3 results on '"Reh DD"'
Search Results
2. Sinus surgery in patients with previously repaired cerebrospinal fluid leaks.
- Author
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Reh DD, Metson R, and Sindwani R
- Subjects
- Adult, Cerebrospinal Fluid Rhinorrhea diagnosis, Chronic Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Nasal Polyps diagnosis, Nasal Polyps surgery, Postoperative Complications diagnosis, Recurrence, Reoperation, Retrospective Studies, Skull Base surgery, Surgery, Computer-Assisted, Tissue Adhesions diagnosis, Tissue Adhesions surgery, Tomography, X-Ray Computed, Cerebrospinal Fluid Rhinorrhea surgery, Endoscopy, Postoperative Complications surgery, Rhinitis surgery, Sinusitis surgery
- Abstract
Objective: To explore surgical technique and outcomes of revision endoscopic sinus surgery (ESS) in patients with previously repaired cerebrospinal fluid (CSF) leaks., Design: A case series of 13 patients with previously repaired iatrogenic CSF leaks who underwent revision ESS for recurrent sinus disease; a review of the preoperative workup, intraoperative findings, and postoperative outcomes., Setting: Two academic medical centers., Patients: Patients were included if they had a history of previously repaired skull base defect and iatrogenic CSF leak in the vicinity of the planned revision ESS., Interventions: Revision ESS was performed in the vicinity of the previously repaired CSF leak. Dissection was carefully performed to avoid a recurrent CSF leak., Main Outcome Measures: Preoperative workup, intraoperative findings, surgical technique, and complications were reviewed., Results: The study population consisted of 7 men and 6 women. Surgical navigation was used for all cases. Intrathecal fluorescein was not used in any case. In no instances was an active preexisting CSF leak identified or a new leak created. No minor or major postoperative complications arose in any of the study patients. All patients were discharged home within 24 hours. The mean (SD) follow-up was 26.0 (16.7) months., Conclusions: Previous skull base injury with CSF leak is not a contraindication to revision ESS. Safe ESS in this setting can be performed and may be recommended to such patients with symptomatic recurrence of their sinus disease. more...
- Published
- 2008
- Full Text
- View/download PDF
Catalog
3. Effect of celecoxib on fasciocutaneous flap survival and revascularization.
- Author
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Wax MK, Reh DD, and Levack MM
- Subjects
- Animals, Celecoxib, Male, Rats, Rats, Sprague-Dawley, Anti-Inflammatory Agents, Non-Steroidal pharmacology, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Dermatologic Surgical Procedures, Fascia blood supply, Fasciotomy, Ischemia prevention & control, Pyrazoles pharmacology, Pyrazoles therapeutic use, Skin blood supply, Sulfonamides pharmacology, Sulfonamides therapeutic use, Surgical Flaps, Tissue Survival drug effects
- Abstract
Objectives: To study the effect of celecoxib (Celebrex; Pfizer, Cambridge, Mass) on (1) primary ischemic time and (2) revascularization of fasciocutaneous free flaps in a rat model., Methods: In the ischemia study, 50 male Sprague-Dawley rats were divided into 2 groups of 25 rats each, a control group and a celecoxib group. Five rats in each treatment group were exposed to ischemic times of 4, 6, 8, 10, and 12 hours. Survival of the flap was assessed 7 days after reversal of the ischemia. Probit curves and the critical ischemic time were calculated. In the revascularization study, 30 male Sprague-Dawley rats were divided into 2 groups of 15 rats each. One group was fed celecoxib, while the other was fed a normal diet. All rats had a 3 x 6-cm fasciocutaneous flap based on the inferior epigastric artery elevated and exposed to 2 hours of primary ischemia. The flap was then sutured back into the wound bed. Each of these groups was then divided into 3 groups of 5 rats whose pedicles were divided on postoperative day 5, 6, or 7. Percentage survival of the flap was measured 7 days later. In both parts of the study, the experimental group was fed celecoxib, 1500 ppm, throughout the interoperative period. In each animal, a 3 x 6-cm ventral fasciocutaneous groin flap based on the left superficial epigastric artery was elevated., Results: In the ischemia study, respective flap survival rates from the control and celecoxib groups at the various ischemic times were as follows: 4 hours, 100% and 100%; 6 hours, 80% and 100%; 8 hours, 80% and 80%; 10 hours, 60% and 60%; and 12 hours, 20% and 10%. The median lethal ischemic times were 9.7 and 9.6 hours, respectively. There was no statistical difference in flap survival between the celecoxib and control groups. In the revascularization study, ligation of the flap pedicle on day 5, 6, or 7 did not result in any difference in the percentage of flap survival among the 3 groups., Conclusion: Celecoxib appears to have no deleterious effect on free tissue transfer survival or healing, as evidenced by revascularization in a fasciocutaneous free flap model. more...
- Published
- 2007
- Full Text
- View/download PDF
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