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Real-time sonographic display of caudal spinal anomalies.

Real-time computerized ultrasonography with 3.5 and 5.0 MHz sector and linear array transducers (Acuson) depicts spinal anatomy and pathology more clearly than was possible with previous ultrasonic equipment. Split screen (dual image) techniques display increased lengths of spine in a single image. Articulated arm, B-mode sonography remains useful for older patients in whom the pathology lies far from the transducer and in a few post-operative patients in whom dense scar frustrates real-time examination. Sonography is a very useful screening tool for subcutaneous pathology, meningoceles and lipomas, but, thus far, has failed to demonstrate consistently the presence of hydromyelia, intracanalicular (epi)dermoid tumors and dermal sinus stalks ascending toward conus medullaris.

Child↗

A prospective search for congenital dermal abnormalities of the craniospinal axis.

Nineteen-hundred and ninety-seven consecutive term newborn infants were examined for cutaneous abnormalities of the craniospinal axis. Fifty-eight of the neonates (3%) had one or more abnormalities. The major findings included 28 (1.4%) deep dimples; 23 (1.2%) presumed sinuses; six (0.3%) skin tags,and one nodular mass. Fifty children were seen in follow-up at 4 to 12 months; in 40 infants the initial major finding persisted unchanged. Surgery has been performed on five children. One dermal sinus was found to terminate at the dura, three sinuses terminated at the coccyx, and a skin tag was associated with a fibrous band that extended to the coccyx. The management of congenital dermal sinuses is discussed.

California↗

Has packing sinus wounds become a ritualistic practice?

Wound healing is both a science and an art, and modern advances in wound management are ensuring that advanced clinicians use both clinical knowledge and experience when deciding on wound dressings and therapies. When there is a lack of evidence, then selection of dressings or therapies becomes extremely difficult and inappropriate treatment can occur. This is generally the situation with sinus wounds. There is very little evidence available to help decide on suitable dressings for these intractable wounds. The use of high frequency ultrasound (HFU) can help to guide practice on whether or not to pack sinus wounds. This article will explore the potential of ultrasound use by describing a case study of a patient with a sinus wound where HFU was used to examine the sinus and inform the practitioners on the appropriate choice of wound dressing.

Aged↗

[Recurrent meningitis. Description of a case in a girl with dermal sinus].

The authors describe a case of recurrent meningitis in a child with a dermal sinus. All the conditions causing this severe pathology are considered, particularly those in the pediatric age. The surgical treatment of the congenital malformation gave a complete resolution of the recurrent infections.

Anti-Bacterial Agents↗

Midline cutaneous and spinal defects. Midline cutaneous abnormalities associated with occult spinal disorders.

Failure of separation of the neuroectoderm from the epithellal ectoderm to proceed in an orderly and complete fashion results in a wide variety of defects involving the skin, spinal cord, and cauda equina, as well as the surrounding structures of mesodermal origin. Congenital dermal sinuses occur most commonly in the lumbosacral region, are usually associated with a spina bifida, and may connect the skin directly to the spinal canal. Epidermoid or dermoid cysts may form at any point along a dermal sinus. Four types of cutaneous or subcutaneous abnormalities commonly seen associated with occult spinal disorders are abnormal hair, angioma, lipoma, and dimple. It is essential that these lesions are investigated at an early age, since surgical excision may prevent future neurologic deficits.

Adolescent↗

[Wound care management of ulceration in a palliative care patient].

The wound care management of a palliative care patient with sinusitis pinoidalis is documented. The treatment is validated by the expert's opinion. There is only little evidence-based treatment of such a lesion. In our experience, photo documentation is helpful in decision-making during the treatment process. In addition, healing of larger defects seems to improve upon frequent and extensive liquid cleansing.

Abscess↗

Pilonidal sinotomy with radiofrequency.

Pilonidal disease is most conveniently treated with sinotomy. A modified approach to the procedure, using radiofrequency technique, is described. The modification resulted in reduced hospital stay, less postoperative pain, early resumption to work and a reduced recurrence rate. The technique and results are described and discussed.

Catheter Ablation↗