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Vassilios A Lachanas

Publications and source records attributed to Vassilios A Lachanas.

18 recordsLinked to original sources
PubMed2006

Osteoid osteoma of the ethmoid bone associated with dacryocystitis.

BACKGROUND: Osteoid osteomas (OO) are small, benign osteoblastic lesions. Ethmoid bone OO has been very rarely reported so far. CASE PRESENTATION: We report a case of a 16-year-old boy suffering from persistent epiphora and a mild pain in the area of median canthus, due to a bone density mass within the right ethmoid air cells extending to the ipsilateral right orbit. The mass was removed via an external ethmoidectomy approach. Histopathologic examination of the specimen set the diagnosis of OO. One year after the operation the patient is free of symptoms, while no recurrence occurred. CONCLUSION: A case of ethmoid bone OO associated with dacryocystitis is reported. Although benign and rare, OO should be considered in differential diagnosis of the ethmoid bone osteoblastic lesions.

Adolescent↗
PubMed2006

Thermal welding versus bipolar tonsillectomy: a comparative study.

OBJECTIVE: To compare thermal welding tonsillectomy (TWT) with bipolar electrocautery tonsillectomy (BET) procedure. STUDY DESIGN AND SETTING: A prospective randomized study was conducted on 150 consecutive adult patients undergoing tonsillectomy. Indications included chronic tonsillitis and obstructive sleep apnea syndrome. Exclusion criteria included peritonsillar abscess history, bleeding disorders, and any other procedure together with tonsillectomy. Patients were randomly assigned to TWT or BET groups. Intraoperative bleeding, operative time, postoperative pain, complication rates, and return to normal diet were evaluated. RESULTS: In the TWT group there was no measurable intraoperative bleeding, while mean bleeding for BET group was 16 mL. No significant difference regarding mean operative time was noticed. Mean postoperative pain score and mean time for return to normal diet were significantly lower in the TWT group. Primary hemorrhage occurred in 1 subject of the BET group. Secondary postoperative hemorrhage was noticed in 1 subject of the TWT group and 3 subjects of the BET group. CONCLUSION: Thermal welding tonsillectomy procedure provides sufficient hemostasis, lower postoperative pain, and quick return to normal diet. EBM RATING: A-1b.

Adolescent↗
PubMed2006

Radiofrequency myringotomy with the topical use of mitomycin C: an experimental study.

OBJECTIVE: To assess the use of radiofrequency myringotomy in combination with mitomycin C as an alternative myringotomy technique on rabbits. STUDY DESIGN: Experimental animal research protocol. SETTING: University of Crete, School of Medicine, Medical Experimental Education and Research Center. METHODS: Radiofrequency myringotomies were performed under general anesthesia on both ears of 20 rabbits. Mitomycin C (0.3 mg/ml) pledgets were applied in the right ears (study group) and saline pledgets in the left ears (control group). Animals were monitored using otomicroscopy weekly until myringotomy closure. Kaplan-Meier survival techniques were used to compare myringotomy patency time between the two sides. INTERVENTION: Radiofrequency myringotomy under general anesthesia on both ears of 20 rabbits. MAIN OUTCOME MEASURE: Myringotomy patency time. RESULTS: The mean patency time of the study group was 5.45 weeks (95% confidence interval, 5.185-5.715 weeks). The mean patency rate for the control side was 1.60 weeks (95% confidence interval, 1.38-1.82 weeks). The Breslow (generalized Wilcoxon) test showed the study group to have significantly longer patency of radiofrequency myringotomy than the control group (p<0.0001). CONCLUSION: The patency period of radiofrequency myringotomy was not long enough to be proposed as an alternative to the insertion of ventilation tubes, although mitomycin C had a significant adjunct effect in prolonging the patency rate of radiofrequency myringotomy on rabbits.

Administration, Topical↗
PubMed2006

Comparative study of laser versus radiofrequency myringotomy in rabbits: The effectiveness of mitomycin C application.

