

European Spine Journal — Tue, 31 Jan 2012 07:05:28 +0100

Conclusion Clinicians treating patients who are planning to undergo elective spinal surgery and are on an antidepressant medication should be aware of this potential effect and should consider tapering off the serotonergic antidepressant prior to surgery. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00586-011-2132-8Authors Amirali Sayadipour, Division of Spinal Surgery, Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, 925 Chestnut St, 5th floor, Philadelphia, PA 19107, USARajnish Mago, Department of Psychiatry, Thomas Jefferson University, Philadelphia, USAChristopher K. Kepler, Division of Spinal Surgery, Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, 925 Ches...

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Assessment of second tier lymph nodes in melanoma and implications for extent of elective neck dissection in metastatic cutaneous malignancy of the parotid

Head and Neck — Tue, 31 Jan 2012 05:00:00 +0100

ConclusionThe risk of harboring occult metastasis in levels I, IV, and V when levels II and III are negative is low. Levels II and III neck dissection is likely to be an effective staging procedure in patients with isolated parotid metastases. © 2012 Wiley Periodicals, Inc. Head Neck, 2012 (Source: Head and Neck)

Ten cases of gastro‐tracheobronchial fistula: a serious complication after esophagectomy and reconstruction using posterior mediastinal gastric tube

Diseases of the Esophagus — Tue, 31 Jan 2012 05:00:00 +0100

SUMMARYGastro‐tracheobronchial fistula (GTF) is a rare but life‐threatening complication specifically observed after esophagectomy and reconstruction using posterior mediastinal gastric tube. Ten cases of GTF were encountered in three hospitals in 2000–2009. Their clinicopathological, surgical, and postoperative care are summarized, together with a review of previously reported cases. GTF was classified as anastomotic leakage (n= 5), gastric necrosis (n= 4), and gastric ulcer type (n= 1). The anastomotic leakage type appeared about 2 weeks (postoperative day [POD]: 8–35) after esophagectomy, was located in the cervical or higher thoracic trachea. Breathing and pneumonia were controlled by tracheal tube placed in the distal of fistula. The gastric necrosis type was noted in patients...

Silent Pain in the Neck

AORN Journal — Mon, 30 Jan 2012 03:56:37 +0100

A 60-year-old man underwent an elective anterior cervical discectomy for persistent right arm weakness caused by cervical stenosis. Later that night, he developed tightness and swelling on the right side of his neck. The surgical unit nurse notified the covering physician, who asked about stridor or other respiratory symptoms. When told that they were absent, he recommended continued close observation. During the next few hours, the patient's symptoms persisted, and he experienced mild dysphagia. The nurse contacted the inhouse intensivist, who evaluated the patient and again found no evidence of respiratory distress or stridor. A few hours later, the patient stood up from bed to use the urinal, began coughing, turned cyanotic, and fell to the floor unconscious. Cardiopulmonary resuscitati...

Towards understanding seasonal variability in cervical artery dissection (CeAD)

Journal of Neurology — Fri, 27 Jan 2012 17:56:39 +0100

Abstract Cervical artery dissection (CeAD) occurs more often in autumn or winter than in spring or summer. We searched for clinical variables associated with this seasonality by comparing CeAD patients with onset of symptoms in autumn–winter (September 22–March 21) versus those with first CeAD symptom in spring–summer (March 22–September 21). We performed a cross-sectional study using data from the multicenter CADISP (Cervical Artery Dissection and Ischemic Stroke Patients) registry. Age- and sex-matched patients with ischemic stroke attributable to a cause other than CeAD (non-CeAD patients) were analyzed to study the specificity of our findings. Autumn–winter CeAD patients had a higher median brachial pulse pressure at admission (55 vs. 52 mmHg; p =&nb...

Stroke and cerebrovascular disease in childhood

Pediatric Neurology — Fri, 27 Jan 2012 01:46:49 +0100

Cerebrovascular diseases in children are heterogeneous and complex. They can occur either in isolation or as a manifestation of a vast array of genetic, inflammatory, or other systemic diseases. A single disease may also predispose patients to stroke through several mechanisms. Trisomy 21, for example, can predispose patients to stroke because of cardiac defects, moyamoya disease, or arterial dissection secondary to cervical instability. Furthermore, the clinical presentation of cerebrovascular diseases can vary dramatically, depending on the age of the child. The editors of an outstanding new book, Stroke and Cerebrovascular Disease in Childhood, succeed in summarizing these diseases in a single comprehensive text. (Source: Pediatric Neurology)

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Preoperative predictive model of cervical lymph node metastasis combining fluorine-18 fluorodeoxyglucose positron-emission tomography/computerized tomography findings and clinical factors in patients with oral or oropharyngeal squamous cell carcinoma

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics — Thu, 26 Jan 2012 20:43:21 +0100

Conclusions: The use of predictive models that include clinical factors and delayed-phase SUVmax and SUV-IR improve preoperative nodal diagnosis. (Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics)

Bilateral internal carotid artery dissection in the postpartum period.

Obstetrics and Gynecology — Thu, 26 Jan 2012 20:30:14 +0100

CONCLUSION: : The pathophysiology of cervical artery dissection appears multifactorial, with evidence suggesting environmental and genetic contributions. Intimal injury related to the Valsalva maneuver during labor as well as hemodynamic and hormonal changes related to pregnancy are presumed causes of peripartum spontaneous carotid artery dissection. Antithrombotic therapy for at least 3 to 6 months after dissection and follow-up neuroimaging are suggested. PMID: 22270449 [PubMed - in process] (Source: Obstetrics and Gynecology)

Merkel Cell Carcinoma of Unknown Primary Origin

Annals of Surgical Oncology — Tue, 24 Jan 2012 07:52:34 +0100

Conclusions Nodal MCCUP is a rare disease affecting primarily elderly white men. Recurrence is observed in approximately one-third of patients, with a 104 month median overall survival after a multimodal treatment approach consisting of surgery along with adjuvant chemotherapy and radiotherapy in the majority of patients. Content Type Journal ArticleCategory MelanomasPages 1-7DOI 10.1245/s10434-011-2213-2Authors Jeremiah L. Deneve, Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USAJane L. Messina, Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USASuroosh S. Marzban, Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USARicardo J. Gonzalez, Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, ...

P16INK4A overexpression predicts lymph node metastasis in cervical carcinomas

Journal of Clinical Pathology — Thu, 19 Jan 2012 05:00:00 +0100

Conclusions Results suggest that p16 expression is an important predictive factor of LN metastasis in cervical cancer patients. Moreover, p16 overexpression is associated with a poor prognosis. Therefore, immunohistochemical evaluation of p16 expression is of potential value for treatment planning in cervical carcinomas. (Source: Journal of Clinical Pathology)

The value of PET/CT to assess clinically negative necks

European Archives of Oto-Rhino-Laryngology — Tue, 17 Jan 2012 07:18:53 +0100

Abstract The aim was to evaluate the efficacy of [18F]-2-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) in evaluating metastasis of head and neck squamous cell carcinoma (HNSCC) to the cervical lymph nodes, with specific attention to the efficacy in regard to clinically negative necks. This was a retrospective review of 243 patients with HNSCC between years 2005 and 2007 treated at a comprehensive cancer care institution who underwent pre-operative PET/CT and neck dissection with either an N0 (112 patients) or N+ (131 patients) clinical nodal status. PET/CT findings were correlated with histopathological results of surgical specimens. A majority of the primary sites were oral cavity and oropharynx (70%), followed by larynx, unknown primary and ...

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Monitoring buried jejunum free flaps with a sentinel: A retrospective study of 20 cases

The Laryngoscope — Tue, 17 Jan 2012 05:00:00 +0100

Conclusions:Monitoring of buried free jejunal flap with a sentinel is an effective method of assessing flap viability after total laryngopharyngectomy and guides re‐exploration in cases of anastomotic complications. (Source: The Laryngoscope)

Variations of the Cervical Internal Carotid Artery

Indian Journal of Otolaryngology and Head and Neck Surgery — Thu, 05 Jan 2012 17:01:22 +0100

The objective of this study was to report the variations of the cervical internal carotid artery, as encountered during neck dissection for head and neck malignancies. A retrospective analysis of neck dissections performed for the management of various head and neck cancers, during 2006–2010 was carried out. Among 102 patients and 119 neck dissections, five of them were found to be having abnormalities of the cervical part of the internal carotid artery during its course in the neck and were analyzed in detail. Out of five subjects, four were males and the other was female with age ranging from 50 to 74 years. Of the five patients two had mild degree of tortuosity, two patients had moderate degree of tortuosity and another patient had severe degree of tortuosity in the course ...

The development of a model for translation of the Neck Disability Index to utility scores for cost-utility analysis in cervical disorders

The Spine Journal — Tue, 03 Jan 2012 05:00:00 +0100

Abstract: Background context: The Neck Disability Index (NDI) is a commonly used disease-specific instrument for cervical spine disorders with good responsiveness and psychometric properties compared with general health status measures. However, NDI scores are unitless and do not have an intrinsic value that is comparable to other health status measures, and these scores have limited value in cost-utility analysis. The translation of disease-specific measures to Short Form-6 Dimensions (SF-6D) utility scores may be useful in cost-utility analysis.Purpose: The purpose of this study is to present a model for translating the NDI to SF-6D utility scores, permitting the use of NDI scores in the cost-utility analysis of cervical disorders.Study design/setting: A secondary analysis of a multicent...

Roller coaster-associated subarachnoid hemorrhage-report of 2 cases. - Rutsch S, Niesen WD, Meckel S, Reinhard M.

SafetyLit: All (Unduplicated) — Sun, 01 Jan 2012 12:07:07 +0100

We report two cases of roller-coaster associated subarachnoid hemorrhage (SAH). A 40-year-old healthy man developed a strong, h... (Source: SafetyLit: All (Unduplicated))

An unusual course of the thoracic duct in relation to the vertebral vessels.

Singapore Medical Journal — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Kaur D, Jain M, Dhall U, Singh K Abstract A variation in the course of the thoracic duct was found in the cervical portion of a male cadaver during routine dissection of the head and neck region for undergraduate students. The thoracic duct, while arching laterally above the clavicle, was coursing posterior to the vertebral vein but anterior to the vertebral artery; it normally passes anterior to both the vertebral vein and artery. To the best of our knowledge, this variation in relation to the vertebral vein has not yet been reported. In addition, after coursing posterior to the vertebral vein, the thoracic duct divided into two branches that drained separately, one at the angle between the internal jugular vein and subclavian vein, and the other into the subclavian vein....

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Laparoscopic Sleeve Gastrectomy: a First Step for Rapid Weight Loss in Morbidly Obese Patients Requiring a Second Non-Bariatric Procedure

Obesity Surgery — Fri, 30 Dec 2011 06:48:23 +0100

Conclusions In this small group, laparoscopic sleeve gastrectomy appears to be an effective and safe first surgical approach for rapid weight loss in high-risk patients that require a second non-bariatric procedure. Content Type Journal ArticleCategory Clinical ResearchPages 1-5DOI 10.1007/s11695-011-0574-zAuthors Jesus E. Hidalgo, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USAMayank Roy, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USAAlexander Ramirez, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USASamuel Szomstein, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL, USARaul J. Rosenthal, Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, FL...

Cage subsidence does not, but cervical lordosis improvement does affect the long-term results of anterior cervical fusion with stand-alone cage for degenerative cervical disc disease: a retrospective study

European Spine Journal — Wed, 28 Dec 2011 16:51:52 +0100

Conclusions The results suggest that the clinical and radiological outcomes of the stand-alone titanium box cage for the surgical treatment of one- or two-level degenerative cervical disc disease are satisfactory. Cage subsidence does not exert significant impact upon the long-term clinical outcome although it is common for the stand-alone cages. The cervical lordosis may be more important for the long-term clinical outcome than cage subsidence Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00586-011-2131-9Authors Wen-Jian Wu, Department of Orthopedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, 200092 Shanghai, ChinaLei-Sheng Jiang, Department of Orthopedic Surgery, Xinhua Hospital, Sh...

Radiographic PEEK double-lucency finding after anterior cervical discectomy and fusion with local autograft and PEEK spacer: a preliminary study.

