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[PMID]: 24859440
[Au] Autor:Pooler BD; Lubner MG; Kim DH; Ryckman EM; Sivalingam S; Tang J; Nakada SY; Chen GH; Pickhardt PJ
[Ad] Address:Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin....
[Ti] Title:Prospective trial of the detection of urolithiasis on ultralow dose (sub mSv) noncontrast computerized tomography: direct comparison against routine low dose reference standard.
[So] Source:J Urol;192(5):1433-9, 2014 Nov.
[Is] ISSN:1527-3792
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE: In this prospective trial we compared ultralow dose computerized tomography reconstruction algorithms and routine low dose computerized tomography for detecting urolithiasis. MATERIALS AND METHODS: A total of 48 consenting adults prospectively underwent routine low dose noncontrast computerized tomography immediately followed by an ultralow dose series targeted at a 70% to 90% reduction from the routine low dose technique (sub mSv range). Ultralow dose series were reconstructed with filtered back projection, and adaptive statistical and model based iterative reconstruction techniques. Transverse (axial) and coronal images were sequentially reviewed by 3 relatively inexperienced trainees, including a radiology resident, a urology fellow and an abdominal imaging fellow. Three experienced abdominal radiologists independently reviewed the routine low dose filtered back projection images, which served as the reference standard. RESULTS: The mean effective dose for the ultralow dose scans was 0.91 mSv (median 0.82), representing a mean ± SD 78% ± 5% decrease compared to the routine low dose. Overall sensitivity and positive predictive value per stone for ultralow dose computerized tomography at a 4 mm threshold was 0.91 and 0.98, respectively. Sensitivity, specificity, positive and negative predictive values, and accuracy per patient were 0.87, 1.00, 1.00, 0.94 and 0.96, respectively. At a 4 mm threshold the sensitivity and positive predictive value per stone of the ultralow dose series for filtered back projection, and adaptive statistical and model based iterative reconstruction was 0.89 and 0.96, 0.91 and 0.98, and 0.93 and 1.00, respectively. Sensitivity, specificity, positive and negative predictive values, and accuracy per patient at the 4 mm threshold were 0.82, 1.00, 1.00, 0.91 and 0.94 for filtered back projection, 0.85, 1.00, 1.00, 0.93 and 0.95 for adaptive statistical iterative reconstruction, and 0.94, 1.00, 1.00, 0.97 and 0.98 for model based iterative reconstruction, respectively. Sequential review of coronal images changed the final stone reading in 13% of cases and improved diagnostic confidence in 49%. CONCLUSIONS: At a 4 mm renal calculus size threshold ultralow dose computerized tomography is accurate for detection when referenced against routine low dose series with dose reduction to below the level of a typical 2-view plain x-ray of the kidneys, ureters and bladder. Slight differences were seen among the reconstruction algorithms. There was mild improvement with model based iterative reconstruction over filtered back projection and adaptive statistical iterative reconstruction. Coronal images improved detection and diagnostic confidence over axial images alone.
[Mh] MeSH terms primary: Algorithms
Multidetector Computed Tomography/standards
Radiographic Image Interpretation, Computer-Assisted
Urolithiasis/radiography
[Mh] MeSH terms secundary: Adult
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prospective Studies
ROC Curve
Reference Standards
Reproducibility of Results
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Entry month:1501
[Cu] Class update date: 150822
[Lr] Last revision date:150822
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:141017
[St] Status:MEDLINE

  2 / 5920 MEDLINE  
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[PMID]: 26293048
[Au] Autor:Sevinc C; Balaban M; Ozkaptan O; Karadeniz T
[Ad] Address:Medicana International Istanbul Hospital, Urology Clinic, Istanbul, Turkey....
[Ti] Title:Flexible Ureterorenoscopy and Laser Lithotripsy for the Treatment of Allograft Kidney Lithiasis.
[So] Source:Transplant Proc;47(6):1766-71, 2015 Jul-Aug.
