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Acoustic analysis and perceptual assessment of voice was performed in only 1 study. No complication from any procedure was mentioned in any of the studies. Outcome of treatment was mentioned in 1 study, whereby after 4.5 months of follow-up, 68% of children showed improvement in symptoms.

Current evidence shows that there is strong relation between reflux and dysphonia in children. PRGL493 Most common laryngoscopic findings suggestive of reflux includes interarytenoid erythema and edema, vocal cord erythema and edema and postglottic edema.

Current evidence shows that there is strong relation between reflux and dysphonia in children. Most common laryngoscopic findings suggestive of reflux includes interarytenoid erythema and edema, vocal cord erythema and edema and postglottic edema.

The aim of this study was to compare radiofrequency ablation (RFA), diode laser, and microdebrider-assisted inferior turbinoplasty (MAIT) in the treatment of chronic nasal obstruction in a one-year follow-up, and to pay special attention to the effect of the procedures on the contractility capacity of the inferior turbinates.

The patients filled a Visual Analogue Scale (VAS) questionnaire regarding nasal symptoms pre- and postoperatively. Saccharin transit time (STT) evaluation and acoustic rhinometry were also performed. A total of 77 patients attended the one-year control visit and had technically reliable acoustic rhinometry results.

All the examined techniques decreased the VAS score for the severity of nasal obstruction statistically significantly. There was no deterioration found in the symptoms of crusting, nasal discharge, and sneezing, nor in mucociliary function in any of the groups. All the three techniques increased the non-decongested total V2-5cm values and decreased the decongested total d technique.

To improve the lymph node dissection as well as protect parathyroid gland and recurrent laryngeal nerve, the carbon nanoparticles and intraoperative neuromonitoring were applied in papillary thyroid microcarcinoma surgery.

Carbon nanoparticles and intraoperative neuromonitoring were used in the experimental group, whereas the control group were not. Routine pathological examination was performed.

The lymph nodes dissected was significantly higher in the experimental group, but the metastatic lymph nodes were not. The number of mistakenly dissected parathyroid gland and postoperative hypoparathyroidism were 3 and 13 in the experimental group respectively, significantly less than 10 and 25 in the control group. The incidences of overall, transient and persistent recurrent laryngeal nerve palsy in the experimental group were 5.5%, 5.5% and 0% respectively, whereas in the control group were 8.6%, 6.9% and 1.7%.

Carbon nanoparticles can improve lymph node dissection in papillary thyroid microcarcinoma surgery, and the combination of carbon nanoparticles with intraoperative neuromonitoring can reduce surgical complications and improve patient quality of life.

Carbon nanoparticles can improve lymph node dissection in papillary thyroid microcarcinoma surgery, and the combination of carbon nanoparticles with intraoperative neuromonitoring can reduce surgical complications and improve patient quality of life.

Warthin-like variant of Papillary thyroid carcinoma (WLPTC) is an uncommon variant of PTC. They resemble Warthin tumour of salivary gland. Microscopically the tumour shows presence of papillae lined by oncocytic cells with typical nuclear features of PTC. The stalks of papillae were filled up with lymphoplasmacytic cells. WLPTC have good prognosis.

A 45-year-old lady presented with thyromegaly. She underwent total thyroidectomy with bilateral selective neck dissection (level II - level VI). Her final histopathology report was WLPTC, Right lobe with lymph nodal metastasis. Post-operatively, she received I131 radio-iodine therapy. She is under follow-up for last four years and is doing well.

Diagnosing WLPTC, a rare variant of PTC can be challenging. Definitive diagnosis helps in management.

Diagnosing WLPTC, a rare variant of PTC can be challenging. Definitive diagnosis helps in management.

Intussusception usually occurs in the paediatric population. When it occurs in the adult population, it is normally caused by a malignant intraluminal pathology.

A 72-year-old female presented to us with right-sided abdominal pain for 3 weeks, associated with vomiting and diarrhoea. She had an appendectomy done 30 years ago and a recent myocardial infarction. Abdominal examination revealed a previous appendectomy scar and tenderness over the right lumbar region. Computed tomography showed ileocaecal intussusception. Right hemicolectomy with a double barrel stoma was performed as she was unstable intraoperatively. Histopathological examination of the tumour showed a well-differentiated neuroendocrine tumour. Subsequent PET scan showed no systemic disease and a reversal of the stoma was done. She remained disease free for a year.

Our patient had undergone a right hemicolectomy despite the high risk of mortality, as there is a high chance of malignancy. Double barrel stoma was done, as she was unstable intraoperatively. Fortunately, she recovered well and had her stoma reversed without any further recurrence of her disease.

Adult patients who present with intussusception should be managed with resection, as there is a high possibility of a malignancy. Early resection should be planned to prevent further spread of the tumour.

Adult patients who present with intussusception should be managed with resection, as there is a high possibility of a malignancy. Early resection should be planned to prevent further spread of the tumour.

Congenital urethrocele is a rare disease in children. The diagnosis is often easy but the management remain difficult due to the risk of urethral stenosis form.

