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Register a new userTranasal Endoscopic Repair of Encephalomeningo Fistula The experience of Damascus University
دور الجراحـة التنظيريـة عبـر الأنـف فـي إغلاق النواسير السحائية الدماغية
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عبد الرزاق شحود جرعتلي( باحث )
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إن خروج سائل رائـق بشكل نقطي ، أو متواصل خطياً من الأنف بشكل متقطع عند تمييل الرأس يجب أن يوجهنا إلى احتمال آونه سائلاً دماغياً شوكياً ، و بذلك ضرورة إجراء الاختبار النوعي على السائل لتأكيد التشخيص ، و عند إقراره ضرورة المسارعة إلى إغلاق الناسور السحائي الدماغي الأنفي بعد تحديد موقعه بالوسائل الخاصة ، و التي أهمها التصوير الطبقي عالي الدقة و المرنان إن لزم الأمر ، و أحياناً حقن مادة الفلوروسيئين عبر البـزل القطني . إن ضرورة إغلاق النواسير تكمن في خطورتها في إحداث هجمات التهاب سحايا خطرة قد تعطب صاحبها و تقضي على مستقبله الفكري و الاجتماعي .
Cerebrospinal fluid ( CSF ) rhinorrhoea may arise from a variety of pathologies. There is a high risk of developing meningitis, with all the associated morbidity and mortality. The diagnosis of (CSF) Rhinorroea should be established beyond reasonable doubt before surgical intervention is embarked upon. I describe management algorithm witch centers around the selective use of nasal endoscopy immunofixation of bata 2 Transferrin.
References used
Brodie Ha (1997) Prophylactic Antibiotics for Posttraumatic Cerebrospinal Fluid Fistulae. Arch Otolaryngol Head Neck Surg 123: 749-752
Bums JA. Dodson Gros CW (1996) Transnasal Endoscopic Repair of Craniofacial Fistulac: A Refined Techninque with Long -term Follow-up Laryngoscope 106: 1080-1083
Choi D. Spam R (1996) Traumatic cerebrospinal fluid leakage: risk factors and the use of prophylactic antibiotics British Journal of Neurosurgery 10(6): 571-575
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Residual palatal fistulas are common after repair of palatal cleft
and tumar incision in palate and nasal cavity.
Repair of residual oronasal fistula is not always successful. Twolayer
closure techniques that close these fistulas with soft tissue
are a common practice. Turnover flaps are the most used flaps
and often the sole method for nasal side closure of fistula.
Anteriorly based inferior turbinate flap can be used to provide soft
tissue for nasal-side closure when turnover flaps will not provide
sufficient tissue for this purpose.
The aim of this study is to assess results of percutaneous closure of secundumtype
atrial septal defect (ASD II) using Amplatzer septal occluders (ASO).
vestibular oro-nasal fistulas and alveolar clefts associate with cleft
lip and palate.
Sliding flaps are the most used flaps and often the sole method for
closure of vestibular oro-nasal fistulas and alveolar clefts. cheek
flap can be used instead of Sliding flaps.
We retrospectively reviewed data of all patients who underwent study or surgery for Lung Cancer from (1997 to 2012) in the department of thoracic surgery at Alassad University Hospital in Damascus. There were 2029 patients with Lung cancer,1727 male
85,11% and 302 female 14,88%,87,53% of patients were smoking, and cough was the most common symptom about 70% of patients. There were 889 squamous cell carcinoma 43,81%, 702 adenocarcinoma 34,79%, 246 small cell carcinoma 12,12%,67 large cell carcinoma 3,3% and 66 carcinoid tumor 3,25%; the staging was 6,35% stageI,14,98% stageII,15,91% stage IIIA,29,02% stageIIIB,33,71% stage IV. Radical Surgery consisted of 621 formal lung resection 229 lobectomies 36,87%, 163 bilobectomies 26,2%, 158 pneumonectomy 25,44%,35 sleeve or bronchoplastic resection 5,63% ,36 partial resection 6,15%. The perioperative mortality was 3,05% and the overall 5 year survival was 22,9%. Our study resembles most of the studies made in the developing countries in the result that the rate of smoking and of lung cancer among women is fewer compared to the International rate. It also resembles most of the European countries in the result that squamous cell carcinoma is the most common pathological pattern, and the size of pulmonary resection is bigger than that in the developed countries where they have earlier diagnosis. Moreover, the rate of the sleeve resection surgery along with the rate of mortality resemble that of the International centers.
To evaluate the role of Endoscopic Sinus Surgery ( ESS ) in excision of inverted
papillomas , and to compare the recurrence rate in this approache with that of external one .
Background: Assessment of new surgical technique in the management of the most important benign
para-nasal sinuses tumor.
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