OBJECTIVE: To compare laser-assisted tympanostomy (LAT) with radiofrequency myringotomy (RFM), as well as the effectiveness of mitomycin C (MC) on the above techniques, in rabbits. STUDY DESIGN: Experimental animal research protocol. SETTING: University of Crete, School of Medicine, Medical Experimental Education and Research Center. METHODS: Bilateral myringotomies were performed under general anesthesia on 40 rabbits. LAT was performed on 20 animals (40 ears) and RFM on the remaining 20 animals (40 ears). MC (0.3 mg/mL) pledgets were applied to the right ears and saline pledgets to the left ears. Animals were monitored weekly using otomicroscopy until myringotomy closure. Kaplan-Meier survival techniques were used to compare myringotomy patency times. INTERVENTIONS: Under general anesthesia, bilateral LAT was performed on 20 rabbits and bilateral RFM on 20 rabbits. MAIN OUTCOME MEASURES: Myringotomy patency time. RESULTS: The mean patency times of the saline-treated ears were: 1.85 weeks (95% confidence interval [CI], 1.556-2.144 wk) for the LAT group and 1.70 weeks (95% CI, 1.494-1.906 wk) for the RFM group. This difference was not significant (p > 0.5). MC application significantly prolonged mean patency time (p < 0.0001) in both LAT and RFM groups. The mean patency times in the MC-treated ears were 5.45 weeks (95% CI, 5.226-5.674 wk) for the LAT group and 5.55 weeks (95% CI, 5.285-5.815 wk) for the RFM group. This difference was not significant (p > 0.5). CONCLUSION: There is no significant difference in myringotomy patency times between LAT and RFM techniques in rabbits, whereas MC significantly prolongs the patency rate of either technique.

Animals↗
PubMed2005

Tonsillectomy using the thermal welding system.

OBJECTIVE: To evaluate and introduce a new method of tonsillectomy using the Thermal Welding System (TWS). METHOD: The TWS is a new surgical instrument which uses direct heat and pressure to seal and divide tissues. Fifty consecutive patients underwent tonsillectomy with the use of the TWS. Inclusion criteria were chronic tonsillitis, peritonsilar abscess history and obstructive sleep apnea syndrome. Patients undergoing adenoidectomy or any other procedure together with tonsillectomy and patients with bleeding disorders were excluded. Intraoperative bleeding, operative time, complication rates and return to normal diet were evaluated. RESULTS: There was no measurable bleeding during surgery in any case. No postoperative hemorrhage or other complication occurred. Mean operative time was 23 min. Mean time for return to normal diet was 8.7 days. CONCLUSIONS: The TWS was found quite effective and safe, providing sufficient hemostasis and minimal intraoperative blood loss.

Adolescent↗
PubMed2005

Symptomatic epilepsy due to a huge frontal sinus mucocele. A case report.

We report the case of a 57-year-old man complaining of headaches and adult onset seizures. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a process which proved to be a huge frontal sinus mucocele, eroding the posterior wall of the frontal sinus and compressing the left frontal lobe. An osteoplastic flap procedure with cranialization and obliteration of the frontal sinus was performed. The seizures and headache disappeared postoperatively. Clinical manifestations, diagnosis and surgical approaches for grand frontal sinus mucoceles are briefly discussed.

Epilepsy↗
PubMed2005

Tonsillectomy using the Ligasure vessel sealing system. A preliminary report.

OBJECTIVE: To evaluate and introduce a new method of tonsillectomy with the use of Ligasure vessel sealing system (LVSS) in pediatric population. METHOD: A prospective study was conducted on children undergoing tonsillectomy with the use of LVSS. Indications included chronic tonsillitis, peritonsilar abscess history, and obstructive sleep apnea syndrome. Patients undergoing adenoidectomy, or any procedure together with tonsillectomy, and patients with bleeding disorders were excluded. Among the available head-pieces, the 'Precise' instrument was used, both as haemostatic and dissection tool. Intraoperative bleeding, operative time, and complication rates, were evaluated. RESULTS: Our series consisted of 83 children among 103 patients undergone LVSS tonsillectomy. There was no measurable bleeding during surgery in any of the cases. In 18 children limited peritonsilar edema was noticed. No postoperative hemorrhage or other complication occurred. Mean operative time was 16 min. CONCLUSIONS: LVSS was found quite effective and safe, providing sufficient haemostasis, minimal intraoperative blood loss, and safety against the variant Creutzfeld-Jakob disease transmission.