[Is] ISSN:1873-2623
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To evaluate the safety and effectiveness of flexible ureterorenoscopy (F-URS) and laser lithotripsy for the treatment of allograft kidney lithiasis. PATIENTS AND METHODS: In a retrospective analysis of 897 consecutive renal transplantations that were performed at our center between February 2008 and December 2014, 6 patients were found to have allograft lithiasis. F-URS and laser lithotripsy were performed 6 times on 5 patients (twice for 1 patient who had stone recurrence after 6 months). Percutaneous nephrolithotomy was used for the remaining patient. Patient demographics and stone characteristics (age, sex, stone size, stone analysis, location, history of shockwave lithotripsy) and perioperative measures (duration of operation, fluoroscopic imaging, success and complication rates) were reviewed. In addition, the technical difficulties of standard F-URS procedures in transplanted kidneys were reviewed and some facilitative techniques were defined to increase the success rate. RESULTS: A total of 5 patients underwent 6 F-URS procedures and laser lithotripsy operations for renal graft lithiasis. The mean stone size was 9.2 mm (7.5-11 mm). The mean operation and fluoroscopy times were calculated as 55 minutes (40-70 minutes) and 57.5 seconds (40-80 seconds), respectively. Treatment was successful in all patients and no severe complications or mortality occurred. One patient experienced transient hematuria and recovered within 36 hours. CONCLUSION: F-URS is a safe, effective, and minimally invasive treatment modality for small- and medium-sized stones in allograft kidney lithiasis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1508
[Js] Journal subset:IM
[St] Status:In-Data-Review

  3 / 5920 MEDLINE  
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[PMID]: 25341724
[Au] Autor:Denburg MR; Leonard MB; Haynes K; Tuchman S; Tasian G; Shults J; Copelovitch L
[Ad] Address:Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; denburgm@email.chop.edu....
[Ti] Title:Risk of fracture in urolithiasis: a population-based cohort study using the health improvement network.
[So] Source:Clin J Am Soc Nephrol;9(12):2133-40, 2014 Dec 5.
[Is] ISSN:1555-905X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND AND OBJECTIVES: Studies have shown decreased bone mineral density in individuals with urolithiasis, but their burden of fracture remains unclear. This study sought to determine whether urolithiasis is associated with increased fracture risk across the lifespan and to delineate sex effects. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A population-based retrospective cohort study using The Health Improvement Network was performed. The median calendar year for the start of the observation period was 2004 (1994-2012). This study identified 51,785 participants with ≥1 of 87 diagnostic codes for urolithiasis and 517,267 randomly selected age-, sex-, and practice-matched participants. Cox regression was used to estimate the hazard ratio (HR) for first fracture. Fractures identified using diagnostic codes were classified by anatomic site. RESULTS: Median age was 53 years, and 67% of participants were men, confirming their greater urolithiasis burden. Median time from urolithiasis diagnosis to fracture was 10 years. The HR for fracture associated with urolithiasis differed by sex and age (P for interactions, P≤0.003). In men, the adjusted HR was greatest in adolescence (1.55; 95% confidence interval [95% CI], 1.07 to 2.25) with an overall HR of 1.10 (95% CI, 1.05 to 1.16). Urolithiasis was associated with higher fracture risk in women aged 30-79 years (HR, 1.17-1.52), and was highest in women aged 30-39 years (HR, 1.52; 95% CI, 1.23 to 1.87). Peak background fracture rates were highest in boys aged 10-19 years and in women aged 70-79 years. The incidence per 10,000 person-years in participants with versus without urolithiasis was 392 versus 258 in male participants aged 10-19 years, and 263 versus 218 in women aged 70-79 years. Distribution of fracture site within sex did not differ between participants with versus without urolithiasis. CONCLUSIONS: Urolithiasis was associated with higher incident fracture risk. The significantly higher risk at times of peak background fracture incidence in adolescent boys and elderly women has profound public health implications.
[Mh] MeSH terms primary: Fractures, Bone/epidemiology
Urolithiasis/epidemiology
[Mh] MeSH terms secundary: Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Case-Control Studies
Child
Female
Great Britain/epidemiology
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Sex Factors
Young Adult
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Em] Entry month:1508
[Cu] Class update date: 150613
[Lr] Last revision date:150613
[Js] Journal subset:IM
[Da] Date of entry for processing:141206
[St] Status:MEDLINE
[do] DOI:10.2215/CJN.04340514

  4 / 5920 MEDLINE  
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[PMID]: 26047751
[Au] Autor:Bouali O; Trabanino C; Abbo O; Destombes L; Baunin C; Galinier P
[Ad] Address:Service de chirurgie pédiatrique, hôpital des enfants de Toulouse, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France. Electronic address: bouali.o@chu-toulouse.fr....
