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Derrick T Lin - One of the best experts on this subject based on the ideXlab platform.
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update on surgical outcomes of lateral temporal Bone Resection for ear and temporal Bone malignancies
Skull Base Surgery, 2016Co-Authors: S K Sinha, Matthew M Dedmon, Matthew R Naunheim, Jennifer C Fuller, Stacey T Gray, Derrick T LinAbstract:Objectives Review outcomes of lateral temporal Bone Resections for ear and temporal Bone malignancy. Design, Setting, and Participants Retrospective review of all lateral temporal Bone Resections performed from 2008 to 2015 at a single tertiary care center. Main Outcome Measures Patient demographics, perioperative variables, overall survival, disease-free survival (DFS), and comparison of Kaplan–Meier curves. Results Overall, 56 patients were identified with a mean follow-up period of 2.3 ± 1.8 years. The predominant histopathologic diagnosis was squamous cell carcinoma (SCC, 54%), followed by salivary gland tumors (18%), and basal cell carcinoma (9%). Tumor stages were T1-T2 in 23%, T3-T4 in 73%, and two unknown primary lesions. Mean overall survival was 4.6 ± 0.4 years. Comparison of tumors with and without lymph node involvement or perineural invasion approached statistical significance for overall survival ( p = 0.07 and 0.06, respectively). DFS was 2.5 ± 0.3 years. Stratification by lymph node status had a statistically significant difference in DFS ( p = 0.03). Subgroup analysis of SCC patients did not reveal significant differences. Conclusions Based on our cohort, most patients with temporal Bone malignancies present with advanced disease, making it difficult to achieve negative margins. Overall, lymph node status was the strongest predictor of survival in this group.
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the occipital flap for reconstruction after lateral temporal Bone Resection
Archives of Otolaryngology-head & Neck Surgery, 2008Co-Authors: Michael G Moore, Michael J. Mckenna, Derrick T Lin, Anthony A Mikulec, Mark A VarvaresAbstract:Objective To investigate the use of the occipital rotational flap as an alternative reconstructive technique following lateral temporal Bone Resection. Methods A retrospective medical record review of 10 patients who underwent reconstruction with an occipital rotational flap after auriculectomy or lateral temporal Bone Resection. Patient and operative variables included age, preoperative ASA (American Society of Anesthesiologists) classification, operative time, total length of hospital stay, and use of preoperative and postoperative radiotherapy. Patient demographic characteristics and medical comorbidities were also recorded. Clinical outcomes included medical complications, minor and major wound complications, and donor site complications. Results Patients' mean age was 73.9 years, and mean ASA classification was 2.8. The mean operative time was 8.1 hours, and the mean length of hospital stay was 5.3 days. Three patients received preoperative radiotherapy, and 7 received postoperative radiotherapy. Two patients developed postoperative medical complications, 2 developed minor wound breakdown, and 1 developed a donor site complication. Conclusion The occipital flap method is reliable and should be considered as an option for reconstruction after lateral temporal Bone Resection in select patients.
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management outcomes following lateral temporal Bone Resection for ear and temporal Bone malignancies
Otolaryngology-Head and Neck Surgery, 2007Co-Authors: Michael G Moore, Michael J. Mckenna, Daniel G Deschler, Mark A Varvares, Derrick T LinAbstract:ObjectiveTo evaluate clinical outcomes following lateral temporal Bone Resection (LTBR) for management of malignancies involving the ear or temporal Bone.Subjects and MethodsA retrospective medical...
Christoph Pautke - One of the best experts on this subject based on the ideXlab platform.