We report a case of a 19-month-old child presenting with a penoscrotal mass. link2 Cystourethroscopy confirmed the diagnosis of an urethrocele of the anterior urethra. link3 Urethrocele repair was performed with good results. We propose to discuss clinical, paraclinical and therapeutic characteristics of congenital urethrocele in children.

An early, precise diagnosis and awareness of the anterior urethral diverticulum in boys with obstructive symptoms can reduce incidence of advanced uropathies.

An early, precise diagnosis and awareness of the anterior urethral diverticulum in boys with obstructive symptoms can reduce incidence of advanced uropathies.

Adolescent idiopathic scoliosis (AIS) can lead to severe deformity. However, early detection and treatment can prevent its progression. Surgical instrumentation for scoliosis treatment has evolved from Harrington instrumentation to pedicle screws. However, there are still some concerns about the efficacy and long-term effects of pedicle screw fixation, and the clinical and radiographic outcomes of surgical treatment for severe AIS (>90°) by posterior spinal fusion alone need to be established.

Eight patients with severe and rigid idiopathic scoliosis were recruited for this study. All surgeries were performed by one senior spine surgeon between 2015 and 2018. Free hand technique, intraoperative neurophysiologic monitoring (IONM), and intraoperative fluoroscopy to assess the screw position was performed.

Severe scoliosis results in a complex three-dimensional spinal deformity that often requires correction in multiple planes. Mean major coronal correction rate was 67% (45-80%). No major complications occurred during the perioperative period and after one year follow up.

Pedicle screws provide three-dimensional deformity correction. There were no complications other than the low-grade late implant-associated infections. Posterior spinal fusion with pedicle screw-only instrumentation obtains a good and stable correction for severe scoliosis.

Pedicle screws provide three-dimensional deformity correction. There were no complications other than the low-grade late implant-associated infections. Posterior spinal fusion with pedicle screw-only instrumentation obtains a good and stable correction for severe scoliosis.

Enema examination is considered safe, but in rare cases, complications may result. Here, we report a rare case of iatrogenic bowel perforation during enema examination through a colostomy without leakage of contrast agent.

A 36-year-old man who had undergone a sigmoid loop colostomy was diagnosed with ulcerative colitis. A bowel enema through a colostomy was performed by nurses and radiological technologists. During the procedure, a balloon catheter was inserted into the proximal lumen of the colostomy, and the balloon was inflated. The patient developed severe abdominal pain a few minutes following withdrawal of the catheter. Computed tomography showed intraperitoneal free air, although contrast agent leakage into the intraperitoneal cavity was not observed. The patient underwent emergency laparotomy. Intraoperatively, there was a 3-cm bowel perforation just inside the colostomy where the inflated balloon was pressing.

The perforation site may have been sealed by the inflated balloon during the enema examination. In addition, the patient maintained a supine position during and after the examination. This led to contrast agent accumulating on the dorsal side and not leaking out from the perforation site after the balloon was deflated.

Iatrogenic bowel perforation can occur without leakage of contrast agent during enema examination through a colostomy, and the examination should be performed under the supervision of an attending doctor. In the case of an enema examination through a colostomy, clinicians must be aware of the possibility of bowel perforation even if leakage of contrast agent is not observed.

Iatrogenic bowel perforation can occur without leakage of contrast agent during enema examination through a colostomy, and the examination should be performed under the supervision of an attending doctor. In the case of an enema examination through a colostomy, clinicians must be aware of the possibility of bowel perforation even if leakage of contrast agent is not observed.

A congenital diaphragmatic hernia (CDH) is rarely diagnosed in adults and can allow passage of abdominal viscera into the chest cavity. A particularly rare association is a wandering spleen due to absence of its diaphragmatic and retroperitoneal attachment which predisposes to elongation of the vascular pedicle with risk of torsion, infarction and rupture.

A 17-year-old girl presented with a two-day history of increasing abdominal pain. Examination identified an abdominal mass. Computer tomography (CT) chest, abdomen and pelvis revealed a significantly enlarged wandering spleen with signs of torsion and an associated large left CDH with viscera in the chest cavity. The patient proceeded to an open splenectomy and repair of CDH. Post-operatively the patient developed ileus and required a temporary chest tube for pneumothorax, but otherwise progressed well.

Untreated CDH with a symptomatic wandering spleen is an extremely rare diagnosis with only one similar previous case report. Clinical detection is unlikely, making CT scanning the diagnostic test of choice. Surgery is recommended given the high morbidity and mortality of associated complications of both conditions. Splenic preserving options are favoured, however the majority of identified cases require splenectomy because of associated torsion or splenomegaly. Reduction of the CDH should be performed with primary closure of the defect and mesh reinforcement where possible.

CDH with associated wandering spleen in adults presents an extremely rare but clinically important diagnosis. Prompt surgical management as reported in this case should be performed to minimise immediate and future complications.

CDH with associated wandering spleen in adults presents an extremely rare but clinically important diagnosis. Prompt surgical management as reported in this case should be performed to minimise immediate and future complications.

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