Journal of Neurosurgery.Spine — Fri, 23 Dec 2011 05:00:00 +0100

Authors: Hellbusch LC, Spangler WJ, Bowder A Abstract Anterior cervical discectomy and fusion (ACDF) is considered a standard neurosurgical treatment for cervical degenerative disc disease, but the methods for determining fusion after ACDF that involves the use of a polyetheretherketone (PEEK) cage are not well defined. The authors examine an image finding called "PEEK double lucency" that may be useful in identifying fusion. This finding was studied to determine if it would be helpful in identifying fusion on radiographs obtained in 148 patients who underwent an ACDF in which a PEEK cage was filled with local autograft bone (bone spurs in the present cases). The presence of a PEEK double lucency was discovered during review of the plain radiographs and defined as a complete radiol...

Analysis of the three United States Food and Drug Administration investigational device exemption cervical arthroplasty trials.

Journal of Neurosurgery.Spine — Fri, 23 Dec 2011 05:00:00 +0100

Conclusions Both anterior cervical discectomy and fusion as well as arthroplasty demonstrate excellent 2-year surgical results for the treatment of 1-level cervical disc disease with radiculopathy. Arthroplasty is associated with a lower rate of secondary surgery and a higher rate of neurological success at 2 years. Arthroplasty may be associated with a lower rate of adjacent-level disease at 2 years, but further follow-up and analysis are needed to confirm this finding. PMID: 22195608 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Stroke Occurrence and Patterns Are Not Influenced by the Degree of Stenosis in Cervical Artery Dissection.

Stroke — Thu, 22 Dec 2011 05:00:00 +0100

CONCLUSIONS: The occurrence and diffusion-weighted imaging lesion patterns in dissection of the cervical artery patients may not be influenced by the degree of stenosis of the dissected artery. Occlusive dissection of the cervical artery was associated with larger infarcts. PMID: 22198988 [PubMed - as supplied by publisher] (Source: Stroke)

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Trans-areola single-site endoscopic thyroidectomy: pilot study of 35 cases

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:30 +0100

Conclusions TASSET is feasible and safe, with great cosmetic benefits and less injury than other procedures. It may become an alternative procedure for treatment of patients with benign thyroid tumors, especially those with strong desire for cervical cosmesis. Content Type Journal ArticlePages 1-9DOI 10.1007/s00464-011-1972-yAuthors Fan Youben, Department of General Surgery, Center of Thyroid, Affiliated Sixth People’s Hospital, Medical School, Shanghai JiaoTong University, 600 Yishan Road, Shanghai, 200233 ChinaWu Bo, Department of General Surgery, Center of Thyroid, Affiliated Sixth People’s Hospital, Medical School, Shanghai JiaoTong University, 600 Yishan Road, Shanghai, 200233 ChinaZhong Chunlin, Department of General Surgery, Center of Thyroid, Affiliated S...

The use of intra-operative blood gas analysis in the investigation of suspected iatrogenic vascular injury

European Spine Journal — Wed, 14 Dec 2011 06:57:08 +0100

Conclusion Blood gas analysis can be a useful adjunct in determining the nature of hemorrhage from vascular structures in spine surgery when visual inspection is indeterminate. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s00586-011-2116-8Authors Brian P. Walcott, Department of Neurosurgery, White Building Room 502, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USAKristopher T. Kahle, Department of Neurosurgery, White Building Room 502, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USABrian V. Nahed, Department of Neurosurgery, White Building Room 502, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA 02114, USAJ...

Unilateral cervical facet dislocation: a biomechanical study of several constructs including unilateral lateral mass fixation supplemented by an interspinous cable.

Journal of Neurosurgery.Spine — Fri, 09 Dec 2011 05:00:00 +0100

Conclusions The unilateral lateral mass construct supplemented by an interspinous cable does reduce range of motion compared with an intact specimen, but is significantly inferior to a C4-6 bilateral lateral mass construct. When using a dorsal approach, the unilateral construct with a cable should only be considered in selected instances. PMID: 22150239 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Accuracy of MRI in prediction of tumour thickness and nodal stage in oral squamous cell carcinoma

Oral Oncology — Fri, 09 Dec 2011 05:00:00 +0100

Summary: We aim to compare radiological with histological tumour thickness (RTT with HTT) for oral squamous cell carcinoma (OSCC), and the ability of both to predict cervical metastasis. The MRI images and histopathology reports of 102 consecutive OSCC cases were compared and therelationship between RTT and HTT, calculated as a “shrinkage factor” by the gradient of the best fitting regression line. Most (69%) tumours appeared thicker on MRI than was revealed by histopathology. Shrinkage factor was 0.70 (interquartile range 0.63–0.77, correlation co-efficient 0.63) for all cases, 0.87 (IQR 0.80–0.95, CC 0.88) for tongue and 0.65 (IQR 0.49–0.82, CC 0.45) for floor of mouth sub-sites. RTT did not correlate well with the presence of nodal metastases in any sub-site, i.e. there was no...

Pattern analysis of regional spread and therapeutic lymph node dissection in cervical cancer based on ontogenetic anatomy.

Gynecologic Oncology — Thu, 08 Dec 2011 05:00:00 +0100

CONCLUSIONS: The pattern of regional spread in cervical cancer can be comprehended and predicted from ontogenetic lymphatic compartments. In patients with early cervical cancer lymph node dissection based on ontogenetic anatomy achieves high regional tumor control without adjuvant radiation. PMID: 22155677 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

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Cervical carotid artery dissection is associated with styloid process length

Neurology — Mon, 05 Dec 2011 05:00:00 +0100

Conclusions: CCAD is associated with a longer styloid process, suggesting that mechanical injury from the styloid may contribute to the pathogenesis of CCAD. (Source: Neurology)

Styloid process length may add to carotid dissection risk

MedWire News - Stroke — Sun, 04 Dec 2011 14:07:42 +0100

Mechanical injury from the styloid process of the temporal bone may contribute to cervical carotid artery dissection, say researchers who found an increased average length of the styloid process in patients with the condition. (Source: MedWire News - Stroke)

Incidental finding of ovarian teratoma on post-therapy scan for papillary thyroid cancer and impact of SPECT/CT imaging

Arquivos Brasileiros de Endocrinologia e Metabologia — Sun, 04 Dec 2011 08:16:21 +0100

A 41-year old woman post thyroidectomy and neck dissection is presented in this case. She initially presented goiter and an enlarged cervical lymph node. She had no family history of cancer or radiation therapy. She had total thyroidectomy and found to have papillary thyroid cancer (T4N1M0). Histopathology report revealed multifocal classical papillary thyroid carcinoma with lympho-vascular invasion, extra-thyroidal extension, and positive lymph nodes. She was treated with 6.5 Gigabecquerel (GBq) of 131Iodine. Whole-body scan showed uptake in the neck and large focus in the left lower abdomen. Single-photon emission computed tomography SPECT/CT demonstrated a round shaped mass in the left pelvis. Pathology revealed cystic teratoma with benign thyroid tissue (struma ovarii), and no malignan...

Postglucose growth hormone nadir and insulin-like growth factor-1 in naïve-active acromegalic patients: do these parameters always correlate?

Arquivos Brasileiros de Endocrinologia e Metabologia — Sun, 04 Dec 2011 08:16:21 +0100

Robotic thyroid surgery: Clinical and anatomic considerations

Clinical Anatomy — Fri, 02 Dec 2011 05:00:00 +0100

This article will discuss the relevant anatomy, operative goals, robotic technique, and clinical considerations of robotic thyroid surgery. Clin. Anat., 2012. © 2011 Wiley‐Liss, Inc. (Source: Clinical Anatomy)

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Adjacent-level biomechanics after single versus multilevel cervical spine fusion.

Journal of Neurosurgery.Spine — Fri, 02 Dec 2011 05:00:00 +0100

Conclusions This study has shown that the biomechanics at adjacent levels to a cervical spine fusion are altered and that there is increased adjacent-segment motion at the levels above and below, after a 2-level compared with a 1-level ACDF. PMID: 22136389 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

One virus one lesion ‐ Individual components of CIN lesions contain a specific HPV type

The Journal of Pathology — Thu, 01 Dec 2011 18:16:08 +0100

AbstractIn 20‐40% of cervical intra‐epithelial neoplasia (CIN) and in 4‐8% of cervical carcinoma tissue specimens, multiple HPV genotypes have been detected. Whole tissue section (WTS) PCR does not determine how the individual types relate causally to complex and multiple CIN. Our objective was to determine whether laser capture micro‐dissection (LCM) with HPV PCR genotyping (LCM‐PCR) could accurately recover type‐specific HPV DNA from epithelial cells in individual areas of CIN and normal epithelium and whether one or more viruses are present in one lesion. For that, histologically selected samples of CIN and normal epithelium were isolated by LCM and analysed by the SPF10 PCR/LiPA25 (version 1) HPV genotyping system for 25 HPV genotypes. HPV genotypes detected in 756 areas of...

MRI in carotid plaque

Artery Research — Thu, 01 Dec 2011 05:00:00 +0100

The emergence of high-resolution imaging methods has enabled MRI to noninvasively image the fine internal structure of cervical arterial walls. This presentation will provide a comprehensive guide to perform high resolution MRI (HR-MRI) of cervical arteries, including the choice of coils, sequences, imaging parameters, and tips for optimal image quality. HR-MRI of carotid atherosclerosis has the potential to be used in treatment decisions or to monitor the effects treatment options. We will explain and illustrate how to quantify plaque volume, determine atherosclerotic plaque burden, detect plaque composition, and ultimately identify unstable plaque before it leads to a clinical event using HR-MRI. Finally, the role of HR-MRI in the diagnosis of cervical dissection and inflammatory disease...

Cervical carotid artery disease in sickle cell anemia: clinical and radiological features

Blood — Thu, 01 Dec 2011 05:00:00 +0100

Cervical internal carotid artery (cICA) occlusion is a recognized cause of acute ischemic stroke (AIS) in sickle cell disease (SCD), but the associated clinical and radiologic features are not well described. We reviewed data on cervical magnetic resonance angiography (cMRA) performed prospectively in 67 patients (55 children) for indications including transcranial Doppler (TCD) abnormalities, AIS, or previous AIS. cICA lesions were seen in 10 (15%) patients, including 4 of 7 patients presenting with AIS, and appear to have been missed on first presentation in 4 of 10 patients with previous AIS. Radiologic features in 7 patients were consistent with dissection. In 2 patients, there was strong clinical and radiologic evidence for thromboembolic AIS, and this was also considered possible in ...

Case series of targeted parathyroidectomy with surgeon-performed ultrasonography as the only preoperative imaging study

Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: Preoperative SUS is accurate in localizing hypersecreting glands; however, IPM remains paramount in determining the extent of neck dissection. The use of SUS as a single imaging method obviates the need for MIBI in most patients and decreases costs of parathyroidectomy guided by IPM. (Source: Surgery)

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Gender and cervical artery dissection

European Journal of Neurology — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: Our analysis of the largest collection of CeAD patients to date confirms male predominance and differences in age at dissection between men and women. Gender differences in putative risk factors may explain the higher frequency of CeAD in men and their older age, but the putative risk factors are probably not specific for CeAD. (Source: European Journal of Neurology)

Delayed presentation of cervical facet dislocations.

Journal of Orthopaedic Surgery — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSION. Preoperative traction is a safe and effective initial treatment for neglected cervical facet dislocation, as it reduces the need for extensive (anterior and posterior) surgery. If closed reduction is successful, anterior discectomy and fusion is the surgery of choice. If not, posterior facetectomy and fusion followed by anterior surgery is preferred. PMID: 22184165 [PubMed - in process] (Source: Journal of Orthopaedic Surgery)

[Myoepithelial carcinoma of salivary glands: a clinical analysis of 13 cases].

Shanghai Journal of Stomatology — Thu, 01 Dec 2011 05:00:00 +0100

CONCLUSIONS: Myoepithelial carcinoma of the salivary glands is a rare tumor. The diagnosis is depended on histology and immunohistochemistry. The tumor has a high rate of distant metastasis and high rate of lymph node metastasis in T3 to T4 cases. Radical surgery is the treatment of choice. Elective neck dissection should be considered in T3 to T4 cN0 cases. The effect of chemotherapy and radiotherapy needs to be investigated. Supported by National Natural Science Foundation of China(30872895) and Key Project of Hunan Provincial Commission of Science and Technology(2008FJ2011). PMID: 22241311 [PubMed - in process] (Source: Shanghai Journal of Stomatology)

The value of ultrasound in the assessment of cervical and abdominal lymph node metastases and selecting surgical strategy in patients with squamous cell carcinoma of the thoracic esophagus treated with neoadjuvant therapy.