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successful surgical management of osteonecrosis of the jaw due to rank ligand inhibitor treatment using fluorescence guided Bone Resection
Journal of Cranio-maxillofacial Surgery, 2013Co-Authors: Sven Otto, Sebastian Baumann, Michael Ehrenfeld, Christoph PautkeAbstract:Osteonecrosis of the jaw has recently been described in patients receiving subcutaneous administration of RANKL-inhibitors (denosumab). However, due to promising study results, more patients will receive denosumab in order to avoid skeletal complications due to metastatic Bone disease and osteoporosis. Therefore, this has the potential to become a comparable challenge to the bisphosphonate induced jaw necrosis in the area of Oral and Maxillofacial Surgery. Indeed, so far no convincing surgical technique has been described to overcome the non-healing mucosal lesions with exposed Bone due to RANKL-inhibitor therapy. In this technical note, we report two successful cases of surgical treatment of jaw-Bone necrosis under RANKL-inhibitor treatment using fluorescence guided Bone Resection. In conclusion, the technique is suggested as treatment option for this entity of osteonecrosis of the jaw. 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
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fluorescence guided Bone Resection in bisphosphonate related osteonecrosis of the jaws first clinical results of a prospective pilot study
Journal of Oral and Maxillofacial Surgery, 2011Co-Authors: Christoph Pautke, Florian Bauer, Sven Otto, Thomas Tischer, Timm Steiner, Jochen Weitz, Kilian Kreutzer, Bettina Hohlwegmajert, Klausdietrich Wolff, Sigurd HafnerAbstract:Purpose Surgical debridement is the therapy of choice in advanced stages of bisphosphonate-related osteonecrosis of the jaws (BRONJ). However, the therapy is currently only loosely standardized because no suitable imaging modalities exist. This study aims to redress this by exploring the suitability and reproducibility of applying a fluorescence-guided Bone Resection to patients with BRONJ. Patients and Methods This prospective pilot study comprised 15 patients with 20 BRONJ lesions (only stages II and III) with a history of intravenous bisphosphonate treatment for metastatic Bone diseases. Before surgical treatment, each patient received a 10-day administration of doxycycline. Fluorescence-guided Resection of necrotic Bone was performed by means of a certified fluorescence lamp. Success of the procedure was proclaimed if mucosal closure was observed and symptoms were absent 4 weeks postoperatively. Results The 4-week postoperative follow-up identified a mucosal closure in 17 of 20 BRONJ lesions (85%). These patients were free of any symptoms. Failure as defined by mucosal dehiscence and exposed Bone was observed in 3 of 20 BRONJ lesions (15%). Conclusion The success rate of this surgical regimen of BRONJ was respectable, and thus fluorescence-guided Bone Resection can be considered an effective treatment for stage II and stage III BRONJ. Furthermore, the reproducibility of the technique offers an opportunity to standardize the surgical therapy. Further studies are called for that compare the fluorescence-guided Bone Resection with conventional surgical approaches, as well as surgical versus conservative treatment in the early stages (stages 0 and I) of BRONJ.
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fluorescence guided Bone Resection in bisphosphonate associated osteonecrosis of the jaws
Journal of Oral and Maxillofacial Surgery, 2009Co-Authors: Christoph Pautke, Florian Bauer, Thomas Tischer, Jochen Weitz, Kilian Kreutzer, Marco R Kesting, Frank Holzle, Andreas Kolk, Stephen R Sturzenbaum, Klausdietrich WolffAbstract:Purpose To date, the therapy of bisphosphonate-associated osteonecrosis of the jaws (BONJ) has been hampered by the lack of imaging modalities that enable the extent of necrosis to be visualized. This study aims to demonstrate the feasibility of tetracycline fluorescence guided Bone Resection in the surgical management of BONJ. Patients and Methods Following a 10-day preoperative administration of doxycycline in patients suffering from BONJ, sufficient doxycycline is incorporated into viable Bone to be visualized with a certified medical lamp emitting exciting light at 400 to 460 nm. Results Viable and necrotic Bone can be discriminated intraoperatively in a routine and reproducible manner by doxycycline Bone fluorescence. Conclusion In the therapy of BONJ, conservative concepts are to be favored. The fact that necrotic Bone can now be selectively resected signifies an improvement of the conservative surgical therapy of BONJ.
Garjae Lavien - One of the best experts on this subject based on the ideXlab platform.
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pubic Bone Resection provides objective pain control in the prostate cancer survivor with pubic Bone osteomyelitis with an associated urinary tract to pubic symphysis fistula
Urology, 2017Co-Authors: Garjae Lavien, Godefroy Chery, Uwais B Zaid, Andrew C PetersonAbstract:Objective To investigate pain intensity perception in prostate cancer survivors with pubic Bone osteomyelitis with an associated urinary tract to pubic symphysis fistula before and after definitive surgical management. Materials and Methods We performed a review of an institutional review board-approved database of prostate cancer survivors with pubic Bone osteomyelitis from 2010 to 2015. Demographic and clinical data were extracted. Pain scores were assessed in patients at varying points before and after definitive treatment using an 11-point numeric rating scale. Statistical analysis was performed using a Wilcoxon signed-rank test and NcNemar's test. Results We identified 16 patients with a median age of 72 who met inclusion criteria. Chronic narcotic use for pain management was noted in 6 of 16 (37.5%) patients preoperatively. No statistical difference was identified between the pain score at the time of diagnosis and after completion of conservative measures (5.5 vs 5.5, P = .76). A statistically significant decrease in median pain score at the first follow-up appointment was seen compared to the preoperative pain score (0 vs. 5.5, P = .0005). At a median follow-up of 9.4 months (interquartile range 3.7-16.5), a sustained decrease in the median pain intensity score was noted in our cohort compared to their preoperative baseline pain score (5.5 vs 0, P = .0005) and pain score at the time of diagnosis (5.5 vs 0, P = .004.) Conclusion Pubic Bone Resection provides immediate and sustained improvement in pain intensity perception in the prostate cancer survivor with pubic Bone osteomyelitis with an associated urinary tract to pubic symphysis fistula.
