Objectives/Hypothesis: The introduction of intranasal pedicled flaps has reduced the incidence of postoperative cerebrospinal fluid (CSF) leaks to less than 5%. Nevertheless, in malignant tumors those flaps are not al...Objectives/Hypothesis: The introduction of intranasal pedicled flaps has reduced the incidence of postoperative cerebrospinal fluid (CSF) leaks to less than 5%. Nevertheless, in malignant tumors those flaps are not always available because of nasal septum invasion. Minimally invasive pericranial flaps (PCF) are associated with minimal adverse effects and good cosmetic appearance. In spite of that, there are only a few reports of this reconstructive technic limited to short surgical series and radio-anatomical analysis. Clinical results of a surgical cohort are presented. Study Design: Cohort prospective study. Methods: Clinical data, including age, gender, stage, histopathological findings, rate of complications and appearance of PCF at fifth day and two months postoperative were recorded. Postoperative morbidities were recorded as wound abnormalities, nasosinusal, orbital and central nervous system complications. Chi-squared test was used to correlate qualitative variables and Student-t-test to correlated qualitative and quantitative variables. Items were considered statistically significant with a p value of less than 0.05 (confidence Interval of 95%). Results: Thirty patients (18 males and 12 females) were registered. Mean age was 51.5 years ± 23.0 and range between 20 and 71 years. Most common histologic subtypes were adenocarcinoma, epidermoid carcinoma and squamous cell carcinoma. Complete resection of the tumor was achieved in all patients including surgical margins. Length of the PCF varies between 9.9 cm and 13.9 cm with a mean of 11.8 cm. There was an association between length of the flaps and the covering structure with the nose apex relation. None patient experienced postoperative cerebrospinal fluid (CSF) leak, frontal sinusitis or other complications. Conclusions: Minimally invasive PCF constitute a good and inexpensive reconstructive option in patients with malignant anterior cranial base tumors in whose nasoseptal flap was not a feasible option.展开更多
Objective:According to the Global Burden of Disease Study,updated in 2018,headache disorders are the second leading cause in the world and impaired quality of life and lead to reduce daily activity and can be the caus...Objective:According to the Global Burden of Disease Study,updated in 2018,headache disorders are the second leading cause in the world and impaired quality of life and lead to reduce daily activity and can be the cause of headache-related disability.So,we desperately need to develop new painless and minimally invasive methods to facilitate diagnosis to improve the quality of headache care.Methods:Our study involved 92 participants over 18 years of age with a diagnosis of primary chronic headache.Among those,36 were with chronic tension type headache,26 were with a chronic migraine,and 30 were healthy participants.All patients were selected according to the criteria of the International Headache Society.Clinical questionnaires,instrumental data,and characteristics of headache episodes were collected from all participants.We evaluated the muscle activity of the pericranial and cervical muscles in patients with chronic headache to compare with healthy participants using Surface electromyography to determine if there is an alteration in muscle activity.Results:Surface electromyography data showed that there was a statistically significant difference in results between the target group and the control group,where patients with primary chronic headache had high amplitude and velocity in the studied muscles on the electromyogram.Among the participants,there was a difference in the intensity of headache attacks on the visual analog scale chronic tension type headache 5.2±1.4,chronic migraine 7.7±1.3,control group 1.6±0.7 and in the frequency of headache attacks per month chronic tension type headache 14.4±1.9,chronic migraine 17.3±2.9,the control group of participants had headache attacks of≤1 per month.Conclusion:We concluded that the patients with primary chronic headaches there are changes in the muscle activity of the pericranial and cervical muscles.In contrast to patients without chronic headaches,which,in turn,the method of surface electromyography may encourage further research in this area.展开更多
文摘Objectives/Hypothesis: The introduction of intranasal pedicled flaps has reduced the incidence of postoperative cerebrospinal fluid (CSF) leaks to less than 5%. Nevertheless, in malignant tumors those flaps are not always available because of nasal septum invasion. Minimally invasive pericranial flaps (PCF) are associated with minimal adverse effects and good cosmetic appearance. In spite of that, there are only a few reports of this reconstructive technic limited to short surgical series and radio-anatomical analysis. Clinical results of a surgical cohort are presented. Study Design: Cohort prospective study. Methods: Clinical data, including age, gender, stage, histopathological findings, rate of complications and appearance of PCF at fifth day and two months postoperative were recorded. Postoperative morbidities were recorded as wound abnormalities, nasosinusal, orbital and central nervous system complications. Chi-squared test was used to correlate qualitative variables and Student-t-test to correlated qualitative and quantitative variables. Items were considered statistically significant with a p value of less than 0.05 (confidence Interval of 95%). Results: Thirty patients (18 males and 12 females) were registered. Mean age was 51.5 years ± 23.0 and range between 20 and 71 years. Most common histologic subtypes were adenocarcinoma, epidermoid carcinoma and squamous cell carcinoma. Complete resection of the tumor was achieved in all patients including surgical margins. Length of the PCF varies between 9.9 cm and 13.9 cm with a mean of 11.8 cm. There was an association between length of the flaps and the covering structure with the nose apex relation. None patient experienced postoperative cerebrospinal fluid (CSF) leak, frontal sinusitis or other complications. Conclusions: Minimally invasive PCF constitute a good and inexpensive reconstructive option in patients with malignant anterior cranial base tumors in whose nasoseptal flap was not a feasible option.
文摘Objective:According to the Global Burden of Disease Study,updated in 2018,headache disorders are the second leading cause in the world and impaired quality of life and lead to reduce daily activity and can be the cause of headache-related disability.So,we desperately need to develop new painless and minimally invasive methods to facilitate diagnosis to improve the quality of headache care.Methods:Our study involved 92 participants over 18 years of age with a diagnosis of primary chronic headache.Among those,36 were with chronic tension type headache,26 were with a chronic migraine,and 30 were healthy participants.All patients were selected according to the criteria of the International Headache Society.Clinical questionnaires,instrumental data,and characteristics of headache episodes were collected from all participants.We evaluated the muscle activity of the pericranial and cervical muscles in patients with chronic headache to compare with healthy participants using Surface electromyography to determine if there is an alteration in muscle activity.Results:Surface electromyography data showed that there was a statistically significant difference in results between the target group and the control group,where patients with primary chronic headache had high amplitude and velocity in the studied muscles on the electromyogram.Among the participants,there was a difference in the intensity of headache attacks on the visual analog scale chronic tension type headache 5.2±1.4,chronic migraine 7.7±1.3,control group 1.6±0.7 and in the frequency of headache attacks per month chronic tension type headache 14.4±1.9,chronic migraine 17.3±2.9,the control group of participants had headache attacks of≤1 per month.Conclusion:We concluded that the patients with primary chronic headaches there are changes in the muscle activity of the pericranial and cervical muscles.In contrast to patients without chronic headaches,which,in turn,the method of surface electromyography may encourage further research in this area.
