The Experts below are selected from a list of 111 Experts worldwide ranked by ideXlab platform
Seema A. Khan - One of the best experts on this subject based on the ideXlab platform.
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A comparison of ductoscopy-guided and conventional surgical excision in women with spontaneous nipple discharge.
Annals of surgery, 2005Co-Authors: Robyn M. Moncrief, Ritu Nayar, Leslie K. Diaz, Valerie L. Staradub, Monica Morrow, Seema A. KhanAbstract:Nipple discharge is responsible for approximately 5% of surgical referrals annually.1 Not all forms of spontaneous nipple discharge (SND) are associated with significant pathologic findings. The clinical features of SND that are associated with a high likelihood of intraductal neoplasia include unilaterality, persistence, emanation from a single duct, and watery, serous, or bloody appearance.2,3 Discharges with these characteristics are classified as pathologic and have traditionally been considered an indication for surgical excision of the involved duct. However, among women with SND who are evaluated surgically, 2% to 25% are diagnosed with either invasive or noninvasive cancer.2–5 When mammography shows significant findings in women with SND, the likelihood of malignancy increases,2 but mammographic imaging is often unhelpful. Galactography has been used to evaluate women with SND with variable success.6,7 When SND is caused by peripheral intraductal lesions, galactography provides localizing information and can also assess the likelihood of malignancy,4 although definitive diagnosis requires central or terminal duct excision (TDE). Duct excision is also therapeutic unless malignancy is discovered. Conventionally, this procedure has been performed blindly, guided by a Lacrimal Probe or blue dye instillation into the duct or by preoperative ductography and wire localization if the lesion is located more than 2 to 3 cm from the ductal orifice.2,8 Mammary endoscopy (ductoscopy) is a recently introduced technique, which may allow more precise identification and delineation of intraductal disease but is not currently a standard practice among most surgeons. Ductoscopy has been reported to result in improved localization of intraductal lesions9–11 and may avoid surgery in women with endoscopically normal ducts. However, ductoscopy adds to time and expense in the operating room, and the yield of significant pathologic lesions reported in separate series of women who are managed with and without ductoscopy at different institutions is reported to be in the range of 90%.2,9 There has not been a direct comparison of the results achieved with these 2 different approaches in terms of lesion yield or amount of tissue excised. We undertook a comparison of findings in women with SND who were managed with and without ductoscopy at the Lynn Sage Breast Program to assess the value of adding ductoscopy to the management of these patients.
Rachel Williams - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic-guided trephination dacryocystorhinostomy (Hesham DCR): technique and pilot trial.
Ophthalmology, 2001Co-Authors: Hesham A. Ibrahim, Joan Laura Noble, Mark Batterbury, Christopher Paul Johnson, Rachel WilliamsAbstract:Abstract Objectives (1) Test the feasibility and the safety of guided transnasal trephination in creating a nasoLacrimal fistula. (2) Develop an appropriate Lacrimal maintainer and test its value in modulating healing at the fistula site. Design Prospective, noncomparative interventional case series. Participants Five cadavers and 19 patients. Method A transcanalicular Lacrimal Probe penetrated the Lacrimal fossa to guide the passage of a flexible trephine up the nose, which created the nasoLacrimal communication. A special wide-caliber Lacrimal maintainer was inserted along Lacrimal tubes within the created passage. Outcome measures For cadaveric study, direct inspection after dissection of the facial flap was performed. For the clinical trial, subjective improvement in watery eye, dye testing, Lacrimal probing, Lacrimal irrigation, and endoscopic nasal examination. Results The technique resulted in the creation of a regular fistula of reproducible diameter into which a standard-shaped wide caliber maintainer could be inserted. Three months after removal of the maintainer and 6 months after surgery, a patent ostium was achieved in 17 of 18 (94%) patients who had a completed procedure. Relief of symptoms was achieved in 83%. Conclusions Guided endoscopic dacryocystorhinostomy provides a simple and safe option for the treatment of nasoLacrimal duct obstruction. The Lacrimal maintainer is a useful device to achieve a large patent nasoLacrimal communication.
J. Jose - One of the best experts on this subject based on the ideXlab platform.
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Management of an infected preauricular sinus, using a Lacrimal Probe.
The Journal of laryngology and otology, 2003Co-Authors: A. P. Coatesworth, H. Patmore, J. JoseAbstract:This paper describes a technique for managing a preauricular abscess that allows drainage of the pus, with little or no disturbance to the underlying sinus, making any subsequent surgery more straight forward.
Burton J. Kushner - One of the best experts on this subject based on the ideXlab platform.
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Solutions Can Be Hazardous for Lacrimal System Irrigation
Archives of Ophthalmology, 1993Co-Authors: Burton J. KushnerAbstract:It is generally recommended that at the conclusion of a nasoLacrimal duct probing procedure in infants, the efficacy of the operation be assessed by confirming the presence of the Lacrimal Probe in the nose by introducing a second Probe through the nares. Direct metal-on-metal contact provides confirmation that the first Probe successfully entered the nasal cavity.1This maneuver is usually followed by the irrigation of a colored solution, most commonly fluorescein, through the Lacrimal system, which is subsequently aspirated from the nose. If the probing procedure was unsuccessful in relieving the obstruction, or if a false passage was made, attempt at irrigation may result in the irrigating solution infiltrating the periorbital tissue. Serious problems may subsequently result if the solution used for irrigation is one that cannot be safely tolerated either subcutaneously or intramuscularly. Report of a Case. I examined a 2-year-old girl because she was noted to have
Michael Solomonov - One of the best experts on this subject based on the ideXlab platform.
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Cone-beam Computed Tomography as a Noninvasive Assistance Tool for Oral Cutaneous Sinus Tract Diagnosis: A Case Series.
Journal of endodontics, 2019Co-Authors: Avi Shemesh, Avi Hadad, Hadas Azizi, Alex Lvovsky, Joe Ben Itzhak, Michael SolomonovAbstract:Abstract An oral cutaneous sinus tract is a relatively uncommon condition that is generally associated with long-standing periapical inflammation. The traditional process of oral cutaneous sinus tract diagnosis is an invasive method based on the insertion of a Lacrimal Probe or wire. The present article describes the use of cone-beam computed tomographic imaging as a noninvasive assistant tool for the verification of the odontogenic origin.