Adolescent↗
PubMed2005

The use of Ligasure Vessel Sealing System in thyroid surgery.

OBJECTIVES: To evaluate the role of Ligasure Vessel Sealing System (LVSS) (Valleylab, Boulder, CO) in thyroid surgery, with emphasis given to the duration of the procedure, as well as potential relevant postoperative complications. STUDY DESIGN AND SETTINGS: A prospective study was conducted from November 1, 2002 to October 31, 2003, on patients undergoing thyroid surgery with the use of LVSS device as the primary means of ligation. All patients' records were placed in a database. Efficacy of hemostasis, operation time, and postoperative complications were assessed. RESULTS: were compared with previous surgical procedures done by our team when the LVSS was not available. RESULTS: LVSS proved effective in providing ligation and hemostasis during thyroid surgery in 72 consecutive patients. There was a mean reduction in operating time of 23 minutes compared with previous surgical thyroid procedures. Transient hypocalcaemia occurred in 4 subjects (5.55%); one incidence of transient paresis of the recurrent laryngeal nerve was also observed. CONCLUSION: LVSS proved quite a reliable and safe device in thyroid surgery; it provided sufficient hemostasis and reducing operative time.

Equipment Design↗
PubMed2005

The use of the Ligasure Vessel Sealing System in parotid gland surgery.

OBJECTIVE: To evaluate the role of the Ligasuretrade mark Vessel Sealing System (LVSS; Valleylab, Boulder, CO) in parotid surgery. STUDY DESIGN: A prospective study was conducted on 12 consecutive patients undergoing superficial parotidectomy, performed by using the LVSS device as the primary means of ligation. Inclusion criteria included parotid mass with no preoperative suspicion of malignancy, and no extension to the deep lobe of the parotid gland. Efficacy of hemostasis, cut-closure time, and postoperative complications were assessed. Results were compared with a historical control group, including cases on which the LVSS was not available. RESULTS: LVSS proved effective in providing ligation and hemostasis. There was a mean time gain of 52 minutes, compared with our historical control group. No postoperative bleeding, seroma, salivary fistula, or Frey syndrome were observed. One case of transient facial weakness occurred, which was completely resolved within 6 months. CONCLUSION: LVSS is a safe device for parotid gland surgery, providing sufficient hemostasis and reducing operative time. EBM RATING: B-2.

Blood Loss, Surgical↗
PubMed2005

Laser-assisted tympanostomy in pediatric patients with serous otitis media.

OBJECTIVES: To evaluate prognostic factors related with cure rate, in pediatric patients with serous otitis media treated with laser-assisted tympanostomy without ventilation tubes, in a single institution. PATIENTS AND METHOD: The procedure was performed on 124 ears in 88 individuals, from 3 to 14 years old. External auditory canal anatomy, type of anesthesia, tympanic membrane and middle ear fluid characteristics, myringotomy size, and laser parameters, in relation to cure rate, were accordingly studied. RESULTS: The overall cure rate by ear at the end of the 2-month follow-up period was 54.83%, whereas 45.17% still suffered from otitis media. Multivariate statistical analysis demonstrated that the presence of a thick tympanic membrane is significantly correlated with pure outcome in children with serous otitis media, when laser-assisted tympanostomy without ventilation tubes is performed favoring a worse cure rate (P < 0.023). Other parameters did not statistically correlate with the outcome. A 41% parental dissatisfaction rate was noticed. CONCLUSION: This study addresses selection bias for children with serous otitis media, candidates for laser-assisted tympanostomy. These are related to the duration of serous otitis media, the condition of middle ear mucosa, the thickness of the tympanic membrane, the type of anesthesia, and the cost of laser apparatus. There is likely to be a causal relationship between outcome and tympanic membrane appearance in children undergoing laser-assisted tympanostomy.

