Successful Treatment of Tracheal Stenosis with Slide Tracheoplasty after the Failure of Resection with End-to-End Anastomosis

The combined effects of inhaled irritant gases and heat in burn patients can result in the development of laryngotracheal strictures. Several factors could adversely affect the development of tracheal stenosis and cause the growth of granulation tissue. Yet the current treatment options for this condition are limited because of the paucity of case reports. We report here on a case of a patient who experienced recurrent upper tracheal stenosis after an inhalation injury. She displayed repetitive symptoms of stenosis even after several laryngomicrosurgeries and resection with end-to-end anastomosis. Finally, 5 yr after the burn injury, slide tracheoplasty was successfully performed and the postoperative check-up findings and the increased airway volume seen on imaging were all satisfactory

The morphometry of soft tissue insertions on the tibial plateau: Data acquisition and statistical shape analysis

This study characterized the soft tissue insertion morphometrics on the tibial plateau and their inter-relationships as well as variabilities. The outlines of the cruciate ligament and meniscal root insertions along with the medial and lateral cartilage on 20 cadaveric tibias (10 left and 10 right knees) were digitized and co-registered with corresponding CT-based 3D bone models. Generalized Procrustes Analysis was employed in conjunction with Principal Components Analysis to first create a geometric consensus based on tibial cartilage and then determine the means and variations of insertion morphometrics including shape, size, location, and inter-relationship measures. Step-wise regression analysis was conducted in search of parsimonious models relating the morphometric measures to the tibial plateau width and depth, and basic anthropometric and gender factors. The analyses resulted in statistical morphometric representations for Procrustes-superimposed cruciate ligament and meniscus insertions, and identified only a few moderate correlations (R 2: 0.37-0.49). The study provided evidence challenging the isometric scaling based on a single dimension frequently employed in related morphometric studies, and data for evaluating cruciate ligament reconstruction strategies in terms of re-creating the native anatomy and minimizing the risk of iatrogenic injury. It paved the way for future development of computer-aided personalized orthopaedic surgery applications improving the quality of care and patient safety, and biomechanical models with a better population or average representation

Protection of the Medial Femoral Condyle Articular Cartilage During Drilling of the Femoral Tunnel Through the Accessory Medial Portal in Anatomic Anterior Cruciate Ligament Reconstruction

Accurate positioning of the femoral tunnel in the native femoral anterior cruciate ligament (ACL) footprint requires drilling through an accessory medial portal (AMP). The AMP is located far medial and at a low level. Despite the benefits of drilling through the AMP, it is possible that the drill bit head will injure the articular cartilage of the medial femoral condyle as it slides along the guide pin to the femoral insertion of the ACL. Because more surgeons are now performing anatomic ACL reconstructions and shifting from transtibial drilling toward transportal drilling, the risk of this injury might be increasing, especially during the beginning of their learning curve. To avoid such injury, a bio-interference screw sheath is used. It is inserted through the AMP over the guide pin until it reaches near the medial wall of the lateral femoral condyle. The drill bit is inserted over the guide pin and through the bio-interference screw sheath. Using the bio-interference screw sheath not only protects the articular cartilage of the medial femoral condyle but also protects the medial meniscus, posterior cruciate ligament, and skin of the AMP from injury because of the close proximity of the drill bit head to these structures during transportal drilling

Canal Transportation and Centring Ratio of Paediatric vs Regular Files in Primary Teeth

Background: During mechanical preparation of the primary root canal, the original anatomy of the tooth should be preserved and the instrument should be perfectly balanced centrally into the canal space for reducing the probability of canal transportation. The aim of this research was to compare canal transportation and canal centring ability in primary root canals using ProTaper Next (Dentsply Mailfair,), AF baby (Fanta), and Kidzo Elephant (Endostar, Poldent Sp.) files. Materials and methods: Eighteen root canals were randomly divided into 3 experimental groups (n = 6 in each group). Instrumentation was performed using ProTaper Next, Fanta AF baby, and Kidzo Elephant files in groups 1, 2, and 3, respectively. During the instrumentation procedure, the irrigation of 2 mL of 1.5% sodium hypochlorite between each file was done, followed by 5 mL of 17% ethylenediaminetetraacetic acid as a final irrigating solution. Cone-beam computed tomography images were obtained before and after instrumentation. Each group was evaluated for transportation and centring ratios. Results: On comparing all the tested groups within each root canal level canal transportation, the results revealed a statistically nonsignificant difference in the buccolingual direction (P > 0.05). Meanwhile, in the mesiodistal direction, group 1 showed a statistically highly significant difference compared to groups 2 and 3 at the cervical level (P 0.05). Regarding the centring ability comparison of the 3 groups within each root canal level, there was a statistically nonsignificant difference amongst all groups (P > 0.05) in both buccolingual and mesiodistal directions. Conclusions: The ProTaper Next regular rotary file and the paediatric rotary files showed no difference in canal transportation and centring ability in the buccolingual direction, while in the mesiodistal direction at the cervical root canal level, the ProTaper Next showed high transportation liability

Effect of formaldehyde inhalation on rabbit nasal mucosa: a light microscopic study—an animal model for inhalational irritants on nasal mucosa

Abstract Background Formaldehyde is associated with many adverse health effects and is classified as a human carcinogen. Formaldehyde is highly water-soluble and readily absorbed and metabolized by the respiratory mucosa upon inhalation. The histopathological effects of formaldehyde on the nasal mucosa and olfactory nerves in adult New Zealand white rabbits were studied to validate this animal model of inhalational irritants. Results Compared to control group 1 (exposed to air), groups 2 and 3 (exposed to formaldehyde for 90 min and 210 min, respectively) exhibited disrupted nasal tissue, ulcerated epithelial coverings, markedly dilated blood vessels, and increased numbers of inflammatory cells in the lamina propria. The olfactory neuro-epithelium exhibited a reduction in the number of cilia. Many sustentacular cells lost their microvilli. Olfactory nerves exhibited nerve bundle shrinkage within the perineural sheath, leaving an empty space with evidence of edema within the nerve fibers. Conclusion Formaldehyde inhalation has destructive effects on the nasal mucosa and olfactory nerves in adult New Zealand white rabbits. These results validate the use of this animal model to assess the effects of inhalational irritants on the nasal mucosa