Total laryngectomy involves removal of the entire larynx. It has historically been performed since 1866, with improvements over time such as the two-stage procedure developed by Gluck to reduce mortality rates. Today it is generally reserved for advanced laryngeal cancers with extensive spread. The procedure involves mobilizing neck structures like the strap muscles and thyroid gland, dissecting and removing the larynx, and closing the resulting pharyngeal defect. Complications can include issues with the skin flap, pharyngocutaneous fistula, tracheal stenosis, and endocrine abnormalities.
This is a presentation I used for my seminar on 'Phonosurgery' on 4th November, 2015. I hope they are useful to you. Constructive as well as Destructive criticism welcomed.
Maxillectomy and craniofacial resection Mamoon Ameen
all maxillectomy types in detail and maxillofacial resection ,indications ,contraindications ,preoperative asssessment and detail techniques and rehabilitations
Cavity obliteration is a procedure done at the end of Mastoidectomy to get a cavity-less mastoid cavity thus solving the problem of discharging post-operative cavity.
This is a presentation I used for my seminar on 'Phonosurgery' on 4th November, 2015. I hope they are useful to you. Constructive as well as Destructive criticism welcomed.
Maxillectomy and craniofacial resection Mamoon Ameen
all maxillectomy types in detail and maxillofacial resection ,indications ,contraindications ,preoperative asssessment and detail techniques and rehabilitations
Cavity obliteration is a procedure done at the end of Mastoidectomy to get a cavity-less mastoid cavity thus solving the problem of discharging post-operative cavity.
A tracheostomy is an opening (made by an incision) through the neck into the trachea (windpipe). A tracheostomy opens the airway and aids breathing.
A tracheostomy may be done in an emergency, at the patient’s bedside or in an operating room. Anesthesia pain relief medication may be used before the procedure. Depending on the person’s condition, the tracheostomy may be temporary or permanent
This presentation discusses oropharyngeal tumors and their management. It contains a few surgical video clippings embedded from my you tube uploads. If you get a security warning just give yes to view the video clipping. I assure you it is safe
This presentation provides insight into the unique software created using eiki engine. This is available in 2 flavors, one which runs right out of a pendrive the other one is installable using dvd media. This is an initiative of drtbalu's otolaryngology online
