Notes

Activities involving earlier flights along with pneumothorax soon after anterior backbone surgical treatment.
The erosive challenge (groups 1 and 3) was carried out in 0.01M hydrochloric acid, 150 mL/cycle, at room temperature (2-minute immersions 4 times a day for 5 days). After all specimens were immersed in coffee for 14 days, new color measurements were performed. For total color change (∆E*), groups 1 (21.01) and 2 (23.10) presented lower values than groups 3 (27.76) and 4 (26.57). For luminosity (∆L*), the opposite occurred (groups 1, -16.84; 2, -17.72; 3, -22.62; and 4, -21.22). For ∆a* and ∆b*, the only statistically significant difference was the group 1 ∆b* value, which was the lowest among all groups. The opacity remained stable in all groups. The results suggest that resin luminosity decreases and color variation increases when surface sealant is applied after erosive cycling and storage.The oral mucosa has superior wound healing potential compared to other mucosal tissues. The objective of this article is to review the current state of evidence on the mechanisms that govern accelerated oral mucosal wound healing and explore clinical approaches that facilitate the natural course of these processes.Panoramic radiography is a useful screening tool for an array of dental and nonodontogenic disorders related to calcification as well as assessment of trauma and development of the oral and maxillofacial complex. Rotational movements of the radiographic source and detector plate may promote ghost image formation, particularly with larger radiopaque objects, and complicate the radiographic interpretation. This article describes cases of a giant submandibular gland sialolith and a giant tonsillolith, each of which appeared as a bilateral presentation due to contralateral ghost images, and discusses their clinical, demographic, and radiographic characteristics. Computed tomographic examinations were used to confirm the unilateral presentation of these objects and for determination of the extent of adjacent soft tissue impingement. Distinguishing an actual panoramic image from a ghost artifact may avoid unnecessary surgical intervention and improve clinical outcomes.Implant-supported overdentures are becoming a common treatment modality, providing functional and esthetic results for patients in need of full-mouth rehabilitation. Because anatomical variations in the residual ridge affect treatment planning, the aim of this retrospective study was to present quantitative descriptions of the interforaminal region by evaluating a large series of cone beam computed tomographic (CBCT) images of the mandibles of edentulous patients in need of anterior dental implants. The sample included a total of 180 CBCT scans (360 sites) of patients requiring endosseous implant placement in the anterior region of the mandible for implant-assisted overdentures. The CBCT images were evaluated for parameters such as ridge height, width, angulation, and undercuts; crestal height; and corticocancellous bone ratios. The statistical analyses included the independent-samples t test and chi-square analysis. The mean (SD) ridge height was 18.16 (0.36) mm on the right side and 17.79 (0.38) mm on the lvely, but the differentiation between the right and left sides was clinically insignificant. BAY-293 mouse Knowledge of the patient's anatomical variations will allow the clinician to formulate an individualized treatment plan.Hyperpneumatization of the temporal bone (HPTB) is a rare finding, and its clinical impact is poorly described in literature. We report the case of a 34-year-old woman with no previous otologic condition, complaining of paroxysmal vertigo and right pulsatile tinnitus shortly after a first scuba diving session. Clinical neurotologic assessment found a right vestibular impairment. Cranial tomodensitometry showed a bilateral hyperpneumatization of the petrosal air cell system. Brain magnetic resonance imaging to rule out any retrocochlear pathology was normal, although the cochleo-vestibular nerve (CVN) appeared to be over lengthened in a narrowed internal auditory canal (IAC), especially on the right-hand side. Pain was alleviated by administration of a low-dose anti-epileptic drug. The clinical, neurological, and radiological findings evoked a right vestibulopathy generated by a limited compression of the CVN; HPTB appeared to contribute to the narrowing of the IAC, especially on the right-hand side.Isolated Eustachian tube osteomata are a very rare entity indeed, with the last case being reported in 1979. We describe a case of the otoscopic finding of a blue-yellowish eardrum and successive identification by computed tomography scan of an osteoma localized in the Eustachian tube. Clinical presentation and diagnostic and therapeutic phases in comparison with the literature will be discussed.Bone-anchored hearing aids (BAHAs) have been used for multiple types of hearing loss both in pediatric and adult cases. In the last decades, the percutaneous BAHA® Connect System (Cochlear Ltd., Sydney, Australia) was replaced by the fully implanted transcutaneous, magnet-based BAHA® Attract System (Cochlear Ltd., Sydney, Australia). Since the implantable part of the Attract device is fully covered with soft tissue, skin complications that were frequently observed in the percutaneous system, could be eliminated. As an outcome of this important advantage of the Attract System, conversion of the percutaneous into a transcutaneous system should be considered. In the following methodology report, a possible surgical technique is described. The method can easily be adopted to different conditions in which the replacement of the percutaneous device is necessary.A case of mastoid dermoid cyst (DC) was presented, and differences with cases of other temporal bone DCs were analyzed. The mastoid DC was also compared with mastoid congenital cholesteatoma. We reported a case of a patient with mastoid DC, evaluating her clinical, radiological, and surgical findings. A review of the literature was performed to compare our findings with those reported. The preoperative radiological evaluation prompted us