Michael G Moore - One of the best experts on this subject based on the ideXlab platform.
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the occipital flap for reconstruction after lateral temporal Bone Resection
Archives of Otolaryngology-head & Neck Surgery, 2008Co-Authors: Michael G Moore, Michael J. Mckenna, Derrick T Lin, Anthony A Mikulec, Mark A VarvaresAbstract:Objective To investigate the use of the occipital rotational flap as an alternative reconstructive technique following lateral temporal Bone Resection. Methods A retrospective medical record review of 10 patients who underwent reconstruction with an occipital rotational flap after auriculectomy or lateral temporal Bone Resection. Patient and operative variables included age, preoperative ASA (American Society of Anesthesiologists) classification, operative time, total length of hospital stay, and use of preoperative and postoperative radiotherapy. Patient demographic characteristics and medical comorbidities were also recorded. Clinical outcomes included medical complications, minor and major wound complications, and donor site complications. Results Patients' mean age was 73.9 years, and mean ASA classification was 2.8. The mean operative time was 8.1 hours, and the mean length of hospital stay was 5.3 days. Three patients received preoperative radiotherapy, and 7 received postoperative radiotherapy. Two patients developed postoperative medical complications, 2 developed minor wound breakdown, and 1 developed a donor site complication. Conclusion The occipital flap method is reliable and should be considered as an option for reconstruction after lateral temporal Bone Resection in select patients.
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management outcomes following lateral temporal Bone Resection for ear and temporal Bone malignancies
Otolaryngology-Head and Neck Surgery, 2007Co-Authors: Michael G Moore, Michael J. Mckenna, Daniel G Deschler, Mark A Varvares, Derrick T LinAbstract:ObjectiveTo evaluate clinical outcomes following lateral temporal Bone Resection (LTBR) for management of malignancies involving the ear or temporal Bone.Subjects and MethodsA retrospective medical...
Mark A Varvares - One of the best experts on this subject based on the ideXlab platform.
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the occipital flap for reconstruction after lateral temporal Bone Resection
Archives of Otolaryngology-head & Neck Surgery, 2008Co-Authors: Michael G Moore, Michael J. Mckenna, Derrick T Lin, Anthony A Mikulec, Mark A VarvaresAbstract:Objective To investigate the use of the occipital rotational flap as an alternative reconstructive technique following lateral temporal Bone Resection. Methods A retrospective medical record review of 10 patients who underwent reconstruction with an occipital rotational flap after auriculectomy or lateral temporal Bone Resection. Patient and operative variables included age, preoperative ASA (American Society of Anesthesiologists) classification, operative time, total length of hospital stay, and use of preoperative and postoperative radiotherapy. Patient demographic characteristics and medical comorbidities were also recorded. Clinical outcomes included medical complications, minor and major wound complications, and donor site complications. Results Patients' mean age was 73.9 years, and mean ASA classification was 2.8. The mean operative time was 8.1 hours, and the mean length of hospital stay was 5.3 days. Three patients received preoperative radiotherapy, and 7 received postoperative radiotherapy. Two patients developed postoperative medical complications, 2 developed minor wound breakdown, and 1 developed a donor site complication. Conclusion The occipital flap method is reliable and should be considered as an option for reconstruction after lateral temporal Bone Resection in select patients.
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management outcomes following lateral temporal Bone Resection for ear and temporal Bone malignancies
Otolaryngology-Head and Neck Surgery, 2007Co-Authors: Michael G Moore, Michael J. Mckenna, Daniel G Deschler, Mark A Varvares, Derrick T LinAbstract:ObjectiveTo evaluate clinical outcomes following lateral temporal Bone Resection (LTBR) for management of malignancies involving the ear or temporal Bone.Subjects and MethodsA retrospective medical...