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. Actually
History
Performed
tracheostomy
● 1866 – Patrick watson credited with the first
laryngectomy
● 1873 – Billroth of Vienna performed total
laryngectomy on a pt with growth larynx
● Bottini of Turin has the longest surviving
record of a total laryngectomy pt – 10 yrs
3. History (Contd) Gluck's hypothesis
● Discovered 50% mortality rates when
laryngectomy pts were studied
● Suggested two stage procedure
● Stage I – Tracheal separation
● Stage II – Total laryngectomy – 2 weeks later
● This staging ensured that tracheo cutaneous
fistula healed before the actual laryngectomy
surgery
4. History (Contd) Sorenson's
contribution
● Sorenson was the
student of Gluck
● 1890 – He
popularized single
staged procedure
● Still practised
incision was first
conceived by him
5. Total laryngectomy not preferred?
● Organ preservation is the order of the day
● Partial laryngectomy and near total
laryngectomy are commonly performed
● Permanent tracheostomy is avoided
6. Indications
● Advanced laryngeal malignancies with
extensive cartilage destruction and extra
laryneal spread
● Involvement of posterior commissure / both
arytenoids
● Circumferential submucosal disease – with /
without vocal fold paralysis
● Subglottic extension to involve cricoid
cartilage
7. Indications (Contd)
● Completion procedure after failed partial
laryngectomy / irradiation
● Hypopharyngeal tumors originating /
spreading to post cricoid area
● Radiation necrosis of larynx unresponsive to
antibiotics / hyperbaric oxygen therapy
● Severe aspiration following partial / near total
laryngectomy
● Massive nodal metastasis
8. Selection criteria
● Pt should be fit for general anaesthesia
● Pt should be motivated for post surgical life
● Hands and fingers should be dexterous since
handling of tracheatosmy tubes need to be
done on a daily basis
● Positive biopsy
● Screening for metastasis
● Second primary to be ruled out in all these
cases
9. Air way assessment
● Pts with stridor should undergo preliminary
tracheostomy under LA
● Skin incision should be sited at the level of
future permanent tracheostome
● Bipedicled skin bridge between skin flap and
tracheostomy site should be avoided
10. Position
● Supine
● Mild extension of
neck
● Ryles tube to be
inserted prior to
surgery
11. Incision choice
● Whether pt has been irradiated / not
● Whether block neck dissection has been
planned along with total laryngectomy
12. Types of incision
● Gluck Sorenson
● Vertical
● Double horizontal
● Crile Y incision
● Low neck horizontal
13. Gluck Sorenson incision
● “U” shaped
● Stoma is incorporated into the incision
● Vertical Limb situated just medial to medial
border of sternomastoid muscle
● Highest limit is the mastoid process on both
sides
● Horizontal limb encircles tracheostome
14. Advantage of Gluck Sorenson
Incision
● Provides good exposure
● Three point junction is avoided
● Pharyngeal closure line is entirely within the
apron flap
● Since the plane of elevation is subplatysmal
the vascularity of the flap is not compromised
15. Flap elevation
● Flap is elevated in
the subplatysmal
plane and stitched
out of the way
● Anterior jugular vein
and Delphian node
is left undisturbed.
They can be
removed along with
specimen
17. Flap elevation (Contd)
● Medial border of sternomastoid identified on
each side
● General investing layer of cervical fascia is
incised vertically from the hyoid bone above
to the clavicle below
● Omohyoid muscle is divided at this stage
● This enables entry into the loose areolar
compartment of neck
18. Loose areolar compartment
Boundaries
● Laterally sternomastoid muscle and carotid
sheath
● Medially – visceral compartment of neck
containing pharynx and larynx
19. Division of strap muscles
● Muscles are divided
close to their sternal
margins
● Division of strap
muscles exposes
thyroid gland
20. Thyroid
● Total / hemithyroidectomy
● Massive midline / bilateral tumors – Total
thyroidectomy preferred
● Unilateral laryngeal tumors –
Hemithyroidectomy is preferred
21. Total thyroidectomy
● Middle thyroid vein secured
● Both superior and inferior thyroid vascular
pedicles
● Parathyroid glands should be preserved
22. Hemithyroidectomy
● On the side of preservation the superior
pedicle and middle thyroid vein alone are
clamped leaving the inferior pedicle intact
● One half of the thyroid gland is removed by
sectioning the isthumus
27. Suprahyoid dissection
● Hyoid bone is skeletonized
● Mylohoid, geniohyroid, digastric sling and
hyoglossus separated from hyoid from medial
to lateral
● Pharynx is entered and epiglottis is delivered
into the neck
● Sternohyoid and thyrohyoid muscle
attachments to the inferior border of hyoid
bone
29. Skeletonization of larynx
● Posterior border of thyroid cartilage is rotated
anteriorly
● Constrictor muscles released from superior
and inferior cornu by sharp dissection
● Laryngeal branch of superior thyroid artery
should be identified and ligated before it
penetrates the thyrohyoid membrane
30. Epiglottis delivery
High pharyngeal
entry is made
avoiding
preepiglottic space.
Epiglottis is
visualized
Surgeon moves to
head end and
grasps the epiglottis
with a forceps
32. Larynx removal
● From above downwards
● Epiglottis is held with a forceps and pulled
forwards
● Pharyngeal mucosa cut laterally with scissors
on both sides of epiglottis aiming towards the
superior cornua of thyroid cartilage
● Constrictor muscles are divided along the
posterior edge of thyroid cartilage
33. Pharyngeal cuts
● Lateral cuts are
joined by horizontal
● Horizontal cut is
given just below the
level of arytenoid
cartilages
● Larynx separated by
incising the tracheal
st
rings (between 1
and 2nd )
35. Pharyngeal closure
● Vertical
● T shaped closure (3 point junction) seen
● 3-0 vicryl is used
● Extramucosal connel suture is performed
● Suture knots should be inside
● Pharyngeal closure can be reinforced using
cervical fascia and muscle layers
38. Skin flap closure
● Skin flap is
repositioned
● Flap is sutured after
anchoring the
tracheostome
● Suction drain is
placed in the neck to
prevent hematoma
formation that could
compromise the flap