[Ti] Title:Péritonite biliaire par rupture traumatique d'un kyste du cholédoque. [Biliary peritonitis after traumatic rupture of a choledochal cyst].
[So] Source:Arch Pediatr;22(7):763-6, 2015 Jul.
[Is] ISSN:1769-664X
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:Choledochal cysts are rare congenital malformations of the biliary tract. Traumatic rupture of a choledochal cyst can be misleading. An 11-year-old boy was admitted for peritonitis and intestinal occlusion after blunt abdominal trauma, evolving over 48 h. Laparotomy revealed bile ascites and a suspected duodenal perforation. After referral to our center, a CT scan showed a perforated choledochal cyst. Six months later, a complete excision of the cyst was successfully performed. This treatment is mandatory because of the risk of further complications such as lithiasis, pancreatitis, cholangitis, biliary cirrhosis, and malignant transformation (cholangiocarcinoma).
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Process

  5 / 5920 MEDLINE  
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[PMID]: 25469022
[Au] Autor:Surlin V; Saftoiu A; Dumitrescu D
[Ad] Address:Valeriu Surlin, 1 Clinic of Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Dolj, Romania.
[Ti] Title:Imaging tests for accurate diagnosis of acute biliary pancreatitis.
[So] Source:World J Gastroenterol;20(44):16544-9, 2014 Nov 28.
[Is] ISSN:2219-2840
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Gallstones represent the most frequent aetiology of acute pancreatitis in many statistics all over the world, estimated between 40%-60%. Accurate diagnosis of acute biliary pancreatitis (ABP) is of outmost importance because clearance of lithiasis [gallbladder and common bile duct (CBD)] rules out recurrences. Confirmation of biliary lithiasis is done by imaging. The sensitivity of the ultrasonography (US) in the detection of gallstones is over 95% in uncomplicated cases, but in ABP, sensitivity for gallstone detection is lower, being less than 80% due to the ileus and bowel distension. Sensitivity of transabdominal ultrasonography (TUS) for choledocolithiasis varies between 50%-80%, but the specificity is high, reaching 95%. Diameter of the bile duct may be orientative for diagnosis. Endoscopic ultrasonography (EUS) seems to be a more effective tool to diagnose ABP rather than endoscopic retrograde cholangiopancreatography (ERCP), which should be performed only for therapeutic purposes. As the sensitivity and specificity of computerized tomography are lower as compared to state-of-the-art magnetic resonance cholangiopancreatography (MRCP) or EUS, especially for small stones and small diameter of CBD, the later techniques are nowadays preferred for the evaluation of ABP patients. ERCP has the highest accuracy for the diagnosis of choledocholithiasis and is used as a reference standard in many studies, especially after sphincterotomy and balloon extraction of CBD stones. Laparoscopic ultrasonography is a useful tool for the intraoperative diagnosis of choledocholithiasis. Routine exploration of the CBD in cases of patients scheduled for cholecystectomy after an attack of ABP was not proven useful. A significant rate of the so-called idiopathic pancreatitis is actually caused by microlithiasis and/or biliary sludge. In conclusion, the general algorithm for CBD stone detection starts with anamnesis, serum biochemistry and then TUS, followed by EUS or MRCP. In the end, bile duct microscopic analysis may be performed by bile harvested during ERCP in case of recurrent attacks of ABP and these should be followed by laparoscopic cholecystectomy.