Advances in Medical Sciences — Fri, 25 Nov 2011 05:00:00 +0100

Conclusions: The high sensitivity and specificity of cervical US make this investigational method sufficient in the assessment of cervical nodal involvement. In esophageal cancer patients with negative cervical lymph nodes on US, three-field lymph node dissection could be avoided. In patients with positive cervical lymph nodes on US one should consider to extend lymph node dissection about lymph nodes of the neck to achieve a curative resection. In patients with negative abdominal US this investigation should be supplemented by more detailed diagnostic methods. PMID: 22119915 [PubMed - as supplied by publisher] (Source: Advances in Medical Sciences)

Thoracic recurrent laryngeal lymph node metastases predict cervical node metastases and benefit from three‐field dissection in selected patients with thoracic esophageal squamous cell carcinoma

Journal of Surgical Oncology — Mon, 21 Nov 2011 05:00:00 +0100

ConclusionsMetastasis to RLN LNs is a reliable indicator of cervical LN metastasis in middle/lower thoracic esophageal cancer, while 3FL offers survival benefit over 2FL in certain patient subgroups. J. Surg. Oncol © 2011 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

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An Analysis of Factors Predicting Lateral Cervical Nodal Metastases in Papillary Carcinoma of the Thyroid [Original Article]

Archives of Otolaryngology — Mon, 21 Nov 2011 05:00:00 +0100

Conclusions The intrathyroidal location of PTC predicts the pattern of nodal spread. Therefore, patients with PTC involving the superior aspect of the lobe should undergo specific imaging evaluation of the lateral neck compartments to determine the need for lateral compartment neck dissection. (Source: Archives of Otolaryngology)

Interventions to reduce haemorrhage during myomectomy for fibroids.

Cochrane Database of Systematic Reviews — Sun, 20 Nov 2011 22:06:03 +0100

CONCLUSIONS: There is limited evidence that misoprostol, vasopressin, bupivacaine plus epinephrine, tranexamic acid, gelatin thrombin matrix, peri-cervical tourniquet, and mesna may reduce bleeding during myomectomy. Bupivacaine plus epinephrine has limited clinical importance compared with other interventions as the clinical impact was small. There is no evidence that oxytocin and morcellation reduce blood loss. Further well designed studies are required to establish effectiveness, safety and the costs of different interventions for reducing blood loss during myomectomy. PMID: 22071823 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Mediastinoscopy: An obsolete procedure?

The Journal of Thoracic and Cardiovascular Surgery — Fri, 18 Nov 2011 11:18:33 +0100

For approximately 50 years, mediastinoscopy has been a pivotal part of the pretreatment staging of lung cancer. At one time, respected thoracic surgical groups in North America and Europe considered mediastinoscopy mandatory before proceeding to resection of a non–small cell lung cancer (NSCLC). However, during the past 30 years, improvements in noninvasive imaging modalities, first computed tomography and then positron emission tomography, led to more selective use of mediastinoscopy focusing on patients with enlarged or hypermetabolic mediastinal lymph nodes. During the past decade, the technology for endobronchial ultrasound (EBUS) has become widely available, and EBUS-guided transbronchial needle aspiration (EBUS-TBNA) of hilar and mediastinal lymph nodes has been shown to be feasibl...

[((18)F)-fluorodeoxyglucose PET/CT in cervix cancer: Lymph node assessment and prognostic/predictive value of primary tumour analysis.]

Cancer Radiotherapie — Fri, 18 Nov 2011 05:00:00 +0100

CONCLUSION: PET has high sensitivity in detecting pelvic and para-aortic lymph nodes. Some primary cervical tumour PET parameters are useful as prognostic and predictive factors. PMID: 22104953 [PubMed - as supplied by publisher] (Source: Cancer Radiotherapie)

Patterns of Cervical Lymph Node Metastases in Primary and Recurrent Papillary Thyroid Cancer

Advances in Urology — Thu, 17 Nov 2011 16:00:47 +0100

The incidence of thyroid cancer is rising in the United States with papillary thyroid cancer (PTC) being the most common type. We performed a retrospective study of 49 patients with PTC who underwent 57 lateral neck dissections (NDs). The extent of NDs varied, but 29 of 57 (51%) consisted of levels II–V. Twelve of 57 (21%) NDs consisted of levels I–V. Twelve of 57 (21%) NDs consisted of levels II–IV. One of 57 (1.8%) necks involved only levels I–IV. One of 57(1.8%) necks involved only levels I–V. One of 57(1.8%) necks involved only levels III–V. Two (3.5%) double-level (III–IV) neck surgeries were also performed. Metastatic PTC adenopathy was confirmed pathologically in 2%-level-I, 45%-level-II, 57%-level-III...

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Single-level anterior cervical discectomy and interbody fusion using PEEK anatomical cervical cage and allograft bone

Journal of Orthopaedics and Traumatology — Wed, 16 Nov 2011 16:47:04 +0100

Conclusion Anterior cervical discectomy and interbody fusion using PEEK anatomical cervical cages can be considered a safe and effective technique to cure cervical disc herniation with intractable pain or neural deficit in cases where conservative treatment failed. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s10195-011-0169-4Authors C. Faldini, Department of Orthopaedic Surgery, Istituto Ortopedico Rizzoli, University of Bologna, Via G.C. Pupilli 1, 40136 Bologna, ItalyM. Chehrassan, Department of Orthopaedic Surgery, Istituto Ortopedico Rizzoli, University of Bologna, Via G.C. Pupilli 1, 40136 Bologna, ItalyM. T. Miscione, Department of Orthopaedic Surgery, Istituto Ortopedico Rizzoli, University of Bologna, Via G.C. Pupilli 1, 40136 Bo...

[Extrapelvic sentinel lymph nodes in cervical cancer: A review.]

Gynecologie, Obstetrique et Fertilite — Wed, 16 Nov 2011 05:00:00 +0100

CONCLUSION: The unusual localizations of sentinel lymph nodes impose to the gynaecologic surgeons to be hardened in performing lymph node dissection in all the territories potentially affected. PMID: 22099973 [PubMed - as supplied by publisher] (Source: Gynecologie, Obstetrique et Fertilite)

Thoracoscopic management of chylothorax after esophagectomy

Surgical Endoscopy — Tue, 15 Nov 2011 07:18:30 +0100

Conclusions The thoracic duct is exposed to injuries during esophagectomies, especially in cases of cancer and postcaustic injuries, leading to fibrotic reaction of the surrounding tissue. Early and delayed chylothorax can be managed efficiently by a thoracoscopic approach replicating the sealing techniques used in thoracotomy. Content Type Journal ArticleCategory Multimedia ManuscriptPages 1-1DOI 10.1007/s00464-011-1988-3Authors C. Callari, IRCAD, Department of Endocrine and Digestive Surgery, University of Strasbourg, Strasbourg, FranceS. Perretta, IRCAD, Department of Endocrine and Digestive Surgery, University of Strasbourg, Strasbourg, FranceM. Diana, IRCAD, Department of Endocrine and Digestive Surgery, University of Strasbourg, Strasbourg, FranceJ. Dagostino,...

Successful treatment of anaplastic meningioma metastatic to cervical lymph nodes

Head and Neck — Tue, 15 Nov 2011 05:00:00 +0100

ConclusionCervical lymph node metastasis of anaplastic meningioma is potentially treatable with surgical resection and IMRT, although further studies with long‐term follow‐up are necessary. © 2011 Wiley Periodicals, Inc. Head Neck, 2011 (Source: Head and Neck)

The outer arterial wall layers are primarily affected in spontaneous cervical artery dissection

Neurology — Mon, 14 Nov 2011 05:00:00 +0100

(Source: Neurology)

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Characteristics and management of intractable neck involvement in tularemia: report of 19 patients

European Archives of Oto-Rhino-Laryngology — Wed, 09 Nov 2011 07:03:25 +0100

In conclusion, intractable neck masses and an abscess can be the initial finding in tularemia, and a high index of suspicion is needed in the differential diagnosis. Superselective neck dissection is a safe and effective option in the treatment of long lasting cervical tularemia unless it responds to medical treatment. Content Type Journal ArticleCategory MiscellaneousPages 1-6DOI 10.1007/s00405-011-1830-5Authors Yusuf Kızıl, Department of Otorhinolaryngology, Gazi University School of Medicine, Ankara, TurkeyUtku Aydil, Department of Otorhinolaryngology, Gazi University School of Medicine, Ankara, TurkeySüleyman Cebeci, Department of Otorhinolaryngology, Gazi University School of Medicine, Ankara, TurkeyOsman Tuğrul Güzeldir, Department of Otorhinolaryngology, Gazi Universi...

Mutations in TGFBR2 gene cause spontaneous cervical artery dissection

Journal of Neurology, Neurosurgery and Psychiatry — Mon, 07 Nov 2011 05:00:00 +0100

Mutations in the genes encoding transforming growth factor β receptors 1 and 2 (TGFBR1 and TGFBR2) have recently been associated with hereditary connective tissue disorders with widespread vascular involvement, including arterial dissection. To determine whether mutations in these genes cause spontaneous cervical artery dissection (sCAD), all coding exons of TGFBR1 and TGFBR2 were sequenced in 56 consecutive patients with sCAD. Novel TGFBR2 disease causing mutations were found in two patients. The two mutations were the pK327R substitution affecting the kinase domain of TGFBR2 and the pC138R substitution falling in the extracellular domain of the protein, involved in TGFβ binding and signalling. No TGFBR1 mutation was found. The findings indicate that TGFBR2 gene mutations are re...

Spontaneous Multiple Cervical Artery Dissection in the Puerperium

Cerebrovascular Diseases — Thu, 03 Nov 2011 23:00:00 +0100

Cerebrovasc Dis 2011;32:511–512 (DOI:10.1159/000332089) (Source: Cerebrovascular Diseases)

Results of Cervical Arthroplasty Compared With Anterior Discectomy and Fusion: Four-year Clinical Outcomes in a Prospective, Randomized Controlled Trial.

Orthopedics — Tue, 01 Nov 2011 04:00:00 +0100

Authors: PMID: 22050256 [PubMed - in process] (Source: Orthopedics)

Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial. Sasso RC, Anderson PA, Riew KD, Heller JG. J Bone Joint Surg Am 2011;93(18):1684–92.

The Spine Journal — Tue, 01 Nov 2011 04:00:00 +0100

The published two-year results of the pivotal U.S. Food and Drug Administration investigational device exemption trial with the use of the Bryan cervical disc arthroplasty compared with anterior cervical discectomy with fusion for treating single-level degenerative cervical disc disease revealed a significantly superior overall success rate in the arthroplasty group. The purpose of this study was to evaluate the midterm safety and effectiveness of the Bryan disc as an alternative to arthrodesis following anterior cervical discectomy. (Source: The Spine Journal)

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Autologus groin lymph node transfer for “sentinel lymph network” reconstruction after head‐and‐neck cancer resection and neck lymph node dissection: A case report

Microsurgery — Tue, 01 Nov 2011 04:00:00 +0100

AbstractLocal or distant metastatic recurrence after therapy is observed in 20–30% of cases of head‐and‐neck cancer. An unfavorable course may occur after cervical lymph node dissection due to loss of immunoprotective lymph nodes in the head‐and‐neck region. To overcome this problem, we performed autologous lymph node transplantation from the groin after head‐and‐neck cancer resection and cervical lymph node dissection. The patient was a 63‐year‐old man with squamous cell carcinoma in the mesopharyngeal lateral wall. After tumor resection and right cervical lymph node dissection, a lymph node‐containing superficial circumflex iliac artery perforator flap was transplanted from the left groin. Pathological examination showed that cancer had invaded the primary tumor tissu...

Contemporary management of lymph node metastases from an unknown primary to the neck: II. A review of therapeutic options

Head and Neck — Thu, 27 Oct 2011 04:00:00 +0100

AbstractAlthough uncommon, cancer of an unknown primary (CUP) metastatic to cervical lymph nodes poses a range of dilemmas relating to optimal treatment. The ideal resolution would be a properly designed prospective randomized trial, but it is unlikely that this will ever be conducted in this group of patients. Accordingly, knowledge gained from retrospective studies and experience from treating patients with known head and neck primary tumors form the basis of therapeutic strategies in CUP. This review provides a critical appraisal of various treatment approaches described in the literature. Emerging treatment options for CUP with metastases to cervical lymph nodes are discussed in view of recent innovations in the field of head and neck oncology and suitable therapeutic strategies for pa...

