Publications by authors named "V Vlachopulos"

3 Publications

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RESULTS OF 15 YEARS OF COLLABORATION BETWEEN THE DEPARTMENTS OF OPHTHALMOLOGY AND STOMATOLOGY IN ONCOLOGICAL SURGERY OF THE ORBIT: A DIAGNOSTIC AND THERAPEUTIC APPROACH.

Cesk Slov Oftalmol 2020 ;76(4):146-157

Aim: To report an overview of the most frequent tumors of the orbit, suggest diagnostic approach and possible solution according to experience with own cohort of patients.

Material And Methods: From patients files from the Department of Ophthalmology and Department of Stomatology, First Medical Faculty, Charles University, and General Faculty Hospital in Prague, Czech Republic, there were selected patients, who underwent the surgery due to the suspicion of malignant development in the orbit during the period 2005 - 2019. From the surgical records we found information about 497 cases. At the Department of Stomatology, there were 282 surgeries under general anesthesia performed, and at the Department of Ophthalmology, there were 215 surgeries, mostly under local anesthesia performed.

Results: The number of surgeries in men and women was equal; patients of all ages were present. The median of patients age operated on at the Department of Stomatology was 53 years, and at the Department of Ophthalmology 63 years. The most common primary benign tumor was the cavernous hemangioma (9 %), the most common non-tumorous expansion was the dermoid cyst (7 %); the most common malignant tumor was the lymphoma (17,5 %). The last mentioned tumor was the most common diagnosis in the whole cohort as well.

Conclusion: Our cohort of patients is comparable with large cohorts published in the literature concerning age and gender distributions. Differences in frequencies of some lesions may be explained by that our cohort includes patients after the surgery only. The malignant lymphoma is the most common diagnosis indicated to surgical procedure, mostly biopsy. Comparing the two cohorts from our departments 20 years apart, the malignant lymphoma remains the most common indication for surgery, but the incidence of adenomas and adenocarcinomas of the lacrimal gland decreased. It is not the goal of this paper to evaluate all possible orbital affections. Suggested surgical approaches are just recommendations according to years of experience; however, in some situations, to choose an individual surgical approach is necessary.
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http://dx.doi.org/10.31348/2020/24DOI Listing
December 2020

External fixation greatly improves outcomes in the surgical treatment of osteoradionecrosis of the jaws without affecting quality of life: a five-year retrospective study.

Br J Oral Maxillofac Surg 2020 11 18;58(9):e45-e50. Epub 2020 Jun 18.

Department of Oral & Maxillofacial Surgery, First Faculty of Medicine, Charles University and the General University Hospital, Prague, Czech Republic.

Osteoradionecrosis of the jaw can be treated using both conservative treatment and surgery. External fixation may be used to bridge large resection defects after sequestrectomy for stabilisation and before secondary mandibular reconstruction. We designed a retrospective analysis of 70 patients with osteoradionecrosis treated between the years 2014 and 2018, and found that the use of external fixation greatly improves their outcomes. Patients were grouped according to Notani's classification: those who had Notani I disease were treated surgically but without external fixation; and those with Notani II and Notani III disease were eligible for external fixation. In those with Notani II disease, there was a significant reduction in the number of pathological fractures that occurred with external fixation. In those with Notani III disease, the success rate of primary sequestrectomy was only 1:14; however, those treated with external fixation all successfully healed after their first operation. It was hypothesised that although external fixation would improve outcome, it would come at a detriment to their quality of life (QoL). However, in a subset of these patients, we showed that in addition to increasing successful healing, patients' QoL with the external fixator was no worse than when they had an active osteonecrotic lesion. The treatment of osteoradionecrosis is cumbersome and advanced stages are associated with more complications. The use of an external fixator significantly reduces the probability of pathological fractures and increases the rate of successful healing in patients after mandibular resection. It does this without greatly interfering with patients' lives, while improving their condition sufficiently to allow for subsequent mandibular reconstruction.
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http://dx.doi.org/10.1016/j.bjoms.2020.05.031DOI Listing
November 2020

EVALUATION OF COMPLICATIONS AFTER ENDOSCOPY ASSISTED OPEN REDUCTION AND INTERNAL FIXATION OF UNILATERAL CONDYLAR FRACTURES OF THE MANDIBLE. RETROSPECTIVE ANALYSIS 2010-2015.

Acta Chir Plast Fall 2016;58(1):5-11

Background: The authors present their experience with endoscopy assisted open reduction and internal fixation of condylar fractures of the mandible. Their results are presented in a retrospective study of 33 patients with unilateral subcondylar fracture, who underwent a surgical procedure between 2010 and 2015. Reduction and fixation, stability of occlusion 12 months after the operation and also presence of complications were evaluated.

Results: Satisfactory reduction (anatomic or physiologic) was achieved in 31 patients. Stability of occlusion was worse in 1 patient (due to condylar absorption). Complications included mainly inflammatory complications (4 patients) and temporary paresis of the facial nerve (3 patients). Impaired function of temporomandibular joint was not reported in any of the patients.

Conclusion: Endoscopy assisted open reduction and internal fixation is an alternative to classical surgical procedures, however it requires special instrumentarium and experienced surgical team.
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April 2017