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Takakura H, Tachino H, Takii K, Imura J, Shojaku H. Localized Amyloidosis of the Nasal Mucosa: A Case Report and Review of the Literature. Front Surg 2021; 8:774469. [PMID: 34805263 PMCID: PMC8602088 DOI: 10.3389/fsurg.2021.774469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022] Open
Abstract
Amyloidosis is a disorder of protein folding in which various proteins automatically aggregate into a highly abnormal fibrillar conformation. Amyloidosis is classified into systemic and localized forms depending on whether the abnormal proteins deposited in several different organs or only a single organ. In localized amyloidosis of the head and neck regions, laryngeal amyloidosis is common; however, localized amyloidosis of the nose is extremely rare. We herein report a case of localized amyloidosis of the nose and review the relevant literature on localized sinonasal amyloidosis. A 41-year-old man presented with a history of severe nasal obstruction, which had persisted for two decades. Nasal endoscopy and imaging studies showed extensive thickening of the bilateral nasal mucosa and diffuse submucosal deposition of calcification. After histopathological and systemic examinations, he was diagnosed with localized amyloidosis of the nasal mucosa. Septoplasty and bilateral inferior turbinoplasty, which consisted of mucosal resection using an ultrasonic bone curette, was performed and his symptoms markedly improved. Localized sinonasal amyloidosis has a good prognosis and surgical resection should be selected as a first-line treatment; however, clinicians should recognize the high probability of recurrence.
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Affiliation(s)
- Hiromasa Takakura
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hirohiko Tachino
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Kouji Takii
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Johji Imura
- Department of Diagnostic Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - Hideo Shojaku
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
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Wen BT, Chen ZQ, Sun CG, Jin KJ, Zhong J, Liu X, Tan L, Yang P, le G, Luo M. Three-dimensional navigation (O-arm) versus fluoroscopy in the treatment of thoracic spinal stenosis with ultrasonic bone curette: A retrospective comparative study. Medicine (Baltimore) 2019; 98:e15647. [PMID: 31096488 PMCID: PMC6531158 DOI: 10.1097/md.0000000000015647] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Three-dimensional intraoperative navigation (O-arm) has been used for many years in spinal surgeries and has significantly improved its precision and safety. This retrospective study compared the efficacy and safety of spinal cord decompression surgeries performed with O-arm navigation and fluoroscopy. The clinical data of 56 patients with thoracic spinal stenosis treated from March 2015 to April 2017 were retrospectively analyzed. Spinal decompression was performed with O-arm navigation and ultrasonic bone curette in 29 patients, and with ultrasonic bone curette and fluoroscopy in 27 patients. Patients were followed-up at postoperative 1 month, 3 months, and the last clinic visit. The neurologic functions were assessed using the Japanese Orthopaedic Association (JOA) Back Pain Evaluation Questionnaire. The accuracy of screw placement was examined using three-dimensional computed tomography (CT) on postoperative day 5. There was no significant difference in the incidences of intraoperative dural tear, nerve root injury, and spinal cord injury between the two groups. The two groups showed no significant difference in postoperative JOA scores (P > .05). The O-arm navigation group had significantly higher screw placement accuracy than the fluoroscopy group (P < .05). O-arm navigation is superior to fluoroscopy in the treatment of thoracic spinal stenosis with ultrasonic bone curette in terms of screw placement accuracy. However, the two surgical modes have similar rates of intraoperative complications and postoperative neurologic functions.
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Affiliation(s)
- Bing-Tao Wen
- Department of Orthopedics, Peking University International Hospital
| | - Zhong-Qiang Chen
- Department of Orthopedics, Peking University International Hospital
| | - Chui-Guo Sun
- Department of Orthopedics, Peking University Third Hospital, Beijing
| | - Kai-Ji Jin
- Department of Orthopedics, Peking University International Hospital
| | - Jun Zhong
- Department of Orthopedics, Peking University International Hospital
| | - Xin Liu
- Department of Orthopedics, Peking University International Hospital
| | - Lei Tan
- Department of Orthopedics, Peking University International Hospital
| | - Peng Yang
- Department of Orthopedics, Peking University International Hospital
| | - Geri le
- Department of Orthopedics, Peking University International Hospital
| | - Man Luo
- Department of Orthopedics, Guangxi International Zhuang Medicine Hospital, Nanning, Guangxi, China