Adolescent↗
PubMed2005

Implications of laser assisted tympanostomy in adults.

OBJECTIVES: To assess outcome in adult individuals undergoing laser-assisted tympanostomy without ventilation tube placement. STUDY DESIGN: Case series with 2-month follow-up. SETTING: Faculty practice, research protocol, tertiary care academic medical center. PATIENTS AND METHOD: Laser-assisted tympanostomy was performed on a total of 142 ears (108 individuals). Indications included serous otitis media with effusion (66 ears/47 patients), functional eustachian tube dysfunction (48 ears/36 patients), acute otitis media (19 ears/16 patients), and endoscopic visualization of the middle ear (9 ears/9 patients). INTERVENTION: The laser-assisted tympanostomy procedure is performed with a CO2 laser under local anesthesia on an outpatient basis. MAIN OUTCOME MEASURES: Patency time of the tympanostomy, presence of fluid after the closure of the tympanostomy, tympanometry and tone audiometry findings, relief of symptoms. RESULTS: Middle ear disease was resolved after the closure of tympanostomy in 47.9% of patients with serous otitis media with effusion. In 79.1% of patients with functional eustachian tube dysfunction, symptoms were diminished. All patients with acute otitis media had a satisfactory outcome. Laser-assisted tympanostomy was found to be quite helpful in patients undergoing middle ear endoscopy. CONCLUSIONS: Laser-assisted tympanostomy without ventilation tubes provides a safe alternative surgical option in adult patients in certain cases. The selection criteria for this procedure are addressed in detail.

Acute Disease↗
PubMed2005

Ligasure versus cold knife tonsillectomy.

OBJECTIVE: To assess parameters related to ligasure tonsillectomy (LT) versus cold knife tonsillectomy (CKT) procedure. STUDY DESIGN: Prospective randomized study. METHODS: A prospective study was conducted on 200 consecutive adult patients undergoing tonsillectomy. Indications included chronic tonsillitis and obstructive sleep apnea syndrome. Patients undergoing adenoidectomy, or any procedure together with tonsillectomy, and patients with peritonsillar abscess history or bleeding disorders were excluded. Patients were randomly assigned to either the LT or CKT group. Intraoperative bleeding, operative time, postoperative pain using a visual analogue scale, and complication rates were evaluated. RESULTS: The LT and CDT groups consisted of 108 and 92 individuals, respectively. In the LT group, there was no measurable intraoperative bleeding, whereas mean bleeding for CKT group was 125 mL. The mean operative time was 15 +/- 1.43 minutes for the LT group and 21 +/- 1.09 minutes for the CKT group (P < .001). The overall mean pain score for the LT group was 3.63, whereas for the CKT group it was 5.09 (P < .001). Primary hemorrhage occurred in one subject of the CKT group. Secondary postoperative hemorrhage was noticed two subjects of the LT group and two subjects of the CKT group. In 21 subjects of the LT group, limited peritonsillar edema was noticed. No other complication occurred in both groups. CONCLUSION: LT procedure provides sufficient hemostasis, lower postoperative pain, and reduced operative time, as well as safety against Creutzfeld Jakob disease transmission.

Adolescent↗
PubMed2005

Benign paroxysmal positional vertigo: 10-year experience in treating 592 patients with canalith repositioning procedure.

