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Virtual Bronchoscopic Navigation Guided Recanalization of Chronic Total Post-Tuberculosis Bronchial Stenosis

Kho SS, Nasaruddin MZ, Abdul Rahaman JA

Arch Bronconeumol, 2022 Nov;58(11):768-769.
PMID: 35606265 DOI: 10.1016/j.arbres.2022.05.003
Matched MeSH terms: Constriction, Pathologic/surgery
Fulltext A Novel Use of Modified Tracheostomy Tubes in Preventing External Auditory Canal Stenosis

Ng CS, Foong SK, Loong SP, Ong CA, Hashim ND

J Int Adv Otol, 2021 Jul;17(4):301-305.
PMID: 34309549 DOI: 10.5152/iao.2021.0078

BACKGROUND: Postoperative or post-traumatic canal restenosis in patients with external auditory canal (EAC) stenosis is a troublesome complication faced by many ear surgeons following canalplasty or meatoplasty. Many ear prostheses and surgical methods have been introduced to prevent the occurrence of such complication. Our aim in this study is to explore the feasibility of using modified non-fenestrated uncuffed tracheostomy tubes (TT) as postoperative stents after ear canal surgery.
METHODS: Canalplasty or meatoplasty was performed under general anesthesia via the posterior auricular transcanal approach. The EAC diameter and length were measured and a non-fenestrated uncuffed TT of suitable size was fitted into the ear canal. The TT was then modified during fitting, to fit onto the concha. Patients were advised on the importance of compliance. The adequacy of the size of the EAC after the surgery was assessed during follow-ups.
RESULTS: A total of 3 patients (4 ears) were included in our study. Various sizes of TTs were fitted into their EAC following canalplasty or meatoplasty. All of them showed excellent postoperative outcome on follow up 2 years after the surgery, with no evidence of postoperative EAC stenosis.
CONCLUSION: Modified TT stent after canalplasty or meatoplasty is proposed as an excellent alternative in preventing restenosis of EAC in centers with limited resources.

Matched MeSH terms: Constriction, Pathologic/surgery
Fulltext The pudendal thigh fasciocutaneous flap for vaginal atresia reconstruction

Azman WS, Halim AS, Samad IA

Med J Malaysia, 2005 Oct;60(4):505-7.
PMID: 16570718

Vaginal defects can either be congenital or acquired due to tumor or trauma. The reconstructions are aimed in producing a good physical and functional result with the least donor site morbidity. The pudendal thigh flap is a sensate fasciocutaneous flap based on the terminal branch of the superficial perineal artery, the continuation of the internal pudendal artery. Although various flaps have been described for vaginal reconstruction, the pudendal thigh flap offers a very attractive alternative.

Matched MeSH terms: Constriction, Pathologic/surgery
Stereotactic neuroendoscopic management of hydrocephalus: a three-year follow-up and analysis of Malaysian children with aqueduct stenosis

Abdullah J, Ariff AR, Ghazaime G, Naing NN

Stereotact Funct Neurosurg, 2001;76(3-4):175-80.
PMID: 12378096

The beneficial effects of stereotactic third ventriculostomy versus ventriculoperitoneal shunt were evaluated in 62 paediatric patients and analysed in relation to age, sex, clinical history, presence of meningomyelocele, magnetic resonance imaging measurements of hydrocephalus and third ventricle floor size. The third ventriculostomy were done on 50 patients using the Richard-Wolf Caemaert Endoscope and the Leksell Stereotactic Frame Model G. These patients were operated using the 4-French Fogarty catheter to open the base of the third ventricle. During the same period of study 12 paediatric patients with aqueduct stenosis who were managed by ventriculoperitoneal shunt were included. Both surgical procedures were compared. Statistically univariate analysis revealed that those patient with an age group of more than six months undergoing ventriculostomy had good outcome. Multivariate analysis revealed that past history of haemorrhage and/or meningitis were predictors of poor outcome. Sex, size of lumbar meningocele at birth, abnormal ventricular anatomy or narrow third ventricular floor size were non predictors of bad outcome in these patients. There was no difference in outcome in both the shunt or ventriculostomy group.

Matched MeSH terms: Constriction, Pathologic/surgery
Fulltext Total proximal ureter substitution using buccal mucosa

Fahmy O, Schubert T, Khairul-Asri MG, Stenzl A, Gakis G

Int J Urol, 2017 04;24(4):320-323.
PMID: 28208217 DOI: 10.1111/iju.13307

The surgical treatment of a long proximal ureteral stricture is a challenging situation for reconstructive surgeons. Despite the underlying morbidities, ileal interposition and autotransplantation are the options available to treat complex cases of long segment ureteral stricture. Buccal mucosa has shown excellent results in urethroplasty. However, its use in ureteral reconstruction is infrequent. We report on a 64-year-old female patient with multiple comorbidities and prior abdominal surgeries for Crohn's disease who underwent a successful total substitution of a long segment of the proximal ureter using buccal mucosa. Regular postoperative isotope scans showed improvement in renal function. Based on the pleasant outcome of this case and review of the literature, buccal mucosa might be a viable option with low morbidity in selected cases.