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Takami M, Nagatal K, Yamada H. Microendoscopic Surgery with an Ultrasonic Bone Curette for a Patient with Intraforaminal Stenosis of the Lumbar Spine Due to an Ossification Lesion: A Technical Case Report. J Orthop Case Rep 2018; 8:57-60. [PMID: 29854695 PMCID: PMC5974679 DOI: 10.13107/jocr.2250-0685.998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: We present a rare case with radiculopathy resulting from intraforaminal stenosis of the lumbar spine due to an ossification lesion. Microendoscopic surgery was chosen because of two strong advantages. One was the ease to reach the nerve foramen and ossification lesion and the other was the non-invasiveness at the posterior supporting structures of the spine. Moreover, an ultrasonic bone curette developed for microendoscopic spine surgery was applied. This is the first detailed case report of microendoscopic surgery using an ultrasonic bone curette for a patient with radiculopathy due to intraforaminal free ossification. Case Report: A 49-year-old woman born in Japan had complained of severe left leg pain for over 7 months in spite of conservative treatment including selective nerve root block. There was no lumbago, muscle weakness, or loss of sensation in her leg. Plain radiography revealed spondylolytic spondylolisthesis classified as Grade II at L4-L5, but there was no instability on dynamic assessment. Computed tomography (CT) showed a free ossification lesion in the foramen at L4-L5. Considering a diagnosis of left L4 radiculopathy due to the free ossification, ossification resection and nerve decompression were performed with posterior spinal microendoscopic surgery using an ultrasonic bone curette. A tubular retractor was introduced into the extraforaminal zone using Wiltse approach. After a part of the ossification lesion and the nerve root were exposed, an ultrasonic bone curette was applied to remove the ossification mass. After decompression, the nerve root was found to be relaxed. The surgical time was 83 min, and blood loss was 5 g. According to the Japanese Orthopedic Association scoring system, her score improved from 21/29 preoperatively to 29/29 postoperatively, and the full score was maintained at the final observation. Post-operative CT revealed the absence of an ossification lesion. Conclusions: For a rare case with radiculopathy resulting from intraforaminal stenosis of the lumbar spine due to an ossification lesion, microendoscopic surgery with an ultrasonic bone curette was very effective. The use of ultrasonic bone curette is easy and safe in microendoscopic surgery and it helps achieve less invasiveness and ideal decompression, without injuring the nerve root.
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Affiliation(s)
- Masanari Takami
- Department of Orthopaedic Surgery, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, Japan.,Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Japan
| | - Keiji Nagatal
- Department of Orthopaedic Surgery, Shingu Municipal Medical Center, 18-7 Hachibuse, Shingu, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama, Japan
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Li Y, Wang H, Cui W, Li C, Zhou P, Zhang Y. [Application of ultrasonic bone curette in posterior cervical single open-door laminoplasty]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2017; 31:683-689. [PMID: 29798649 DOI: 10.7507/1002-1892.201702002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective To investigate the safety and reliability of ultrasonic bone curette in posterior cervical single open-door laminoplasty. Methods The clinical data were retrospectively analyzed, from 193 patients who underwent single open-door laminoplasty (C 3-7) from January 2012 to January 2016. The patients were divided into three groups according to different instruments: posterior single open-door laminoplasty was performed with ultrasonic bone curette in 61 cases (group A), with bite forceps in 73 cases (group B), and with micro-grinding drill in 59 cases (group C). There was no significant difference in gender, age, the course of disease, underlying disease and preoperative Japanese Orthopedic Association (JOA) score, visual analogue scale (VAS) between groups ( P>0.05). The operative time, intraoperative blood loss, drainage volume at 48 hours, JOA score, improvement rate, VAS and perioperative com-plication were compared. Results The operative time, intraoperative blood loss, and drainage volume at 48 hours of group A were significantly less than those in groups B and C ( P<0.05), but there was no significant between groups B and C ( P>0.05). The follow-up time was 12-21 months (mean, 14.6 months) in group A, 24-36 months (mean, 27.5 months) in group B, and 28-47 months (mean, 38.1 months) in group C. There were no cerebrospinal fluid leakage and incision infection in three groups. No complications of internal fixation loosening and rupture occurred during the follow-up. Rediating pain occurred in 6 cases of group A, 8 cases of group B, and 6 cases of group C, and was cured at 1 week after dehydration and physical therapy. No nerve root palsy was found in three groups. Fracture of portal axis occurred in 5 cases (7 segments) of group B and was fixed by micro titanium plate. The JOA score and VAS score at last follow-up were significantly improved when compared with preoperative scores in three groups ( P<0.05); there was no significant difference in JOA score and improvement rate and VAS score between groups ( P>0.05). Conclusion It is safe and reliable to use the ultrasonic bone curette in posterior cervical single open-door laminoplasty. It can shorten the operative time and has similar clinical curative effect to the traditional operation, and the lateral rotation of the lamina can be avoided.