to plan a surgical approach to the lesion, suspecting the presence of a mastoid congenital cholesteatoma. The surgical findings were in line with the presence of a mastoid DC. Only two cases reported in the literature presented features that fulfilled the criteria of a true mastoid DC. A DC confined to the mastoid region is an extremely rare clinical entity, with asymptomatic and slow growth. Preoperative radiological differentiation between congenital cholesteatoma and DCs with atypical features can be difficult. However, surgical excision is the treatment of choice in both cases. Diagnosis is confirmed by the histological evaluation.Pneumocephalus after cochlear implantation is very rare with five reported cases in the literature. The presence of clinical features in the immediate postoperative period has never been reported, because they occur weeks after surgery. These neurological manifestations can compromise the patient's life; thus, it is important to have proper knowledge and management of these manifestations. We present a case report with a review of the literature. A 35-year-old man began having seizures a few hours after a cochlear implantation. Computed tomography (CT) scan revealed a pneumocephalus and bone defect at the level of the electrode's drilling path, not objected during the surgery. The patient was handled conservatively, and in subsequent reviews, CT objected reabsorption of the pneumocephalus. The presence of a pneumocephalus should be taken into account in the neurological features of a patient with cochlear implant, especially if mastoid bone defects are suspected during surgery. The management of the pneumocephalus will, in most cases, be conservative, consisting of clinical observation and imaging tests. Surgical treatment is reserved for situations in which the clinical manifestations are very symptomatic and when they are tension pneumocephalus.Isolated primary cutaneous amyloidosis (PCA) of the external ear is extremely rare. We describe the case of a 65-year-old woman presenting with itching within the left external auditory canal (EAC). Otoscopy revealed a 3 mm whitish lesion involving the cartilaginous portion of the left EAC. The lesion was excised. Histological and immunohistochemical features were consistent with keratinic amyloidosis. A clinical workup was negative for systemic amyloidosis. As far as we know, only nine cases of PCA exclusively involving the EAC have been reported. The frequent occurrence of itching in these patients and the keratinic nature of the amyloid support the role of chronic stimulation/irritation in the pathogenesis of isolated amyloidosis the EAC.The stapedial artery is an embryologic structure that very rarely persists into adulthood. Termed the persistent stapedial artery (PSA), it is most often asymptomatic, identified retrospectively, and can complicate middle ear surgery. A 70-year-old woman presented with profound bilateral sensorineural hearing loss and elected to undergo cochlear implantation. During surgery, a pulsatile, cord-like structure was found obscuring the round window niche. A high-resolution computed tomography (HRCT) imaging review confirmed PSA diagnosis. A cochleostomy was made using a cochleostomy burr and gentle vessel compression. Complete insertion of the cochlear implant was achieved and its placement confirmed. The patient went on to develop open-set discrimination. We report the first successful case of cochlear implantation in the face of a PSA. link2 Inverted HRCT imaging was found to enhance PSA visualization and may aid preoperative diagnosis. A cochleostomy technique is recommended for electrode insertion to minimize the risk of bleeding.Establish outcomes following cochlear implantation (CI) in patients with Jervell and Lange-Nielsen Syndrome (JLNS). Methods Systematic review and narrative synthesis. link3 Databases searched on Medline, Pubmed, Embase, Web of Science, Cochrane Collection and ClinicalTrials.gov. No limits placed on language or year of publication. Review conducted in accordance with the PRISMA statement. Searches identified 63 abstracts and 19 full texts. Of these, 9 studies met inclusion criteria reporting outcomes in 66 patients with at least 72 implants. Hearing outcomes were generally good. Mortality secondary to cardiac complications within the follow up period occurred in at least five cases (7.6%), though three of these were thought to be unrelated to surgery. Potentially dangerous arrhythmias without associated morbidity were also noted in at least five patients. The methodological quality of included studies was modest, predominantly consisting of case reports and non-controlled case series with small numbers of patients. All studies were OCEBM grade IV. One study contributed 41/66 patients (62%). Hearing outcomes following CI in JLNS are generally good with the majority of patients experiencing useful hearing improvement. Significant peri-operative cardiac risks exist and should be discussed with the patient and family during pre-operative counselling and prompt thorough investigation, pre-operative optimisation and peri-operative monitoring.This study aimed to establish outcomes following cochlear implantation (CI) in patients with superficial siderosis (SS). MEDLINE, Embase, Web of Science, Cochrane, and ClinicalTrials.gov databases were searched for this systematic review. No limits were placed on the language or the year of publication. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of a total of 46 studies, 19 studies met the inclusion criteria reporting outcomes in 38 patients. Of the 44 implants, 23 implants (52.27%) had good hearing outcomes at the last follow-up, 9 (20.45%) were initially beneficial for the patient, but then the performance deteriorated (4 of which were re-implanted), and 12 (27.27%) were not beneficial for the patient. All studies were classified as grade 4 studies using the Oxford Centre for Evidence-Based Medicine (OCEBM) grading system, being retrospective in nature and consisting of case reports and noncontrolled case series with a small number of patients.
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