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"clinical-techniques"
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A novel chairside technique to assess the interocclusal clearance and abutment axial walls during tooth preparation
The importance of a judicious and unerring abutment tooth preparation in the field of prosthodontics has always been paramount. It is not uncommon for many clinicians to face challenges during laboratory fabrication of fixed prostheses, caused due to inappropriate occlusal clearance and over axial wall taper of the abutment tooth. With evolving technologies and methods, the modus operandi for attaining such tooth preparation is varying; however, every technique has its own shortcomings. The technique mentioned in the article is cost-effective as it uses modified Heister mouth gag forceps to achieve the desired objective of evaluating the prepared abutment morphology three-dimensionally with minimum chairside time.
Journal Article
Using the facial grimace scale to evaluate rabbit wellness in post-procedural monitoring
Rabbits are commonly used in biomedical research and might undergo potentially painful procedures during the course of a study. This column discusses the rabbit facial grimace scale as a tool for monitoring post-procedural pain and explains how it can be incorporated into a worksheet for evaluating rabbit wellness.
Journal Article
Transoral Chondrolaryngoplasty: Scarless Reduction of the Adam’s Apple
The purpose of our study is to test the feasibility of transoral thyroid chondrolaryngoplasty using a similar approach to transoral thyroidectomy. This approach would allow for gender-affirming surgery while avoiding an external neck scar. We carried out our cadaveric feasibility study in an anatomy laboratory at an academic center. Five fresh cadavers were used for this study. We used a lower oral vestibular incision, along with retractors and an endoscope to dissect and gain access to the laryngeal prominence of the thyroid cartilage. Portions of the laryngeal prominence were then removed using scissors to achieve a satisfactory neck contour. Endoscopic as well as extracorporeal photographs were taken to demonstrate the approach. We were able to remove the laryngeal prominence successfully in all of our cadaveric specimens with this transoral approach.
Journal Article
Denture tracker for edentulous Alzheimer's patients
Dementia in Alzheimer's disease complicates the caregivers in tracking the patients. Many options are discussed in the literature. A novel technique is essential to improve the quality of life and to assist in locating the patients. The Global Position System (GPS) trackers are attached to dentures and the movements are observed through a mobile application. This technique discusses on a simple method of tracking Alzheimer's edentulous patients with the support of removable dentures. Denture tracking devices are a secured form of tracking patients. A GPS device in dentures assists in locating the patient's movement and supports the caretakers.
Journal Article
Fashioned Mucoperichondrium Flap Technique in Caudal Septal Deviation
Caudal septal dislocation is a common finding, and it could lead to functional as well as aesthetic morbidity. There are different techniques to support the anterior end of the nasal septum and stabilize it in midline position. There are technical and practical difficulties in those techniques. This study describes a newly fashioned mucoperichondrium flap technique in caudal septal dislocation. This study was done in 40 patients (29 male and 11 female) with a mean (SD) age of 25 (3.2) years who had symptomatic septal deviation with minor and moderate caudal septal dislocation. The mucoperichondium flap on the side of the columellar dislocation was fashioned to be straight and stretched by excision of the extra length. It acted as a supporting scaffold for the straightened septum to be secured and fixed in the midline without need of any stabilizing sutures. All the patients had satisfactory functional and cosmetic results with correction of the columellar dislocation.
Journal Article
Techniques in Otolaryngology: Ultrasound-Guided Transcervical Fine-Needle Aspiration of Laryngeal Masses
Traditionally, laryngeal masses are diagnosed with direct laryngoscopy with biopsy under general anesthesia. The use of transcervical ultrasound–guided fine-needle aspiration for the diagnosis of base of tongue lesions, thyroid nodules, and cervical lymph node metastases has been well documented, and its use in the diagnosis of laryngeal masses has increased in recent years. We report a technique for office-based transcervical ultrasound–guided fine-needle aspiration for laryngeal masses without cervical metastasis (N0), with outcomes from 6 patients. Benefits of this approach included limited side effects, rapid in-office diagnosis, avoidance of aerosolizing procedures during the COVID-19 pandemic, and avoidance of tracheostomy.
Journal Article
Endoscopic Transoral Image-Guided Retrieval of Infratemporal Fossa Foreign Bodies
Removal of foreign bodies from the infratemporal fossa is surgically challenging and fraught with risks. This report describes our experience with a minimally invasive transoral technique, utilizing endoscopic and image guidance technology, for retrieval of infratemporal fossa foreign bodies in 6 patients. The technique was successfully applied in all cases with identification and retrieval of the foreign bodies, which included 4 hypodermic needles broken off during dental injections, a cottonoid surgical sponge lost during a facial fracture repair, and a maxillary molar displaced during attempted extraction. Complications were limited to transient postoperative lingual and inferior alveolar nerve sensory deficits in 1 patient.
Journal Article
Endoscopic Inside-Out Mastoidectomy with the Ultrasonic Bone Aspirator
We report our experience using the ultrasonic bone aspirator (UBA) for transcanal endoscopic “inside out” mastoidectomy. The UBA has irrigation, suction, and nonrotatory ultrasonic bone-removing technology in 1 handpiece, which makes it appropriate for bone removal during this procedure. The results of our study show that this technique is safe and effective for patients with cholesteatoma in a small sclerotic mastoid. We also discuss the nuances associated with using the UBA during endoscopic ear surgery.
Journal Article
Bilayer Graft for Incisionless In-Office Endoscopic Repair of Tympanic Membrane Perforations: A Pilot Study
Tympanic membrane (TM) perforations may result in significant patient morbidity. While intraoperative myringoplasty or tympanoplasty allow for effective repair, not all patients are candidates for general anesthesia. Herein, we describe a novel graft design and technique for in-office repair of TM perforations in the clinic setting. Two pieces of porcine submucosa material were interdigitated to create a bilayer design with lateral and medial flanges. Topical and injected lidocaine were used for local anesthesia. The perforation was rimmed. Grafts were grasped, and medial flanges were placed through the perforation, with lateral flanges resting on the TM surface. TM repair occurred in 5 awake patients with a mean age of 72 years. There were no complications. All perforations healed, with 1 case requiring a minor in-office revision. Audiometry was performed at 4 weeks. The preoperative air-bone gap (mean 0.25, 0.5, 1, 2, and 4 kHz) was 12.2 ± 4.1 dB, and postoperatively, it was 4.2 ± 2.4 dB (P = .001). Novel design of available graft material may allow for effective in-office TM repair.
Journal Article