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Affiliation(s)
- Yuwei Li
- Department of Spine Surgery, the First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000,
| | - Haijiao Wang
- Department of Spine Surgery, the First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000, P.R.China
| | - Wei Cui
- Department of Spine Surgery, the First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000, P.R.China
| | - Cheng Li
- Department of Spine Surgery, the First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000, P.R.China
| | - Peng Zhou
- Department of Spine Surgery, the First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000, P.R.China
| | - Yonghui Zhang
- Department of Spine Surgery, the First Affiliated Hospital of Luohe Medical College, Luohe Henan, 462000, P.R.China
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Rastelli MM, Pinheiro-Neto CD, Fernandez-Miranda JC, Wang EW, Snyderman CH, Gardner PA. Application of ultrasonic bone curette in endoscopic endonasal skull base surgery: technical note. J Neurol Surg B Skull Base 2014; 75:90-5. [PMID: 24719795 DOI: 10.1055/s-0033-1354580] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2013] [Accepted: 07/01/2013] [Indexed: 10/25/2022] Open
Abstract
Background Endoscopic endonasal surgery (EES) of the skull base often requires extensive bone work in proximity to critical neurovascular structures. Objective To demonstrate the application of an ultrasonic bone curette during EES. Methods Ten patients with skull base lesions underwent EES from September 2011 to April 2012 at the University of Pittsburgh Medical Center. Most of the bone work was done with high-speed drill and rongeurs. The ultrasonic curette was used to remove specific structures. Results All the patients were submitted to fully endoscopic endonasal procedures and had critical bony structures removed with the ultrasonic bone curette. Two patients with degenerative spine diseases underwent odontoid process removal. Five patients with clival and petroclival tumors underwent posterior clinoid removal. Two patients with anterior fossa tumors underwent crista galli removal. One patient underwent unilateral optic nerve decompression. No mechanical or heat injury resulted from the ultrasonic curette. The surrounding neurovascular structures and soft tissue were preserved in all cases. Conclusion In selected EES, the ultrasonic bone curette was successfully used to remove loose pieces of bone in narrow corridors, adjacent to neurovascular structures, and it has advantages to high-speed drills in these specific situations.
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Affiliation(s)
- Milton M Rastelli
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Carlos D Pinheiro-Neto
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Juan C Fernandez-Miranda
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Eric W Wang
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Carl H Snyderman
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States ; Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Paul A Gardner
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
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Matsuoka H, Itoh Y, Numazawa S, Tomii M, Watanabe K, Hirano Y, Nakagawa H. Recapping hemilaminoplasty for spinal surgical disorders using ultrasonic bone curette. Surg Neurol Int 2012; 3:70. [PMID: 22754735 PMCID: PMC3385071 DOI: 10.4103/2152-7806.97542] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 04/02/2012] [Indexed: 11/21/2022] Open
Abstract
Objective: The authors present a novel method of the recapping hemilaminoplasty in a retrospective study of patients with spinal surgical disorders. This report describes the surgical technique and the results of hemilaminoplasty using an ultrasonic bone curette. The aim of this study was to examine the safety and effectiveness of the hemilaminoplasty technique with ultrasonic bone curette. Methods: Between April 2003 and July 2011, 33 patients with various spinal diseases (17 spinal tumors, 5 dural arteriovenous fistulas, 3 syringomyelia, 2 sacral perineural cysts, and 2 arachnoid cysts) were treated microsurgically by using an ultrasonic bone curette with scalpel blade and lightweight handpiece. The ultrasonic bone curette was used for division of lamina. After resection of the lesion, the excised lamina was replaced exactly in situ to its original anatomic position with a titanium plate and screw. Additional fusion technique was not required and the device was easy to handle. All patients were observed both neurologically and radiologically by dynamic plain radiographs and computed tomography (CT) scan. Results: The operation was performed successfully and there were no instrument-related complications such as dural laceration, nerve root injury, and vessels injury. The mean number of resected and restored lamina was 1.7. CT confirmed primary bone fusion in all patients by 12 months after surgery. Conclusion: The ultrasonic bone curette is a useful instrument for recapping hemilaminoplasty in various spinal surgeries. This method allows anatomical reconstruction of the excised bone to preserve the posterior surrounding tissues.
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Affiliation(s)
- Hidenori Matsuoka
- Department of Neurosurgery, Southern TOHOKU General Hospital, Southern TOHOKU Research Institute for Neuroscience, Japan
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Abstract
OBJECTIVES Orbitofrontal fibrous dysplasia often involves the bony orbit and optic canal. Although fibrous dysplasia reportedly produces compression of the optic nerve leading to visual disturbances, optic nerve decompression in patients without clinical signs of optic neuropathy remains controversial. We describe the recent development of surgical techniques and equipment for optic nerve decompression in orbitofrontal fibrous dysplasia. METHODS Optic nerve decompression was performed prophylactically for five patients and therapeutically for one patient using the transcranial extradural route. A high-speed drill and continuous suction-irrigation system has been used in five patients since 1998, and an ultrasonic bone curette in two patients since 2004. RESULTS The continuous suction-irrigation system was particularly effective for decreasing heat transfer and thus preventing thermal injury to the optic nerve from the high-speed drill. The ultrasonic bone curette was also effective, allowing bone removal with minimal pressure from the tip of the handpiece and without catching cotton pledgets or damaging surrounding tissues. Orbital dystopias and craniofacial deformities induced by fibrous dysplasia were also successfully corrected. Postoperatively, disturbance in visual function was present in only two patients. Mean follow-up period was 4.9 years. CONCLUSIONS This equipment may contribute to the development of new modalities for optic nerve decompression in orbitofrontal fibrous dysplasia.
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Affiliation(s)
- Takumi Abe
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan
| | - Kaneshige Satoh
- Department of Plastic Surgery, Showa University School of Medicine, Tokyo, Japan
| | - Akira Wada
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan
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