OBJECTIVE: To assess the long-term efficacy of canalith repositioning procedure (CRP) in the treatment of patients with benign paroxysmal positional vertigo (BPPV). BACKGROUND: Alternative theories for the pathophysiology of BPPV have been redefined in the past few years. CRP is considered to be the standard technique for its management. However, long-term follow-up results have been minimally reported in the literature. PATIENTS/METHODS: Five hundred ninety-two patients, 290 (49%) men and 302 (51%) women, were enrolled in this prospective study; their ages ranged from 18 to 84 (mean 59) years. At the time of their first examination, patients reported the duration of symptoms varied from 1 day to 18 months. Inclusion criteria were patient history compatible with BPPV and positive provocative maneuver (either Dix-Hallpike or Roll test). A variant of Epley and Barbeque maneuver was used. The Epley maneuver was used for posterior and anterior canal involvement, and "Barbeque roll" was used for horizontal canal involvement. Short-term follow-up was obtained 48 hours and 7 days after initial treatment, whereas long-term follow-up was obtained at repeated 6 month intervals. RESULTS: The posterior semicircular canal was involved in 521 (88%) patients treated, whereas the horizontal and anterior semicircular canals were involved in 59 (10%) and 12 (2%) patients, respectively. Symptoms subsided immediately in 497 (84%) patients. In 77 (13%) patients, the Dix-Hallpike maneuver remained positive after 48 hours, and CRP was performed again. Patients' mean follow-up was 46 months; 544 (92%) of 592 patients treated reported no symptoms of vertigo. CONCLUSION: Our data, based on long-term follow-up, suggest that CRP remains an efficient and long-lasting noninvasive treatment for BPPV.

Adolescent↗
PubMed2005

Bilateral nasolabial cysts associated with recurrent dacryocystitis.

OBJECTIVE: Nasolabial cysts are rare, nonodontogenic, soft-tissue, developmental cysts occurring inferior to the nasal alar region. They are thought to arise from remnants of the nasolacrimal ducts and they are frequently asymptomatic. We report a rare case of bilateral nasolabial cysts accompanied by bilateral chronic dacryocystitis. CASE REPORT: A 48-year-old woman suffering from bilateral chronic dacryocystitis was referred to our department for endonasal dacryocystorhinostomy. She had undergone external dacryocystorhinostomy on the left side a few years earlier. Physical examination and computed tomography scan revealed nasolabial cysts bilaterally inferior to the nasal alar region. The cysts were removed via a sublabial approach and endoscopic dacryocystorhinostomy was performed on the right side. Ten months after surgery, the patient was asymptomatic. CONCLUSION: There may be a correlation, due to embryological reasons, between the presence of nasolabial cysts and the presence of chronic dacryocystitis. Both can be corrected surgically, under the same anaesthesia, without visible scar formation.

Chronic Disease↗
PubMed2004

Cocaine flakes versus tetracaine/adrenaline solution for local anaesthesia in septoplasty.

The aim of this prospective study was to evaluate the efficacy of cocaine flakes compared to tetracaine with adrenaline solution, as a local anaesthetic for patients undergoing septoplasty. From January 2001 to December 2002, 220 patients underwent septoplasty under local anaesthesia. Patients were randomly classified in group A and group B, where cocaine and the solution of tetracaine/adrenaline were used respectively. A visual analogue scale was used to evaluate the severity of the patients'pain during the procedure. The patients of group B showed a statistically significant lower pain score than patients of group A. We believe that the solution of tetracaine/adrenaline is an effective and safe anaesthetic for patients undergoing septoplasty under local anaesthesia.

Adolescent↗
PubMedDate not supplied

The use of tetracaine 0.25% solution in nasal packing removal.

BACKGROUND: The aim of this study was to evaluate efficacy of Merocel nasal package rehydration with tetracaine 0.25% solution, in reducing discomfort of nasal packing removal after septoplasty. METHODS: A prospective study was conducted on patients undergoing pure septoplasty. Merocel packing was applied in each side and kept for 2 days postoperatively. Merocel was rehydrated before removal, with 4 mL of saline on one side and 4 mL of tetracaine 0.25% solution on the other side. Patients were asked to evaluate severity of pain during nasal packing removal on each side by a visual analog scale. Patients' data, pain score, and potential complications were placed in a database and statistically assessed. RESULTS: Our series consisted of 141 persons. Statistical analysis showed significant lower pain score in favor of the tetracaine group. No tetracaine complications or side effects occurred. CONCLUSION: Merocel packing rehydration with tetracaine 0.25% solution is an easy, safe, inexpensive, and effective analgesia method for nasal packing removal in septoplasty.

Adolescent↗