Cervical adenoid basal carcinoma associated with invasive squamous cell carcinoma: A report of rare co-existence and review of literature

World Journal of Surgical Oncology — Tue, 18 Oct 2011 00:26:52 +0100

We report a 64-year-old asymptomatic lady with an abnormal cervical cytology, who underwent a conization to reveal an ABC with overlying microinvasive SCC. Doubtful resection margins led us to perform radical hysterectomy with lymph node dissection. Subsequent pathological examination showed a true invasive SCC co-existing with ABC, with invasion of the parametrium. Unlike the indolent course of many pure ABC patients, the prognosis of 11 previously reported co-existing invasive SCC with ABC patients appears to depend on the SCC component. Our case reiterates the importance of adequate biopsy with careful interpretation to cover the possibility of a co-existent malignancy. Besides, it presents an argument in favor of radical surgery for the primary treatment of suspicious associated malign...

The role of preoperative neck ultrasounds to assess lymph nodes in patients with suspicious or indeterminate thyroid nodules

Journal of Surgical Oncology — Mon, 17 Oct 2011 04:00:00 +0100

ConclusionThyroid nodule microcalcifications on ultrasound and category of FNAB appear to be the best predictors of metastatic disease. Because the surgical approach was altered in only a few patients, further analysis is needed to delineate whether performing cervical ultrasound for suspicious/indeterminate nodules is cost effective. J. Surg. Oncol © 2011 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

Bioabsorbable anterior cervical plate fixation for single-level degenerative disorders: early clinical and radiographic experience

The Spine Journal — Mon, 17 Oct 2011 04:00:00 +0100

Conclusions: Bioabsorbable ACP fixation was associated with a high rate of graft extrusion and early loss of intersegmental cervical alignment. Inferior clinical outcomes were observed in patients in the bACP group compared with the mACP group. Based on these findings, continued use of the bACP used in this study cannot be recommended. (Source: The Spine Journal)

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Management of the “Violated Neck” in the era of chemoradiation

The Laryngoscope — Wed, 12 Oct 2011 04:00:00 +0100

Conclusions:In the era of chemoradiation, completion neck dissection following an open cervical biopsy does not appear to provide a survival advantage. A high proportion of HPV‐positive oropharyngeal tumors may explain the favorable outcomes observed. (Source: The Laryngoscope)

Is neck dissection needed in squamous-cell carcinoma of the maxillary gingiva, alveolus, and hard palate? A multicentre Italian study of 65 cases and literature review

Oral Oncology — Wed, 12 Oct 2011 04:00:00 +0100

We present a retrospective multicentre study of 65 patients with squamous-cell carcinomas of the maxillary alveolar ridge and hard palate and review of the existing literature.The overall incidence of cervical metastases was 21%. We evaluated the significance of primary-site tumours as indicator of regional disease.The maxillary squamous-cell carcinoma cases in our multicentre study and in the literature review exhibited aggressive regional metastatic behaviour, comparable with that of carcinomas of the tongue, mouth floor, and mandibular gingiva. Based on our findings, we recommend selective neck dissection in clinically negative necks as a primary management strategy for patients with maxillary squamous-cell carcinomas involving the palate, maxillary gingiva, or maxillary alveolus. (Sour...

Renal ultrasound to detect hydronephrosis: A need for routine imaging after radical hysterectomy?

Gynecologic Oncology — Tue, 11 Oct 2011 04:00:00 +0100

CONCLUSION: There is no place for routine renal ultrasound following radical hysterectomy. Patients should be instructed about the symptoms that may be related to hydronephrosis, to allow for renal ultrasound on indication. PMID: 21996260 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

Cervical artery dissection following a turbulent flight. - Quinn C, Cooke J, O'Connor M, Lyons D.

SafetyLit: All (Unduplicated) — Mon, 10 Oct 2011 00:10:04 +0100

BACKGROUND: Cervical artery dissection is a common cause of stroke in young patients without vascular risk factors and may affect the carotid or vertebral arteries. The risk of spontaneous dissection is higher in those with genetic predisposing factors whi... (Source: SafetyLit: All (Unduplicated))

Cervical disc arthroplasty versus fusion for single-level symptomatic cervical disc disease: a meta-analysis of randomized controlled trials

Archives of Orthopaedic and Trauma Surgery — Sat, 08 Oct 2011 15:44:29 +0100

Conclusion Compared with ACDF, CDA carry a lower incidence of dysphagia complications and reoperation related to adjacent-segment degeneration, and a higher prevalence of neurological and overall success at 2 years postoperatively. As the poor quality of the included studies, it is still uncertain whether CDR is more effective and safer than ACDF treating single-level symptomatic cervical disc disease. Future large-scale RCTs with long-term follow-up are needed to provide clear evidence. Content Type Journal ArticleCategory Orthopaedic SurgeryPages 1-11DOI 10.1007/s00402-011-1401-7Authors Hua Jiang, Department of Orthopedics and Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008 People’...

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Craniocervical Arterial Dissection in Children: Diagnosis and Treatment

Current Treatment Options in Neurology — Thu, 06 Oct 2011 15:42:03 +0100

Opinion statement Diagnosis of craniocervical arterial dissection (CCAD) in children begins with a careful history and physical in a child with a transient ischemic attack (TIA) or arterial ischemic stroke (AIS). The extent of radiologic evaluation for suspected CCAD is based upon careful consideration of the risks associated with the best imaging techniques, weighed against the benefits of enhanced vascular imaging with better diagnostic sensitivity. Although conventional angiography (CA) and CT angiography (CTA) have a higher sensitivity than magnetic resonance angiography (MRA), they are accompanied by risks: for CA, femoral hematoma, femoral arterial pseudoaneurysm, recurrent AIS, and radiation exposure; for CTA, radiation. For children (non-neonates) with suspected CC...

Impact of elective neck dissection on regional recurrence and survival in cN0 staged oral maxillary squamous cell carcinoma

Oral Oncology — Wed, 05 Oct 2011 04:00:00 +0100

Summary: To evaluate the impact of elective neck dissection (END) on regional recurrence and survival in cN0 staged patients with maxillary squamous cell carcinoma (SCC).Eighty-six patients with maxillary SCC and clinically staged N0 cervical lymph-nodes were evaluated in this single center retrospective study.Seventy-four of 86 patients were included in this analysis, of which 36 patients were treated with END, 38 without END. Following END, pathohistologically verified regional lymph-nodes in the initially cN0 neck were found in three (8%) patients. In both the +END and non-END group regional recurrences occurred exclusively in patients with T4 primaries. The overall regional recurrence rate was 17% in the +END and 18% in the non-END group, respectively. The 5-year overall survival rate ...

Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion for multilevel cervical spondylosis: a systematic review

Archives of Orthopaedic and Trauma Surgery — Tue, 04 Oct 2011 05:52:38 +0100

Conclusion Nonunion rates of ACDF are higher than those of ACCF for multilevel cervical spondylosis. Sometimes, clinical outcome of ACCF was better than ACDF for multilevel cervical spondylosis. Content Type Journal ArticleCategory Orthopaedic SurgeryPages 1-7DOI 10.1007/s00402-011-1402-6Authors Sheng-Dan Jiang, Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 ChinaLei-Sheng Jiang, Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 ChinaLi-Yang Dai, Department of Orthopaedic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092 China ...

Neurosonographic Monitoring of 105 Spontaneous Cervical Artery Dissections

Journal of Vascular Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Conclusions: Changes in the lumen of cervical arteries afflicted with spontaneous cervical artery dissection occur most frequently within the first few months after the dissection, but recanalization may occur up to 1 year later. Early recurrence is reasonably common but involves arteries previously unaffected by dissection. Recurrence of spontaneous cervical artery dissection is strongly associated with a family history of arterial dissection. (Source: Journal of Vascular Surgery)

Cervical juxtafacet cyst after anterior cervical discectomy and fusion.

Neurosurgical Focus — Sat, 01 Oct 2011 04:00:00 +0100

Authors: Sivakumar W, Elder JB, Bilsky MH Abstract Anterior cervical discectomy and fusion (ACDF) is a common neurosurgical procedure, and the benefits, long-term outcomes, and complications are well described in the literature. The development of a juxtafacet joint cyst resulting in radiculopathy is a rare outcome after ACDF and merits further description. The authors describe a patient in whom a juxtafacet joint cyst developed after ACDF procedures, resulting in surgical intervention. When a juxtafacet joint cyst develops after ACDF, symptoms can include radiculopathy, neck pain, and neurological symptoms such as paresthesias and motor weakness. The presence of a juxtafacet joint cyst implies instability in that region of the spine. Patients with this pathological entity may requ...

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The innovation of neck dissection in our department

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

In the head and neck cancer operation, it is obviously that neck dissection is one of the most important technique. The technique is not only important for the control of the disease but also measuring surgeon's level in the field of head and neck cancer operation. Though neck dissection is operated in the basis of unified philosophy, each operators have used several techniques and devices. Recently the functional neck dissection to conserve organs has been main current. The purpose of this technique is that sternocleidomastoid muscle (SCM), accessory nerve, internal jugular vein (IJV) are conserved as much as possible and functional disturbance after the operation is reduced. We have paid attention to identify anatomical parameter certainly to resect fat tissues on the deep cervical fasci...

[Surgical repair of postintubation esophago-tracheal fistulas: report of two operated cases].

Orvosi Hetilap — Fri, 30 Sep 2011 21:10:41 +0100

In conclusion, it can be stated that adaptation of surgical techniques for the individual pathologic situation helped the authors to find the way to the successful outcome. Orv. Hetil., 2011, 152, 1618-1622. PMID: 21945871 [PubMed - in process] (Source: Orvosi Hetilap)

Response To Albuquerque Cervical Arterial Dissection Study

ChiroACCESS: Tools for Better Patient Care — Fri, 30 Sep 2011 00:00:00 +0100

A recent publication in the Journal of Neurosurgery adds to the debate over the advisability of performing cervical manipulations, in that the procedure is reported to have led to the appearance and description of 13 cases of craniocervical artery dissections. (Source: ChiroACCESS: Tools for Better Patient Care)

Cervical Artery Dissection Following a Turbulent Flight

Aviation, Space, and Environmental Medicine — Thu, 22 Sep 2011 23:48:50 +0100

(Source: Aviation, Space, and Environmental Medicine)

Four cases of spinal accessory nerve passing through the fenestrated internal jugular vein

Surgical and Radiologic Anatomy — Thu, 22 Sep 2011 05:51:46 +0100

Conclusion Although this anomaly is rare, head and neck surgeons should be aware of this anomalous relationship between the SAN and the IJV in order to avoid accidental injury to these structures during ND. Content Type Journal ArticleCategory Anatomic VariationsPages 1-3DOI 10.1007/s00276-011-0875-xAuthors Yuriko Hashimoto, Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, JapanNaoki Otsuki, Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, JapanKouichi Morimoto, Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-...

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Results of cervical arthroplasty compared with anterior discectomy and fusion: four-year clinical outcomes in a prospective, randomized controlled trial.

The Journal of Bone and Joint Surgery. American volume — Wed, 21 Sep 2011 04:00:00 +0100

CONCLUSIONS: The forty-eight-month follow-up data in the present report showed consistent, sustained significantly superior outcomes for cervical spine arthroplasty compared with cervical spine fusion. The arthroplasty cohort continued to show significantly greater improvements in Neck Disability Index, neck pain score, arm pain score, and Short Form-36 physical component score, as well as the primary outcome measure, overall success, at forty-eight months following surgery. LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence. PMID: 21938372 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Differential features of carotid and vertebral artery dissections: The CADISP Study

Neurology — Mon, 19 Sep 2011 04:00:00 +0100

Conclusion: In the largest published series of patients with CEAD, we observed significant differences between VAD and ICAD in terms of risk factors, baseline features, and functional outcome. (Source: Neurology)

Regional Recurrence after Lymphadenectomy for Clinically Evident Lymph Node Metastases from Papillary Thyroid Cancer: A Cohort Study

Annals of Surgical Oncology — Tue, 13 Sep 2011 05:49:41 +0100

Conclusions Patients with CELNM have an appreciable incidence of early regional cervical recurrence but not distant metastases. Among clinical and pathological factors evaluated, the number of metastatic LNs is associated with recurrence. Content Type Journal ArticleCategory Endocrine TumorsPages 1-7DOI 10.1245/s10434-011-1890-1Authors Parth K. Shah, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USAKinjal K. Shah, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USAGiorgos C. Karakousis, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USACaroline E. Reinke, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USARachel R. Kel...