Matched MeSH terms: Constriction, Pathologic/surgery
Fulltext Refractory Chronic Diffuse Granular Myringitis with Medial Meatal Stenosis

Wei Ling S, Lim CC, Mohd Damanhuri Shah MFSB, Devesahayam PR

J Int Adv Otol, 2024 Sep 26;20(5):458-461.
PMID: 39391172 DOI: 10.5152/iao.2024.231292

Granular myringitis is a chronic inflammatory condition of the tympanic membrane that does not involve the middle ear. Various treatment modalities have been proposed for the treatment of granular myringitis, but there is no standard treatment regime. A 60-year-old woman had left persistent ear discharge for 4 months. Examination revealed diffuse granulation tissue, forming a pseudomembrane at the medial aspect of the ear canal and obstructing the tympanic membrane. An audiogram revealed mild-to-moderate left-sided conductive hearing loss. She was treated with multiple courses of ear drop antibiotics but had no improvement. The decision for surgical intervention was driven by the presence of a grade IV medial meatal stenosis, the potential risks associated with prolonged medical management, the distressing impact on the patient's life, and a shared decision-making process. A combined transcanal and postauricular endoscopic approach whereby excision of the granulation tissue, canalplasty, and myringoplasty were performed. She exhibited complete symptom resolution and reported an improved quality of life. This approach yielded successful symptom resolution, highlighting its potential in managing refractory chronic granular myringitis. We aimed to carefully weigh the risks of surgery against its potential benefits in a refractory chronic case, acknowledging the inherent risks and disadvantages of surgical interventions. Further studies are warranted to evaluate the long-term outcomes and benefits of this approach.

Matched MeSH terms: Constriction, Pathologic/surgery
Velopharyngeal and choanal stenosis after radiotherapy for nasopharyngeal carcinoma

Hussein J, Tan TS, Chong AW, Narayanan P, Omar R

Auris Nasus Larynx, 2013 Jun;40(3):323-6.
PMID: 22652485 DOI: 10.1016/j.anl.2012.05.004

Choanal stenosis is a well recognized late complication of radiotherapy for nasopharyngeal carcinoma. However velopharyngeal stenosis post radiotherapy for nasopharyngeal carcinoma is rare. We present here a case of bilateral choanal stenosis and velopharyngeal stenosis in a patient treated with radiotherapy for nasopharyngeal carcinoma. A 58-year-old woman presented to our otolaryngology clinic with a one year history of nasal obstruction. She was diagnosed to have nasopharyngeal carcinoma 12 years ago for which she received radiotherapy. Clinical examination revealed bilateral choanal stenosis and velopharyngeal stenosis. Treatment of choanal stenosis and velopharyngeal stenosis is challenging due to high incidence of recurrence and patients frequently require multiple procedures. The patient underwent a transnasal endoscopic excision of velopharyngeal scar tissue and widening of posterior choana using Surgitron®, mitomycin-C applied topically to the surgical wound and bilateral stenting under general anesthesia. The stents were kept for two weeks, and 3 years post operation velopharyngeal aperture and posterior choana remained patent. As illustrated in this case velopharyngeal stenosis can occur after radiotheraphy and should not be overlooked. Combine modality of transnasal endoscopic excision of velopharyngeal scar tissue, widening of choanal stenosis with Surgitron® followed by the application of mitomycin-C and stenting has been shown to be an effective option.
Study site: ENT clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Matched MeSH terms: Constriction, Pathologic/surgery
Currarino triad with dual pathology in the presacral mass: report of a case

Thambidorai CR, Muin I, Razman J, Zulfiqar A

Dis Colon Rectum, 2003 Jul;46(7):974-7.
PMID: 12847376

PURPOSE: Currarino triad, which comprises anorectal stenosis, anterior sacral defect, and a presacral mass, is an uncommon cause of constipation in children and adults. The presacral mass in this triad is most often caused by an anterior sacral meningocele, a teratoma, or an enterogenous cyst, but rarely may be caused by dual pathology. A neonate with Currarino triad and dual pathology in the presacral mass is described in this report.
METHOD: A male Chinese neonate, who presented with abdominal distention and constipation on the second day of life, was found to have features of Currarino triad. Colostomy was done in the neonatal period, and the presacral mass was excised by posterior sagittal perineal approach at the age of six months.
RESULTS: The excised presacral mass consisted of an anterior meningocele and a teratoma. The patient continued to have constipation during follow-up and required anorectoplasty to correct residual anorectal stenosis. At the time of this report the patient was three years old and growing normally with normal anorectal function.
DISCUSSION: Of a total of about 200 cases of complete Currarino triad found in the literature, in only 22 patients did the presacral mass contain both meningocele and teratoma. The features of these 22 patients and the current views on the surgical management of Currarino triad are discussed.

Matched MeSH terms: Constriction, Pathologic/surgery