[Mh] MeSH terms primary: Diagnostic Imaging
Gallstones/complications
Pancreatitis/diagnosis
[Mh] MeSH terms secundary: Acute Disease
Animals
Diagnostic Imaging/methods
Gallstones/diagnosis
Gallstones/therapy
Humans
Pancreatitis/etiology
Pancreatitis/therapy
Predictive Value of Tests
Prognosis
Risk Factors
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1508
[Cu] Class update date: 150121
[Lr] Last revision date:150121
[Js] Journal subset:IM
[Da] Date of entry for processing:141203
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v20.i44.16544

  6 / 5920 MEDLINE  
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[PMID]: 25428680
[Au] Autor:Pricop C; Maier A; Negru D; Malau O; Orsolya M; Radavoi D; Serban DR
[Ad] Address:University of Medicine and Pharmacy of Iasi. bobopricop@yahoo.com.
[Ti] Title:Extracorporeal shock waves lithotripsy versus retrograde ureteroscopy: is radiation exposure a criterion when we choose which modern treatment to apply for ureteric stones?
[So] Source:Bosn J Basic Med Sci;14(4):254-8, 2014.
[Is] ISSN:1840-4812
[Cp] Country of publication:Bosnia and Hercegovina
[La] Language:eng
[Ab] Abstract:The aim of this study is to compare two major urological procedures in terms of patient exposure to radiation. We evaluated 175 patients, that were subjected to retrograde ureteroscopy (URS) and extracorporeal shock waves lithotripsy (ESWL) for lumbar or pelvic ureteral lithiasis, at two urological departments. The C-arm Siemens (produced in 2010 by Siemens AG, Germany) was used for ureteroscopy. The radiological devices of the lithotripters used in this study in the two clinical centers had similar characteristics. We evaluated patient exposure to ionizing radiation by using a relevant parameter, the air kerma-area product (PKA; all values in cGy cm(2)), calculated from the radiation dose values recorded by the fluoroscopy device. PKA depends on technical parameters that change due to anatomical characteristics of each case examined, such as body mass index (BMI), waist circumference, and stone location. For the patients subjected to ESWL for lumbar ureteral lithiasis the mean of PKA (cGy cm(2)) was 509 (SD=180), while for those treated for pelvic ureteral lithiasis the mean of PKA was 342 (SD=201). In the URS group for lumbar ureteral lithiasis, the mean of PKA (cGy cm(2)) was 892 (SD=436), while for patients with pelvic ureteral lithiasis, the mean of PKA was 601 (SD=429). The patients treated by URS had higher exposure to ionizing radiation dose than patients treated by ESWL. The risk factors of higher radiation doses were obesity, exposure time, and localization of the stones.
[Mh] MeSH terms primary: Lithotripsy
Ureterolithiasis/radiography
Ureterolithiasis/therapy
Ureteroscopy
[Mh] MeSH terms secundary: Adult
Aged
Aged, 80 and over
Female
Fluoroscopy
Humans
Lumbosacral Region
Male
Middle Aged
Obesity/complications
Pelvis
Prospective Studies
Radiation Dosage
Ureterolithiasis/complications
Young Adult
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1508
[Cu] Class update date: 150224
[Lr] Last revision date:150224
[Js] Journal subset:IM
[Da] Date of entry for processing:141127
[St] Status:MEDLINE
[do] DOI:10.17305/bjbms.2014.4.99

  7 / 5920 MEDLINE  
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[PMID]: 24242980
[Au] Autor:Govil A; Agrawal MK; Agrawal D; Udawat H
[Ad] Address:Department of Gastroenterology, Santobka Durlabhji Memorial Hospital, Near Rambagh Circle, Bhawani Singh Road, Bapu Nagar, Jaipur, 302 015, India, gutcare@hotmail.com.
[Ti] Title:Role of endoscopic ultrasonography in patients with first episode of idiopathic acute pancreatitis.
[So] Source:Indian J Gastroenterol;33(3):241-8, 2014 May.