Endothelial Dysfunction in Carotid Elongation

Journal of Neuroimaging — Tue, 13 Sep 2011 04:00:00 +0100

CONCLUSIONSAmong subjects with carotid elongation, those with severe kinking have an impaired endothelial‐dependent vasodilation and might be prone to carotid dissection. J Neuroimaging 2011;XX:1–3. (Source: Journal of Neuroimaging)

Sonographic Examination of the Neck after Definitive Radiotherapy for Node-Positive Oropharyngeal Cancer [HEAD AND NECK]

American Journal of Neuroradiology — Fri, 09 Sep 2011 04:00:00 +0100

CONCLUSIONS: In experienced hands, serial US is an inexpensive noninvasive reassuring follow-up strategy after definitive head and neck RT, even when CT findings are equivocal. (Source: American Journal of Neuroradiology)

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Outcome in early cervical cancer following pre-operative low dose rate brachytherapy: A ten-year follow up of 257 patients treated at a single institution.

Gynecologic Oncology — Wed, 07 Sep 2011 04:00:00 +0100

CONCLUSIONS: Preoperative LDR-UVBT results in good disease control with a low complications rate. Its accuracy could be improved by a better selection of patients. Lymph nodes and parametrial evaluation remains a challenging issue that should be achieved with imaging and minimal invasive surgery. PMID: 21906789 [PubMed - as supplied by publisher] (Source: Gynecologic Oncology)

The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature.

Acta Oto-Laryngologica — Mon, 05 Sep 2011 04:00:00 +0100

We report three cases of retropharyngeal node metastasis from thyroid papillary carcinoma, including a case of bilateral nodal metastasis. Retropharyngeal node metastasis was successfully resected in all three patients by the transcervical approach. As pointed out in past reports, this report also suggests that prior neck dissection and/or metastasis to cervical lymph nodes might alter the direction of lymphatic drainage to the retrograde fashion, resulting in the unusual metastasis to the retropharyngeal lymph nodes, and there is a possibility of a bilateral pattern. Also, it is necessary to consider the possibility of metastasis from a papillary thyroid carcinoma in the differential diagnosis of lymph node swelling in the parapharyngeal space. PMID: 21888566 [PubMed - as supplied by ...

Lumbosacral spondylodiscitis: an unusual complication of abdominal sacrocolpopexy

International Urogynecology Journal — Fri, 02 Sep 2011 05:47:49 +0100

Abstract Lumbosacral spondylodiscitis, an unusual complication of abdominal sacrocolpopexy using synthetic polypropylene mesh is reported. A young sexually active female with stage IV pelvic organ prolapse was managed with abdominal hysterectomy and sacrocolpopexy. Cervical dysplasia demanded hysterectomy and sacrocolpopexy was done to achieve good long-term results. Mesh exposure was noticed in the early post-operative period which initially responded to conservative management. Eight weeks later, the patient reported with severe pain in lower back restricting her physical movements and ambulation. Further evaluation with magnetic resonance imaging (MRI) confirmed lumbosacral spondylodiscitis, due to the infected mesh which warranted a complete removal of mesh by laparoto...

Sentinel lymph node biopsy is unsuitable for routine practice in younger female patients with unilateral low-risk papillary thyroid carcinoma

BMC Cancer — Thu, 01 Sep 2011 23:00:00 +0100

Conclusions: Compared to a single technique, there was a significantly higher SLN identification rate for the combined technique in younger female with ipsilateral, low-risk PTC (T1-2N0M0). Thus, a combined SLN biopsy technique seems to more accurately stage lymph nodes, with better identification of SLN located out of the central compartment. Regardless of the procedure used, the high FNR renders the current SLN techniques unsuitable for routine practice. Based on these results, prophylactic node dissection of level VI might be considered because 38.1% of our patients had such node metastases. (Source: BMC Cancer)

Outcomes of endoscopic and surgical resection for a second primary cancer in the residual cervical esophagus after thoracic esophagectomy

Diseases of the Esophagus — Thu, 01 Sep 2011 23:00:00 +0100

SummaryPatients who have received subtotal esophagectomy for thoracic esophageal cancer must be closely monitored for second primary malignancies. The purpose of this study is to review and assess patients who developed a second primary esophageal cancer in the residual cervical esophagus. Between 1996 and 2010, 10 patients were diagnosed in our hospital with esophageal squamous cell cancer in the residual cervical esophagus after undergoing thoracic esophagectomy and were treated with endoscopic or surgical resection. Data from these patients were reviewed retrospectively. Seven of the 10 patients (70%) had multiple primary carcinoma lesions at the time of their esophagectomy. A second primary cancer in the residual cervical esophagus was detected in eight patients during follow‐up endo...

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Unilateral macroglossia as sole presenting manifestation of internal carotid artery dissection.

Ear, Nose and Throat Journal — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Stübgen JP Abstract A patient presented with acute-onset, painless, unilateral enlargement of the tongue. Steroid treatment for angioedema was ineffective, and a biopsy of an apparent mass of the tongue base showed normal tissue. Subsequent magnetic resonance imaging showed enlargement, enhancement, asymmetric T2 hyperintensity of the left half of the tongue, and dissection of the left cervical internal carotid artery (ICA) at the skull base. Unilateral enlargement of the tongue due to acute neurogenic denervation may be the sole clinical presentation of a spontaneous arterial dissection at the skull base. The hypoglossal neuropathy resulted from compression by the pseudoaneurysmal ICA dilatation or ischemia from interruption of the vasa nervorum. PMID: 21938704 [PubM...

Adjacent-level degeneration after cervical disc arthroplasty versus fusion. Maldonado CV, Paz RD, Martin CB. Eur Spine J 2011;20 (Suppl 3):403–7. Epub 2011 Jul 28.

The Spine Journal — Thu, 01 Sep 2011 04:00:00 +0100

The principal objective of this study was to evaluate the incidence of adjacent-segment degeneration (ASD) in patients who underwent cervical disc arthroplasty (CDA) as compared with anterior cervical discectomy and fusion (ACDF). (Source: The Spine Journal)

Effect on clinical outcomes of patient pain expectancies and preoperative Mental Component Summary scores from the 36-Item Short Form Health Survey following anterior cervical discectomy and fusion. Carr FA, Healy KM, Villavicencio AT, et al. J Neurosurg Spine 2011 Aug 5. [Epub ahead of print]

The Spine Journal — Thu, 01 Sep 2011 04:00:00 +0100

The primary purpose of this study was to analyze what effect preoperative patient expectations and 36-Item Short Form Health Survey (SF-36) Mental Component Summary (MCS) scores have on clinical outcomes. To the authors’ knowledge, there are no prospective studies that have examined the effects of both preoperative pain expectations and SF-36 MCS scores on clinical outcomes and satisfaction with results following anterior cervical discectomy and fusion (ACDF). (Source: The Spine Journal)

Connection between the spinal dura mater and suboccipital musculature: Evidence for the myodural bridge and a route for its dissection—A review

Clinical Anatomy — Wed, 31 Aug 2011 23:00:00 +0100

This article summarizes the anatomic and clinical research literature related to this structure and provides a simple approach to dissect the myodural bridge and its attachment to the posterior atlanto‐occipital membrane/spinal dura mater complex and summarizes the case for its possible inclusion in medical anatomy curricula. Clin. Anat., 2011. © 2011 Wiley‐Liss, Inc. (Source: Clinical Anatomy)

Anterior surgery in selective patients with massive ossification of posterior longitudinal ligament of cervical spine: technical note

European Spine Journal — Wed, 31 Aug 2011 05:53:00 +0100

Conclusion Anterior surgery using our technique may be a relatively simple and safe procedure in selective patients with massive ossification of posterior longitudinal ligament of cervical spine. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00586-011-1996-yAuthors Xinwei Wang, Department of Orthopedics, Changzheng Hospital, Second Military Medical University of China, 415 Fengyang Road, Shanghai, 200003 ChinaDeyu Chen, Department of Orthopedics, Changzheng Hospital, Second Military Medical University of China, 415 Fengyang Road, Shanghai, 200003 ChinaWen Yuan, Department of Orthopedics, Changzheng Hospital, Second Military Medical University of China, 415 Fengyang Road, Shanghai, 200003 ChinaYing Zhang, Department of Orthopedics, Changzh...

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Patterns of Lymph Node Metastasis and Survival for Upper Esophageal Squamous Cell Carcinoma [ORIGINAL ARTICLES: GENERAL THORACIC]

The Annals of Thoracic Surgery — Tue, 30 Aug 2011 23:00:00 +0100

Conclusions Recurrent laryngeal lymph node chains are those most commonly affected by nodal metastasis, and the prevalence of cervical lymph node involvement is high, at more than 40%. Esophagectomy with three-field lymph node dissection in patients with upper esophageal SCC can be performed with acceptable morbidity and mortality. Curative R0 resection for upper esophageal SCC achieved a satisfactory 5-year survival rate. (Source: The Annals of Thoracic Surgery)

Remodeling of adjacent spinal alignments following cervical arthroplasty and anterior discectomy and fusion

European Spine Journal — Tue, 30 Aug 2011 05:42:07 +0100

Conclusions The remodeling of cervical and thoracic curves after cervical ADR and ACDF was coupled and complementary. Cervical ADR contributed the restorations of angulations of cervical and thoracic spines. The neck VAS improved more after cervical ADR than after ACDF. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00586-011-2000-6Authors Sung Bae Park, Department of Neurosurgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, KoreaTae-Ahn Jahng, Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744 KoreaChun Kee Chung, Department of Neurosurgery, Seoul National University College of Medicine, Seoul National University H...

Surgical treatment of spontaneous intracranial hypotension secondary to degenerative cervical spine pathology: a case report and literature review

European Spine Journal — Sat, 27 Aug 2011 05:52:06 +0100

Conclusion Two months after this novel surgical blood patch procedure the patient was asymptomatic and follow-up imaging demonstrated complete resolution. Content Type Journal ArticleCategory Case ReportPages 1-6DOI 10.1007/s00586-011-1979-zAuthors Christopher D. Witiw, School of Medicine, University of Manitoba, Winnipeg, MB, CanadaAria Fallah, Division of Neurosurgery, St. Michaels Hospital, University of Toronto, Toronto, ON, CanadaPaul J. Muller, Division of Neurosurgery, St. Michaels Hospital, University of Toronto, Toronto, ON, CanadaHoward J. Ginsberg, Division of Neurosurgery, St. Michaels Hospital, University of Toronto, Toronto, ON, Canada Journal European Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source: European Spine Journal)

Vertebral artery dissection in a patient practicing self-manipulation of the neck

Journal of Chiropractic Medicine — Thu, 18 Aug 2011 04:00:00 +0100

Conclusion: This case suggests that careful history taking and awareness of the symptoms of VAD are necessary in cases of sudden head and neck pain. More research is needed on the relationship between vertebral artery dissection and self-manipulation of the neck. (Source: Journal of Chiropractic Medicine)

High-Resolution Double Inversion Recovery Black-Blood Imaging of Cervical Artery Dissection Using 3T MR Imaging [HEAD & NECK]

American Journal of Neuroradiology — Wed, 17 Aug 2011 23:00:00 +0100

SUMMARY: We performed high-resolution DIR-BBI of the cervical arteries at 3T in 19 subjects with cervical dissection. It offered excellent visualization of both the lumen and arterial wall, allowing detection of the primary and secondary features of dissection. We suggest that this is a highly useful technique for diagnosis of cervical dissection, either routinely or in equivocal cases of suspected dissection. It also offers further insight into the pathogenesis of this disorder. (Source: American Journal of Neuroradiology)

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Pathways for cervical metastasis in malignant neoplasms of the head and neck region

Clinical Anatomy — Wed, 17 Aug 2011 23:00:00 +0100

AbstractThere have been significant changes in the evaluation and management of lymphatic metastases in the neck during the past several decades, and knowledge of the functional anatomy of the cervical lymphatics is fundamental to the clinical management of metastasis in this region. This review provides a comprehensive description of the cervical lymphatics and discusses how this knowledge is used in the modern management of the neck lymphatics in the setting of common cancers of the head and neck. The patterns of tumor spread can be delineated based on the well‐studied functional anatomy of the lymphatic networks in the cervical region. The characteristics and patterns of metastatic spread for two common cancers found in this region, squamous cell carcinoma and cutaneous malignant mela...

