Background The endoscopic-assisted technique has been utilized with various intracranial lesions with many approaches. In the cerebellopontine angle (CPA), the technique has been used to combine the benefits of the operating microscope and the endoscope. In this study, we highlight the use of the endoscopic-assisted technique in resection of CPA epidermoid tumors to ensure a total resection, decrease complications and protect the neurovascular tangles. Results In the endoscopic-assisted group, only 18.8% of the patients had post-operative residual in the post-operative MRI. However, in the microscopic only group 56.3% of the patients had post-operative residual. Consequently, there is a statistically significant difference regarding the post-operative residual between the two groups. Conclusions The endoscopic-assisted approach is superior to the microscopic only approach in the excision of CPA epidermoids and minimizing the post-operative residual and the recurrence.
Background Rhinoplasty is considered one of the most challenging operations in the plastic surgery. Esthetic or functional reshaping purposes of the nose can be stressing for both surgeon and patient. Different types of graft materials have been used to perform augmentation rhinoplasty. Free diced cartilage (FDC) was recently established in dorsal nasal rhinoplasty for better handling of irregularities as well as contour deficits of dorsal nasal outcomes. The main purpose of the present study is to assess the effectiveness of the use of FDC in dorsal nasal and nasal tip rhinoplasty and evaluation of its advantages and disadvantages using the validated Nasal Obstruction Symptom Evaluation (NOSE) scale and the Rhinoplasty Outcome Evaluation (ROE) questionnaire to assess nasal obstruction and patient satisfaction. Results This prospective study was conducted between March 2018 and December 2019, 20 patients were included and planned for rhinoplasty using FDC to camouflage dorsal and nasal tip deformities. All patients (11males and 9 females) underwent open rhinoplasty through inverted v columellar incision, taken FDC from nasal septum. A statistical significant difference between pre- and post-operative NOSE scores was found (P < 0.001). Post-operative rhinoplasty outcome evaluation scores ranged from 45 to 100 with mean ± SD (83.15 ± 13.22). Excellent satisfaction was the most noted in 17 patients (85%), while 2 patients (10%) reported good satisfaction and 1 patient (5%) with acceptable satisfaction. Conclusion It was found that the FDC technique is an effective method for camouflage and augmentation of nasal dorsum as well as nasal tip in reconstructive and esthetic rhinosurgery for either primary or secondary rhinoplasty.
There are major efforts carried out by governmental institutions to improve the sustainability of construction projects. One of the most important problems and challenges facing project's sustainability is deterioration of urban and short life time of building. The aim of this study is to identify the main factors affecting the sustainable projects in order to develop a program to evaluate the sustainability and increase the efficiency of construction by re-evaluating the most affecting factors in the sustainability of the projects and identify the obstacles facing implementation of sustainable buildings. To achieve the research objectives, a questionnaire was designed to gather information from engineers of different specializations in construction sectors. The questionnaire includes eighty nine factors which are the most important factors affecting the sustainability of construction projects through the five stages of the project. Two hundred questionnaire were distributed and only one hundred and nine responded .The data were analysed by using one of a statistical programs SPSS. The analysed results shows that the selecting sustainability material, developing appropriate rates for all project resources carefully, planning maintenance for construction work and following work that was carried out according to the requirements and specifications of contract. These are the most critical factors which help in sustaining construction, whether before or during construction, and making routine and corrective maintenance of the most prominent factors that help to maintain the service life of building and sustaining it after its establishment. A Program was developed to evaluate the sustainability of construction either before or after construction, in order to increase the efficiency of a sustainable project and maintaining its life span. The output of the program was represented as a degree of sustainability by evaluation during a certain stage or all the stages of a project and reevaluating the most important elements affecting on sustainability of project, reaching its highest level of sustainability. It is concluded from the program of evaluating sustainability that the degrees of sustainability may varies from one building to another according to the importance, the volume of construction, the period in which the evaluation is done and the faced challenges. The construction sector in Egypt needs to disseminate the concepts and Principles of sustainability more broadly as it is not applied enough in Egypt.
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