The full British Thoracic Society Guideline for Bronchiectasis in Adults is published in Thorax. The following is a summary of the recommendations and good practice points. The sections referred to in the summary refer to the full guideline. The appendices are available in the full guideline.
SAO is an effective operation and, in trained hands, an appropriate first-line procedure for treating intractable epistaxis. Use of diathermy significantly improves the short- and long-term outcome of this surgery.
The increased number and specific phenotypical changes of sensory nerves may play a role in nasal hypersensitivity and provide new targets for the treatment of rhinitis.
Background The association between spontaneous cerebrospinal fluid CSF leak/rhinorrhea and idiopathic intracranial hypertension IIH has been increasingly recognized over the last years However considerable variability of opinion regarding the assessment investigations and management of patients with spontaneous CSF rhinorrhea remains Methods A consensus group was formed from experts from Europe Asia Australia South and North America Following literature review and open discussions with members of the panel a set of statements was produced A modified Delphi method was used to refine expert opinion with rounds of questionnaires and a consensus group meeting in Santo-Rhino meeting in September Results Fi y statements of total on spontaneous CSF leak and IIH reached consensus In of statements the median response was strongly agree and in the remaining statements the median response was agree Eleven statements were excluded because they did not reach consensus and one new statement was added during SantoRhino meeting The final statements refer to patient history and clinical examination "History taking should include presence of headache tinnitus and visual defects" investigations role of Thin Slice Computed Tomography and CISS/FLAIR sequences in Magnetic Resonance Imaging principles of management watchful waiting or measures to reduce ICP are supplementary but cannot subsitute surgical closure surgical technique intraoperative early postoperative and long term management Conclusion We present fi y consensus statements on the diagnosis investigation and management of spontaneous CSF rhinorrhea based on the currently available evidence and expert opinion Although by no means comprehensive and final we believe they can contribute to the standardization of clinical practice Early diagnosis prompt surgical closure of the defect assesment for and treatment of potentially co-existing idiopathic intracranial hypertension in a comprehensive multidisciplinary approach are essential in order to successfully manage spontaneous CSF rhinorrhea reduce associated morbidity and prevent recurrence
No staging system for cholesteatoma has been universally adopted. All previous attempts failed to gain acceptance because of the lack of clinical relevance. We have devised a simple system to stage cholesteatoma which is based on the extent of lesion, ossicular condition and the preoperative complications. To illustrate the systems potential value, data from 119 new patients with cholesteatoma are presented and classified according to our proposed scheme. This shows a relationship between the stage of disease, ossicular damage and the occurrence of complications. The proposed staging system is potentially useful when considering the type of surgery required and when comparing published data reporting the results of tympanomastoid surgery.
A significant correlation was found between the degree of objective facial asymmetry, particularly in anthropometric nasal measurements, and the subjective perception of a face as asymmetrical in patients requesting aesthetic rhinoplasty. This relationship may be a factor in patients who request rhinoplasty and should be explored in this patient group.
The polydioxanone plate is a safe and reliable absorbable implant that has many different applications in rhinoplasty and septal surgery. It not only acts as a scaffold but also stimulates and guides cartilage regeneration.
AIMTo review and report functional outcomes, complications, and survivorship associated with total knee arthroplasty (TKA) in the treatment of post-traumatic arthritis (PTA).METHODSWe conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for English-language clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles. We extracted data on patients’ demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.RESULTSSixteen studies, four prospective and ten retrospective, examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion (ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.CONCLUSIONAlthough associated with higher complication rates, TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.
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