Closed Platysmotomy: A New Procedure for the Treatment of Platysma Bands Without Skin Dissection

Aesthetic Plastic Surgery — Wed, 17 Aug 2011 05:57:53 +0100

This report aims to describe a procedure for deactivating these bands using a percutaneous approach that eliminates the need for submental, cutaneous incision and dissection. This technique involves the use of a steel wire loop that encircles the platysma band and is connected to a device known as the platysmotome through two puncture holes in the skin. Three to six sections along each band eliminate the platysma band, leaving no visible marks on the skin. This method is indicated as an isolated procedure for patients with visible platysma bands and no skin flaccidity, patients with recurring bands after face-lifting and no cervical skin flaccidity, patients who have bands with little cervical skin flaccidity but do not care to undergo face-lifting, and patients who undergo face-lif...

Cervical variations of the phrenic nerve

The Laryngoscope — Mon, 15 Aug 2011 23:00:00 +0100

Conclusions:The present study demonstrates the wide variability within the cervical anatomy of the phrenic nerve. (Source: The Laryngoscope)

Composite platysmofascial flap in reconstruction following partial vertical laryngeal resections

The Laryngoscope — Mon, 15 Aug 2011 23:00:00 +0100

Conclusions:The method of our choice for laryngeal reconstruction after partial vertical laryngeal resections is paramedially based horizontal platysmofascial composite flap with the insertion opposite to the side of the primary laryngeal tumor. (Source: The Laryngoscope)

Management of parapharyngeal giant pleomorphic adenoma

Oral and Maxillofacial Surgery — Sat, 13 Aug 2011 06:13:56 +0100

Conclusions Preoperative diagnosis management of PPS giant tumors should be based on imaging and upon open transoral biopsy if possible. The transparotid–intraoral approach provided adequate visibility to remove large PAs involving the prestyloid PPS. Content Type Journal ArticlePages 1-6DOI 10.1007/s10006-011-0289-2Authors Pedro Infante-Cossio, Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Manuel Siurot Av, 41013 Seville, SpainEduardo Gonzalez-Cardero, Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Manuel Siurot Av, 41013 Seville, SpainLuis-Miguel Gonzalez-Perez, Department of Oral and Maxillofacial Surgery, Virgen del Rocio University Hospital, Manuel Siurot Av, 41013 Seville, SpainManuel ...

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The conservative treatment of postoperative chylous ascites in gynecologic cancers: four case reports

Archives of Gynecology and Obstetrics — Fri, 12 Aug 2011 06:11:19 +0100

Conclusion Chylous ascites should be considered in the differential diagnosis of abdominal distension following retroperitoneal surgery. Cases generally respond well to conservative treatment. However, treatment options should be personalized, and the right treatment should be chosen for each patient. The best measure is to pay utmost attention to the ligation of large lymph vessels during lymph dissection. Content Type Journal ArticlePages 1-3DOI 10.1007/s00404-011-2050-3Authors Turgut Var, Zekai Tahir Burak Women’s Health Research and Education Hospital, Tunali Hilmi Cad. Binnaz Sok. No. 1/5 Kavaklidere, Ankara, 06100 TurkeyTayfun Güngor, Zekai Tahir Burak Women’s Health Research and Education Hospital, Tunali Hilmi Cad. Binnaz Sok. No. 1/5 Kavaklidere, Anka...

Intra-operative frozen section analysis of common iliac lymph nodes in patients with stage IB1 and IIA1 cervical cancer

Archives of Gynecology and Obstetrics — Fri, 12 Aug 2011 06:11:16 +0100

Conclusion The frozen section analysis of common iliac lymph nodes can develop the accuracy of the para-aortic lymphadenectomy and metastasis rate of para-aortic lymph node in patients with stage IB1 and IIA1 cervical cancer. Content Type Journal ArticlePages 1-6DOI 10.1007/s00404-011-2038-zAuthors Xiaojuan Lv, Department of Gynecology Oncology, Zhejiang Provincial Cancer Hospital, 38 Guangji Road, Hangzhou, People’s Republic of ChinaLu Chen, Department of Gynecology Oncology, Zhejiang Provincial Cancer Hospital, 38 Guangji Road, Hangzhou, People’s Republic of ChinaHua Yu, Department of Gynecology Oncology, Zhejiang Provincial Cancer Hospital, 38 Guangji Road, Hangzhou, People’s Republic of ChinaXiang Zhang, Department of Gynecology Oncology, Zhejiang Provincia...

A comparison of anterior cervical discectomy and corpectomy in patients with multilevel cervical spondylotic myelopathy

European Spine Journal — Mon, 08 Aug 2011 19:54:37 +0100

Conclusions Surgical managements of 3- or 4-level CSM by ACDF or ACCF showed no significant differences in terms of achieved clinical symptom improvements, with the exception of better postoperative NDI scores in ACDF. In addition, ACDF is better than ACCF in terms of blood loss, lordotic curvature improvement and instrumentation and graft related-complication rates, with the exception of operation times. Content Type Journal ArticlePages 1-8DOI 10.1007/s00586-011-1961-9Authors Qiushui Lin, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003 ChinaXuhui Zhou, Department of Orthopedics, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003 ChinaXinwei Wang, Depa...

A comparative biomechanical study of traditional and in-line plating systems following immediate stabilization of single and bi-level cervical segments

Clinical Biomechanics — Mon, 08 Aug 2011 04:00:00 +0100

In this study, a cervical cadaver model is subjected to physiological loads and stabilized with in-line one-screw, and traditional two-screw per vertebral body plates.Methods: Three groups of eight fresh frozen human cadaver cervical spines (C2–C7) were tested by applying pure moments of 1.5Nm. Motion was obtained at C5–C6, and C4–C5/C5–C6 for single-level and bi-level experiments, respectively, in flexion–extension, lateral bending and axial rotation. Specimens were tested, 1) intact, 2) injured (anterior discectomy), 3) with interbody fusion spacer, 4) in-line one-screw plate+spacer, and 5) two-screw plate+spacer, using four available plate brands.Findings: Single-level plating with interbody spacer restricted range-of-motion with respect to the spacer-alone construct in flexio...

Extended lower trapezius myocutaneous flap in burn scar reconstruction of the face and neck of children

Pediatric Surgery International — Sat, 06 Aug 2011 05:47:01 +0100

Conclusions The extended lower trapezius myocutaneous flap is valuable in the management of burn reconstruction in the pediatric population. Content Type Journal ArticlePages 1-6DOI 10.1007/s00383-011-2948-7Authors Xing-Yue Zheng, Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, ChinaXin Guo, Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, ChinaTai-ling Wang, Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College, 33 Badachu Road, Shijingshan District, Beijing, ChinaJia-Qi Wang, Plastic Surgery Hospital of Chinese Academy of Medical Scie...

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Effect on clinical outcomes of patient pain expectancies and preoperative Mental Component Summary scores from the 36-Item Short Form Health Survey following anterior cervical discectomy and fusion.

Journal of Neurosurgery.Spine — Thu, 04 Aug 2011 23:00:00 +0100

Conclusions Patients who expected no pain postoperatively reported better scores on the nonstandardized outcome measure scales (VAS arm/neck, satisfaction with results), and higher SF-36 MCS scores. Higher preoperative MCS scores were related to better overall (standardized and nonstandardized) clinical outcomes (VAS neck, NDI, SF-36 PCS/MCS, and satisfaction with results). The results suggest that optimism in patients' expectations as well as mental well-being are related to improved clinical outcomes and higher patient satisfaction. PMID: 21819184 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

Assessment of adjacent-segment mobility after cervical disc replacement versus fusion: RCT with 1 year’s results. Nabhan A, Ishak B, Steudel WI, Ramadhan S, Steimer O. Eur Spine J 2011;20(6):934–41. Epub 2011 Jan 8

The Spine Journal — Mon, 01 Aug 2011 04:00:00 +0100

In conclusion, the adjacent segment could show a higher segmental motion, when compared with the segment either treated with prostheses or fusion. There was no significant difference in segmental motion adjacent to prosthesis or fusion. Clinical results did also show no significant difference in pain relief between both groups. (Source: The Spine Journal)

Biomechanical analysis of the anterior cervical fusion.

Computer Methods in Biomechanics and Biomedical Engineering — Sun, 31 Jul 2011 23:00:00 +0100

Authors: Fernandes PC, Fernandes PR, Folgado JO, Levy Melancia J This paper presents a biomechanical analysis of the cervical C5-C6 functional spine unit before and after the anterior cervical discectomy and fusion. The aim of this work is to study the influence of the medical procedure and its instrumentation on range of motion and stress distribution. First, a three-dimensional finite element model of the lower cervical spine is obtained from computed tomography images using a pipeline of image processing, geometric modelling and mesh generation software. Then, a finite element study of parameters' influence on motion and a stress analysis at physiological and different post-operative scenarios were made for the basic movements of the cervical spine. It was confirmed that the results...

Management of lateral cervical metastases in papillary thyroid cancer: Patterns of lymph node distribution.

Ear, Nose and Throat Journal — Sun, 31 Jul 2011 23:00:00 +0100

Authors: King JM, Corbitt C, Miller FR Abstract In this article we discuss the management of lateral cervical lymph node metastases in papillary thyroid cancer (PTC). We conducted a retrospective analysis of cases of PTC at our tertiary academic medical center involving 32 patients who underwent 39 neck dissections for the management of lateral cervical metastases from 2000 to 2007. Of these patients, 18 underwent primary neck dissections at the time of thyroidectomy after fine-needle aspiration biopsy confirmed the PTC. Secondary neck dissections for delayed metastases were performed in 14 patients who had previously undergone thyroidectomy for confirmed PTC. All 32 patients had positive nodes in at least one level. Our results highlight the high incidence of multilevel cervical m...

Adjacent-level degeneration after cervical disc arthroplasty versus fusion

European Spine Journal — Wed, 27 Jul 2011 15:47:36 +0100

Conclusions Preservation of motion in the CDA patients was not associated with a reduction of the incidence of symptomatic adjacent-segment disease and there may be other factors that influence ASD. Content Type Journal ArticlePages 1-5DOI 10.1007/s00586-011-1916-1Authors Carlos Valencia Maldonado, Department of Neurosurgery, Hospital Insular of Las Palmas, Plaza Doctor Pasteur, s/n., 35016 Las Palmas de Gran Canaria, SpainRicardo Díaz-Romero Paz, Department of Neurosurgery, Hospital Insular of Las Palmas, Plaza Doctor Pasteur, s/n., 35016 Las Palmas de Gran Canaria, SpainClaudia Balhen Martin, Department of Radiology of Clinica Lomas Altas, Grupo C.T. Scanner, Mexico city, Mexico Journal European Spine JournalOnline ISSN 1432-0932Print ISSN 0940-6719 (Source...

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An anterior approach to spinal pathology of the upper thoracic spine through a partial manubriotomy.

Journal of Neurosurgery.Spine — Thu, 21 Jul 2011 23:00:00 +0100

Authors: Lam FC, Groff MW Surgical pathology in the region of the upper thoracic spine (T1-4) is uncommon compared with other regions of the spine. Often times posterior and posterolateral approaches can be used, but formal anterior decompression often requires a low anterior cervical approach combined with a sternotomy, which yields significant perioperative morbidity. The authors describe a modified low anterior cervical dissection combined with a partial manubriotomy that they have used to successfully access and decompress anterior pathology of the upper thoracic spine. Their modified approach spares the sternoclavicular joints and leaves the sternum intact, decreasing the morbidity associated with these added procedures. PMID: 21780863 [PubMed - as supplied by publisher] (Sour...

The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy

European Spine Journal — Thu, 21 Jul 2011 18:15:39 +0100

Conclusions We found that intramedullary SI change is a poor prognostic factor and the intramedullary contrast (Gd-DTPA) enhancement on preoperative MRI should be viewed as the worst predictor of surgical outcomes in cervical myelopathy. Contrast (Gd-DTPA) enhancement and postoperative MRI are useful for identifying the prognosis of patients with poor neurological recovery. Content Type Journal ArticlePages 1-8DOI 10.1007/s00586-011-1878-3Authors Yong Eun Cho, Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, 146-92, Dogok-Dong, Kangnam-gu, Kangnam, PO Box 1217, Seoul, 135-720 KoreaJun Jae Shin, Department of Neurosurgery, Sanggye Paik Hospital, Inje University College of Medicine, ...