[Is] ISSN:0975-0711
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:BACKGROUND/AIMS: Acute pancreatitis (AP) evades an etiological diagnosis in up to 10 % to 30 % of patients. This group, ie. idiopathic acute pancreatitis (IAP) is prone to a high recurrence (up to 70 %). Endoscopic ultrasound (EUS) is promising, but there is limited data on elucidating the cause of IAP, from India. This observational study was designed to study the role of EUS after the first episode of IAP. METHODS: All patients diagnosed to have first episode of IAP were included in the study and taken up for EUS examination after 6 weeks. Patients with conditions known to predispose or precipitate AP, like alcohol binge, drugs, metabolic or autoimmune conditions, or even a positive family history, were excluded from the study. RESULT: A total of 51 patients were included. EUS positivity was found in 29 (56.9 %) patients. It included common bile duct (CBD) calculus in 5 (9.8 %), CBD sludge in 4 (7.8 %), gallbladder calculus in 2 (3.9 %), gallbladder sludge in 2 (3.9 %), and chronic pancreatitis (CP) in 16 (31.4 %) patients. Fourteen patients had a normal study and eight patients had indeterminate CP. CONCLUSIONS: EUS is safe and has a reasonable diagnostic yield in patients with first episode of IAP. CP and biliary lithiasis are the most frequent positive findings on EUS. EUS should be included in the diagnostic protocol after the first episode of IAP, rather than waiting for recurrent episodes.
[Mh] MeSH terms primary: Endosonography/methods
Pancreatitis/ultrasonography
[Mh] MeSH terms secundary: Acute Disease
Adolescent
Adult
Aged
Child
Gallstones/ultrasonography
Humans
Male
Middle Aged
Observational Study as Topic
Recurrence
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1508
[Js] Journal subset:IM
[Da] Date of entry for processing:140516
[St] Status:MEDLINE
[do] DOI:10.1007/s12664-013-0422-2

  8 / 5920 MEDLINE  
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[PMID]: 25306481
[Au] Autor:de Cógáin MR; Lieske JC; Vrtiska TJ; Tosh PK; Krambeck AE
[Ad] Address:Department of Urology, Mayo Medical School and Mayo Clinic, Rochester, MN....
[Ti] Title:Secondarily infected nonstruvite urolithiasis: a prospective evaluation.
[So] Source:Urology;84(6):1295-300, 2014 Dec.
[Is] ISSN:1527-9995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To characterize patients who form nonstruvite stones associated with infection (secondarily infected calculi), and to define the bacteria associated with these. MATERIALS AND METHODS: Patients undergoing percutaneous nephrolithotomy were prospectively recruited. Medical records were reviewed, and stones were analyzed using micro computed tomography and infrared spectroscopy. A fragment of each stone was sent for bacterial culture. Patients were categorized by stone culture results (SC ±) and the presence of struvite (ST ±). The Fisher exact test was used for comparison of proportion. Sterility of intraoperative SC was established with independently collected controls. RESULTS: In total, 125 patients were enrolled: 24 SC+/ST-, 19 SC+/ST+, and 82 SC-/ST-. Proportions of patients with prior urologic surgery, diabetes, and immunodeficiency were similar between groups. Patients with neurogenic bladder were more likely to have SC+/ST+ stones or SC+/ST- stones than SC-/ST- stones (26% vs 8% vs 0%, respectively; P <.01). Among patients with metabolic evaluations, hypocitraturia was found in 31.6% (6 of 19) SC+/ST- patients, 46.7% (7 of 15) SC+/ST+ patients, and 26.0% (19 of 73) of SC-/ST- patients (P = .28). Approximately 40% of cultured organisms in the secondarily infected calculi possessed urease and another 40% citrate lyase activities. CONCLUSION: Secondarily infected stones were detected in approximately 20% of this surgical cohort and may be more common than previously appreciated. Neurogenic bladder appeared to predispose patients to either struvite or secondarily infected stones. The role of bacterial infection in stone formation is unclear but may include alteration of urinary components, acting as a nidus for crystallization, or inducing inflammation.