Failure of resorbable plates and screws in an ovine model of anterior cervical discectomy and fusion

The Spine Journal — Thu, 21 Jul 2011 04:00:00 +0100

Conclusions: Although the bioresorbable plates and screws did not elicit an iatrogenic tissue response, a high percentage of them failed mechanically. This phenomenon was difficult to observe radiographically, as the radiolucent markers were not able to convey these instrumentation failures. Additionally, there was only a 25% fusion rate. These findings suggest that resorbable implant materials with the current biomechanical and chemical properties are inadequate for cervical fusion. The results of this study strongly suggest that radiographic outcomes alone may not be adequate and that gross or histologic methods should accompany radiographs in studies of bioresorbable materials in animal models. (Source: The Spine Journal)

Pharyngolaryngoesophagectomy in a patient with an aberrant right subclavian artery: Report of a case

Surgery Today — Tue, 19 Jul 2011 23:19:47 +0100

We report a case of carcinoma of the hypopharynx and cervical esophagus in a patient with an aberrant right subclavian artery. Barium esophagograhy, endoscopy, and computed tomography showed a resectable tumor in the hypopharynx and cervical esophagus, coexistent with an aberrant right subclavian artery. We performed pharyngolaryngoesophagectomy with bilateral neck dissection and gastric pull-up through cervical, right thoracic, and abdominal incisions. We also partially resected the aberrant right subclavian artery with reimplantation in the right common carotid artery. To our knowledge, this is the first report of pharyngolaryngoesophagectomy with transposition of an aberrant right subclavian artery. Content Type Journal ArticlePages 1112-1116DOI 10.1007/s00595-010-4421-yAuthor...

Cervical arterial dissections due to segmental mediolytic arteriopathy

Neurology — Sun, 17 Jul 2011 23:00:00 +0100

(Source: Neurology)

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Sonographic Examination of the Neck after Definitive Radiotherapy for Node-Positive Oropharyngeal Cancer [HEAD & NECK]

American Journal of Neuroradiology — Wed, 13 Jul 2011 23:00:00 +0100

Axillary lymph node metastasis in papillary thyroid carcinoma: Report of a case and review of the literature

Journal of Cancer Research and Therapeutics — Mon, 11 Jul 2011 23:00:00 +0100

We report a case of axillary lymph node metastasis as a consequence of recurrent papillary thyroid carcinoma (PTC) in a 64-year-old lady. The patient initially presented in 2004 with a 10 × 10 cm size thyroid swelling of approximately 3-year duration and bilateral cervical lymphadenopathy. She underwent total thyroidectomy with bilateral neck dissection then. Pathological examination confirmed that the resected lesions were PTC and nodal metastases from thyroid. On follow-up over the next 6 years, she underwent excisions twice for cervical nodal recurrences. She presented to us in January 2010 with multiple right axillary adenopathy. Therapeutic right axillary dissection was done. Histopathologic examination revealed metastatic PTC with tall cell differentiation in 7 out of the...

Cervical intradural disc herniation and cerebrospinal fluid leak

Neurology India — Wed, 06 Jul 2011 23:00:00 +0100

We report a 45-year-old male who presented with sudden onset right lower limb weakness after lifting heavy weight. Magnetic resonance imaging of the cervical spine showed C5/6 disc prolapse with intradural extension. The patient underwent C5/6 discectomy through anterior cervical approach. Postoperatively, the patient improved in stiffness but developed cerebrospinal fluid leak and the leak resolved with multiple lumbar punctures. (Source: Neurology India)

Adjacent-level cervical ossification after bryan cervical disc arthroplasty compared with anterior cervical discectomy and fusion.

The Journal of Bone and Joint Surgery. American volume — Tue, 05 Jul 2011 23:00:00 +0100

Authors: Garrido BJ, Wilhite J, Nakano M, Crawford C, Baldus C, Riew KD, Sasso RC Ossification of the anterior longitudinal ligament and the anulus adjacent to an anterior cervical arthrodesis has been termed adjacent-level ossification development. Initial studies suggested an association with the placement of plates <5 mm from an adjacent disc space. A follow-up study demonstrated that this ossification rarely occurs in association with arthrodeses without plate fixation. In the present study, our goal was to determine the incidence of adjacent-level ossification in patients who underwent cervical arthrodesis with plate fixation as compared with that in patients who underwent cervical arthroplasty. PMID: 21776570 [PubMed - in process] (Source: The Journal of Bone and Joint...

Commentary on an article by Ben J. Garrido, MD, et al.: "Adjacent-Level Cervical Ossification After Bryan Cervical Disc Arthroplasty Compared with Anterior Cervical Discectomy and Fusion": Cervical Disc Replacement Shows Compelling Difference in Adjacent-Level Ossification Development.

The Journal of Bone and Joint Surgery. American volume — Tue, 05 Jul 2011 23:00:00 +0100

Commentary on an article by Ben J. Garrido, MD, et al.: "Adjacent-Level Cervical Ossification After Bryan Cervical Disc Arthroplasty Compared with Anterior Cervical Discectomy and Fusion": Cervical Disc Replacement Shows Compelling Difference in Adjacent-Level Ossification Development. J Bone Joint Surg Am. 2011 Jul 6;93(13):e761-1 Authors: Hart RA PMID: 21776561 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

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Late nodal metastasis of T2 oral cancer can be reduced by a combination of preoperative ultrasonographic examination and frozen section biopsy during supraomohyoid neck dissection.

Acta Oto-Laryngologica — Mon, 04 Jul 2011 23:00:00 +0100

Conclusion: The occult metastasis rate for T2 oral cancer can be reduced by ultrasonography (US). Also, the late metastasis rate is considered to be reduced by combining US with frozen section biopsy (FSB) during supraomohyoid neck dissection (SOHND). Objectives: Early oral cancer has been reported to show occult metastases in 15-53% of patients, but the criteria or methods for the diagnosis of cervical lymph node metastasis are unclear in many studies, and there is no clear definition of occult metastasis. In patients with T2 oral cancer, the diagnosis of lymph node metastasis by US and its pathological diagnosis (pN) after neck dissection were compared to evaluate the usefulness and limitations of US, occult metastasis rate, significance of SOHND as preventive neck dissection, and use of...

A case of cerebellar infarction presenting as thunderclap headache

Neurological Sciences — Fri, 01 Jul 2011 05:41:47 +0100

Abstract Thunderclap headache (TCH) refers to a sudden-onset, severe headache that features in subarachnoid hemorrhage, unruptured intracranial aneurysm, cerebral venous thrombosis, pituitary apoplexy, cervical artery dissection, and hypertensive reversible posterior leukoencephalopathy. TCH is a rare manifestation in cerebral or cerebellar infarctions. Herein, we report on a 60-year-old woman with a thunderclap headache as the first symptom of cerebellar infarction, in the absence of abnormal findings in the brain computed tomography (CT), CT angiography, and lumbar puncture. An urgent brain MRI showed an acute infarction of the right cerebellar hemisphere. The next day, the patient presented with right side ataxia. In emergency cases presenting with thunderclap headache,...

Central cervical lymph node metastases in papillary thyroid cancer: a systematic review of imaging‐guided and prophylactic removal of the central compartment

Clinical Endocrinology — Thu, 30 Jun 2011 23:00:00 +0100

Conclusion: Metastatic central lymph nodes are found in nearly half of all patients with PTC when prophylactic central lymph node dissection is performed. With unreliable imaging modalities, prophylactic central lymph node dissection should be performed on all patients with PTC. (Source: Clinical Endocrinology)

Polymethylmethacrylate-assisted Ventral Discectomy: Rate of Pseudarthrosis and Clinical Outcome with a Minimum Follow-up of 5 Years

BMC Musculoskeletal Disorders — Mon, 27 Jun 2011 23:00:00 +0100

Conclusions: PMMA assisted discectomy shows a high rate of pseudarthrosis. But the clinical long-term success does not seem to be negatively affected by this. (Source: BMC Musculoskeletal Disorders)

Transcervical videoscopic esophageal dissection during two-field minimally invasive esophagectomy: early patient experience

Surgical Endoscopy — Fri, 24 Jun 2011 05:43:12 +0100

Conclusions The TVED approach may avoid the morbidity of transthoracic esophageal dissection by improving esophageal visualization. Complications with TVED appear to correlate with obesity and comorbidities. Although TVED appears feasible, a larger experience is required. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1811-1Authors Michael Parker, Department of Surgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 322246, USASteven P. Bowers, Department of Surgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 322246, USARoss F. Goldberg, Department of Surgery, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL 322246, USAJason M. Pfluke, Department of Gen & Bariatric Surgery, Wilford Hall Med Ctr, 12906 N Hunters Cir, ...

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Prospective, randomized, multicenter study of cervical arthroplasty: 269 patients from the Kineflex|C artificial disc investigational device exemption study with a minimum 2-year follow-up.

Journal of Neurosurgery.Spine — Thu, 23 Jun 2011 23:00:00 +0100

Conclusions Cervical total disc replacement allows for neural decompression and clinical results comparable to ACDF. Kineflex|C was associated with a significantly greater overall success rate than fusion while maintaining motion at the index level. Furthermore, there were significantly fewer Kineflex|C patients showing severe adjacent-level radiographic changes at the 2-year follow-up. These results from a prospective, randomized study support that Kineflex|C CTDR is a viable alternative to ACDF in select patients with cervical radiculopathy. PMID: 21699471 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery.Spine)

A Patient With Internal Carotid Artery Dissection.

Physical Therapy — Wed, 22 Jun 2011 23:00:00 +0100

DISCUSSION:/b> In this case, the patient's sudden onset of signs of Horner syndrome was indicative of a medical emergency-internal carotid artery dissection. PMID: 21700762 [PubMed - as supplied by publisher] (Source: Physical Therapy)

Is Mediastinoscopy Still the Gold Standard to Evaluate Mediastinal Lymph Nodes in Patients with Non-Small Cell Lung Carcinoma?

The Thoracic and Cardiovascular Surgeon — Sun, 19 Jun 2011 23:00:00 +0100

CONCLUSION: Our data shows that due to its high sensitivity and accuracy, mediastinoscopy is still the most reliable method to evaluate mediastinal lymph nodes in patients with NSCLC. PMID: 21692019 [PubMed - as supplied by publisher] (Source: The Thoracic and Cardiovascular Surgeon)

Cruveilhier plexus: an anatomical study and a potential cause of failed treatments for occipital neuralgia and muscular and facet denervation procedures.

Journal of Neurosurgery — Thu, 16 Jun 2011 23:00:00 +0100

Conclusions Physical examinations that reveal unexpected results, such as altered sensory dermatome findings, may be attributed to the Cruveilhier plexus. Based on findings in the present study, surgical procedures, such as those aimed at completely denervating the upper posterior cervical musculature, facets, or nerves supplying the skin of the occiput, must also transect the Cruveilhier plexus. PMID: 21682566 [PubMed - as supplied by publisher] (Source: Journal of Neurosurgery)

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Pattern of cervical lymph node metastasis in tonsil cancer: Predictive factor analysis of contralateral and retropharyngeal lymph node metastasis

Oral Oncology — Thu, 16 Jun 2011 23:00:00 +0100

Summary: The purpose of this study was to determine the pattern of cervical lymph node metastasis in tonsil cancer including the retropharyngeal (RPLN) nodal metastasis. Seventy-six tonsillar squamous cell carcinoma patients who underwent surgery-based treatment were retrospectively analyzed. Most patients had advanced stage (stages III and IV: 81.6%) tonsil cancer. Sixteen patients were treated with surgery only. Postoperative radiotherapy was performed to 38 patients, and chemoradiation to 22 patients. Seventy-one therapeutic neck dissections and 27 elective neck dissections were performed. Thirty-four patients underwent RPLN dissection based on the preoperative inclusion criteria. There was a statistically significant metastasis in level I or V nodes, when the ipsilateral multilevel, or...

Clinical utility and prospective comparison of ultrasonography and computed tomography imaging in staging of neck metastases in head and neck squamous cell cancer in an Indian setup

International Journal of Clinical Oncology — Wed, 15 Jun 2011 05:46:10 +0100

Conclusions The accuracy and sensitivity of USG in detection of cervical lymph node metastases make it a potentially promising and cheap preoperative tool for staging neck node metastases and optimizing the treatment plan for surgeons, especially in countries such as India. Content Type Journal ArticlePages 1-8DOI 10.1007/s10147-011-0250-2Authors Mohammad Ashraf, Department of Surgical Oncolgy, Chittaranjan National Cancer Institute (CNCI), 37, S P Mukherjee Road, Kolkata, 26 IndiaJaydip Biswas, Department of Surgical Oncolgy, Chittaranjan National Cancer Institute (CNCI), 37, S P Mukherjee Road, Kolkata, 26 IndiaJayesh Jha, Department of Surgical Oncolgy, Chittaranjan National Cancer Institute (CNCI), 37, S P Mukherjee Road, Kolkata, 26 IndiaSandeep Nayak, Departme...

Esthesioneuroblastoma: Is There a Need for Elective Neck Treatment?

International Journal of Radiation Oncology * Biology * Physics — Wed, 15 Jun 2011 04:00:00 +0100

Conclusion: The high rate of regional failures when the neck is not electively treated justifies elective nodal RT in patients with both Kadish Stages B and C. In addition, our experience confirms the beneficial effect on local control of adjuvant RT to the tumor bed. (Source: International Journal of Radiation Oncology * Biology * Physics)

Cervical mullerian adenosarcoma with heterologous sarcomatous overgrowth: a fourth case and review of literature.

BMC Cancer — Fri, 10 Jun 2011 23:00:00 +0100

Conclusions: The rarity of MASO of the cervix involves a management difficult. Most authors recommend total abdominal hysterectomy, usually accompanied by bilateral salpingo-oophorectomy. There is no common agreement on staging by lymphadenectomy during primary surgery and adjuvant chemo-radio therapy. (Source: BMC Cancer)

Benign Salivary Gland Tissue Inclusion in a Pulmonary Hilar Lymph Node From a Patient With Invasive Well-Differentiated Adenocarcinoma of the Lung: A Potential Misinterpretation for the Staging of Carcinoma

International Journal of Surgical Pathology — Thu, 09 Jun 2011 23:00:00 +0100

Benign epithelial and nonepithelial inclusions have been found in lymph nodes in multiple body sites. These inclusions have been seen in cervical, axillary, mediastinal, abdominal, and pelvic lymph nodes. They appear as benign epithelial, parathyroid, decidual, mesothelial, angiolipomatous, nevus cells, or Tamm—Horsfall protein. Although heterotopic salivary gland tissue is not infrequent in paraparotid lymph nodes, it has only been described in lymph nodes of the pulmonary hilum once. A 68-year-old woman with gastric lymphoma now in remission presented for routine follow-up and was found to have a lung mass. After a fine needle aspiration biopsy diagnosis of adenocarcinoma, lobectomy and lymph node dissection were performed. Histological sections of lung demonstrated a well-differen...

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Coexistence of early microinvasive endometrioid adenocarcinoma and CIN3 in the uterine cervix in a 32-year-old Japanese woman

Diagnostic Pathology — Thu, 09 Jun 2011 23:00:00 +0100

In conclusion, the author reported a rare case of simultaneous EMEA and CIN 3 with extensive immunohistochemical findings. (Source: Diagnostic Pathology)

Etiologic investigation of ischemic stroke in young adults

Neurology — Sun, 05 Jun 2011 23:00:00 +0100

Conclusions: Our findings suggest that PFO-ASA may be a major cause of ischemic stroke in young adults. (Source: Neurology)

Primary mucosal malignant melanoma of the oral cavity

European Journal of Plastic Surgery — Sat, 04 Jun 2011 06:06:49 +0100

In this study, three mucosal malignant melanoma cases and the literature have been reviewed. Three cases who presented with a primary malignant melanoma of the oral cavity have been retrospectively analyzed. All three patients were female with a mean age of 31.3 years, and the median follow-up period was 18.6 (6–36) months. The tumor was located on the maxillary gingiva in case 1 and in the hard palate–maxillary gingiva in cases 2 and 3. Case 2 had a distant metastasis during first admission. The tumor was excised with a 2-cm surgical margin in all cases. Case 2 received adjuvant chemotherapy. During the follow-up period, case 1 had a cervical lymphadenopathy 8 months after the first operation, so she underwent cervical lymph node dissection then received chemotherapy. ...

Endovascular recanalization of symptomatic flow-limiting cervical carotid dissection in an isolated hemisphere.

Neurosurgical Focus — Tue, 31 May 2011 23:00:00 +0100

Conclusions The treatment of ICAD may be difficult in patients with subacute unstable neurological deficits related to symptomatic hypoperfusion, especially in the setting of a hemodynamically isolated hemisphere. Anticoagulation alone may be insufficient in these patients. Although there is no widely accepted guideline for the treatment of ICAD, the authors recommend stent-mediated endovascular recanalization in cases of symptomatic flow-limiting hemodynamic compromise, especially in cases of an isolated hemisphere lacking sufficient communicating artery compensatory perfusion. PMID: 21631217 [PubMed - in process] (Source: Neurosurgical Focus)

Ultrasound‐Guided Cervical Nerve Root Block: Spread of Solution and Clinical Effect

Pain Medicine — Tue, 31 May 2011 23:00:00 +0100

Conclusions. This study suggests that injected solution by ultrasound‐guided cervical nerve root block mainly spreads to the extraforaminal direction compared with conventional fluoroscopic technique. Therefore, present clinical study involves possibility of safer selective nerve root block with sufficient analgesic effects by ultrasound guidance, despite the absence of intraforaminal epidural spread of solution. (Source: Pain Medicine)

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One stage anterior-posterior approach for traumatic atlantoaxial instability combined with subaxial cervical spinal cord injury.

Chinese Journal of Traumatology — Tue, 31 May 2011 23:00:00 +0100

Conclusions: Traumatic atlantoaxial instability may combine with subaxial CSCI, misdiagnosis of which should be especially alerted and avoided. For severe cases, one stage anterior-posterior approach to decompress the upper and lower cervical spine, together with reposition, bone grafting and fusion, as well as internal fixation can immediately restore the normal alignments and stability of the cervical spine and effectively improve the spinal nervous function, thus being an ideal approach. PMID: 21635798 [PubMed - in process] (Source: Chinese Journal of Traumatology)

Sternocleidomastoid region restoration with lateral hemisoleus muscle incorporatied in free fibular flap for reconstruction of radical neck dissection and hemimandibulectomy

Microsurgery — Mon, 30 May 2011 23:00:00 +0100

AbstractIn the treatment of head and neck carcinoma, radical cervical lymphadenectomy leaves the affected side of the neck devoid of the sternocleidomastoid muscle, thus more vulnerable to the unwanted side effects of the adjuvant radiotherapy. It also causes asymmetry and cosmetically unpleasant appearance of the cervical region. In the reported case with widely ulcerated squamous‐cell carcinoma over mandible, hemimandibulectomy and radical neck dissection was performed. Following the mandibular reconstruction, the lateral hemisoleus muscle of the harvested osteomyocutaneous fibula flap was utilized to restore the ipsilateral sternocleidomastoid region. This new application promises to be a useful method, which can aid in the restoration of the aesthetic contour of the neck and provide ...

Long-term outcomes of internal carotid artery dissection

Journal of Vascular Surgery — Sun, 29 May 2011 23:00:00 +0100

Conclusions: Most cervical carotid dissections can safely be conservatively managed, with the majority achieving anatomic and symptomatic resolution, with low rates of recurrence over long-term follow-up. (Source: Journal of Vascular Surgery)

In Response to Dr. Lacout et al.

International Journal of Radiation Oncology * Biology * Physics — Fri, 27 May 2011 17:35:19 +0100

To the Editor: We thank Lacout et al. for their interest in our article . We analyzed 74 patients with locally advanced head-and-neck cancer who had evidence of at least one cervical lymph node metastasis with extracapsular extension (ECE) after neck dissection. Thirty patients had ECE-positive lymph nodes with a diameter of ≤7 mm. The presence of these small ECE-positive lymph nodes was associated with decreased regional relapse-free survival, metastasis-free survival, and overall survival in multivariate Cox regression analyses. As described in the article , preoperative neck staging was performed either by computed tomography (CT) or standard magnetic resonance imaging (MRI). (Source: International Journal of Radiation Oncology * Biology * Physics)

Confirmation of Horner's syndrome using apraclonidine eye drops

Postgraduate Medical Journal — Wed, 25 May 2011 23:00:00 +0100

Horner's syndrome describes a triad of pupillary miosis, partial eyelid ptosis and facial anhidrosis caused by disruption of the sympathetic pathway from the posterior hypothalamus to the eye. Diagnostic confirmation is crucial as causes can include life-threatening carotid dissection and apical lung tumours. Often the signs are subtle, with a difference of only 1-2 mm between affected and unaffected pupils and a similarly mild degree of ptosis. Anhidrosis is rarely obvious and generally present only in preganglionic lesions, as the sudomotor fibres diverge from the main pathway just after the superior cervical ganglion. Historically pharmacological confirmation used 4% topical cocaine to inhibit norepinephrine re-uptake, dilating only the normal pupil. In modern practice, this is now diff...

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First-bite syndrome in oncologic patients

European Archives of Oto-Rhino-Laryngology — Wed, 25 May 2011 16:01:49 +0100

In this study, we discuss why FBS is misdiagnosed in oncologic patients, the possible pathophysiological mechanisms of radiotherapy and its plausibility as a new modality of treatment in selected cases. Content Type Journal ArticlePages 1-4DOI 10.1007/s00405-011-1645-4Authors Tiago Porfírio Costa, Department of Otorhinolaryngology II, Pulido Valente Hospital, North Lisbon Hospital Center, Alameda das Linhas de Torres, 117, 1769-001 Lisbon, PortugalCarlos Eugenio Nabuco de Araujo, Department of Otorhinolaryngology II, Pulido Valente Hospital, North Lisbon Hospital Center, Alameda das Linhas de Torres, 117, 1769-001 Lisbon, PortugalJoana Filipe, Department of Otorhinolaryngology II, Pulido Valente Hospital, North Lisbon Hospital Center, Alameda das Linhas de Torres, 117, 1769-001 Li...

Development of a new trans-oral endoscopic approach for mediastinal surgery based on 'natural orifice surgery': preclinical studies on surgical technique, feasibility, and safety [Original articles]

European Journal of Cardio-Thoracic Surgery — Mon, 23 May 2011 23:00:00 +0100

Conclusion: These preclinical studies showed that the mediastinum could be reached by a trans-oral endoscopic approach, based on natural orifice surgery. Complete compartment resection of the paratracheal and subcarinal lymph node stations was possible in a well-defined and clearly visible working space. This approach may enhance the extent of mediastinal resections in oncologic surgery. (Source: European Journal of Cardio-Thoracic Surgery)

Papillary thyroid carcinoma does not have standard course in children

Pediatric Surgery International — Mon, 23 May 2011 17:04:55 +0100

Conclusion Total thyroidectomy and excision of affected lymph nodes is the current mode of surgical management for thyroid papillary carcinoma in children. However, especially in young children (<10 years), modified lymph node dissection should be added to total thyroidectomy in order to avoid leaving the residual tumor foci which can impair the efficacy of the ablation therapy. Content Type Journal ArticlePages 1-6DOI 10.1007/s00383-011-2932-2Authors İbrahim Karnak, Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, TurkeyBurak Ardıçlı, Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, TurkeySaniye Ekinci, Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara...

Clinical impact of cervical lymph node involvement and central neck dissection in patients with papillary thyroid carcinoma: a retrospective analysis of 368 cases

European Archives of Oto-Rhino-Laryngology — Mon, 23 May 2011 17:04:44 +0100

In conclusion, cervical lymph node metastatic involvement at the time of initial surgery is an independent risk factor of tumor recurrence. CND provided an up-staging of more than 30% of patients with a clinically N0 neck, but was associated with significant morbidity regarding parathyroid function. Content Type Journal ArticlePages 1-8DOI 10.1007/s00405-011-1639-2Authors Alexandre Bozec, Département de Chirurgie, Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06189 Nice, FranceOlivier Dassonville, Département de Chirurgie, Institut Universitaire de la Face et du Cou, Centre Antoine Lacassagne, 33 avenue de Valombrose, 06189 Nice, FranceEmmanuel Chamorey, Département de Statistiques Médicales, Centre Antoine Lacassagne, 33 aven...