[Mh] MeSH terms primary: Magnesium Compounds/chemistry
Nephrostomy, Percutaneous/adverse effects
Phosphates/chemistry
Urinary Tract Infections/microbiology
Urolithiasis/microbiology
Urolithiasis/surgery
[Mh] MeSH terms secundary: Adult
Aged
Calcium Oxalate/chemistry
Calcium Phosphates/chemistry
Cohort Studies
Female
Humans
Incidence
Male
Middle Aged
Nephrostomy, Percutaneous/methods
Postoperative Care
Preoperative Care
Prognosis
Prospective Studies
Risk Assessment
Uric Acid/chemistry
Urinalysis
Urinary Tract Infections/epidemiology
Urinary Tract Infections/etiology
Urinary Tract Infections/physiopathology
Urolithiasis/complications
Urolithiasis/diagnosis
[Pt] Publication type:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL
[Nm] Name of substance:0 (Calcium Phosphates); 0 (Magnesium Compounds); 0 (Phosphates); 15490-91-2 (struvite); 2612HC57YE (Calcium Oxalate); 268B43MJ25 (Uric Acid); 97Z1WI3NDX (calcium phosphate)
[Em] Entry month:1501
[Cu] Class update date: 150815
[Lr] Last revision date:150815
[Js] Journal subset:IM
[Da] Date of entry for processing:141129
[St] Status:MEDLINE

  9 / 5920 MEDLINE  
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[PMID]: 25912855
[Au] Autor:Garconnet J; Foletti JM; Guyot L; Chossegros C
[Ad] Address:Service de stomatologie et chirurgie maxillofaciale, centre hospitalier universitaire de la Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France. Electronic address: juliegarconnet@yahoo.fr....
[Ti] Title:Suture du nerf lingual: note technique. [Suture of lingual nerve: Technical note].
[So] Source:Rev Stomatol Chir Maxillofac Chir Orale;116(3):143-6, 2015 Jun.
[Is] ISSN:2213-6541
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:INTRODUCTION: Because of its anatomical position, the lingual nerve may be severed during oral surgical procedures, such as third molar removal. Early suturing of the nerve promotes better recovery. We describe the end-to-end suture of this nerve. OPERATIVE PROCEDURE: The suture is carried-out under general anesthesia. The approach is made in the mouth floor, in the same way as for submandibular gland lithiasis transoral removal. This approach allows good exposure and some laxity to displace the nerve stumps. The latter can then be sutured under microscope assistance before closing the mucosa. DISCUSSION: Lingual nerve suture is a simple, quick and inexpensive procedure. Unlike other procedures, it cannot be used in case of large loss of substance because of the small amount of laxity of the nerve. Nerve function recovery is better if performed before the 6th post-traumatic month, and in young patients.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:D; IM
[St] Status:In-Process

  10 / 5920 MEDLINE  
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[PMID]: 25841269
[Au] Autor:Louvrier A; Foletti JM; Guyot L; Chossegros C
[Ad] Address:Service de chirurgie maxillo-faciale et stomatologie, centre hospitalier La Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France; Service de chirurgie maxillo-faciale, de stomatologie et d'odontologie hospitalière, centre hospitalier universitaire de Besançon, boulevard Fleming, 25030 Besa...
[Ti] Title:Abord combiné des lithiases parotidiennes. Note technique. [Combined approach of parotid lithiasis. A technical note].
[So] Source:Rev Stomatol Chir Maxillofac Chir Orale;116(3):139-42, 2015 Jun.
[Is] ISSN:2213-6541
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:INTRODUCTION: Sialendoscopy, extracorporeal lithotripsy and transoral removal are the usual treatments for parotid lithiasis. These techniques cannot treat all the patients. In fact, removal of lithiasis bigger than the ductal diameter and situated in the middle or posterior third of the duct may fail with such techniques. For this reason the combined approach has been developed. Our technical note describes this procedure. TECHNICAL NOTE: Preoperative check-up needs an ultrasound or a CT scan of the parotid region. The procedure is conducted under general anesthesia. It begins with the localization of the lithiasis with help of the sialendoscope light visible through the skin. A face lift approach is performed giving access to the SMAS that is opened over the lithiasis and the transilluminated area. A window is opened on the duct and the lithiasis is removed. Proximal duct permeability is assessed with the sialendoscope. The different layers are sutured and a suction drainage is left in place. DISCUSSION: Combined approach is indicated in case of failure of conservative techniques. It provides good results in removal of lithiasis located in the posterior or middle thirds of the duct. Its morbidity is low. It can avoid performing a parotidectomy and lowers the risk of facial palsy. In case of failure, botulinum toxin injection may be indicated.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:D; IM
[St] Status:In-Process


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