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141. Preoperative ultrasound for the diagnosis of thyroglossal duct cysts: A validation study. (PubMed)

Preoperative ultrasound for the diagnosis of thyroglossal duct cysts: A validation study. To evaluate the use of ultrasound to distinguish between thyroglossal duct cysts (TGDC) and dermoid cysts (DC) for surgical planning. To validate the SIST (septae + irregular wall + solid components = TGDC) scoring system proposed by Oyewumi et al. [1].This was a retrospective chart review of pediatric patients with midline neck masses who presented between the years of 2005 and 2014 and underwent

2019 International Journal of Pediatric Otorhinolaryngology

142. Atypical thyroglossal duct cyst with intra-laryngeal and para-glottic extension. (PubMed)

Atypical thyroglossal duct cyst with intra-laryngeal and para-glottic extension. Thyroglossal duct cysts (TDC) are the most common congenital neck masses. Although they are anatomically closely related to the larynx, intra-laryngeal extension is very rare. We present a case, review the literature and discuss the challenges of intra-laryngeal TDC. A 55-year-old man presented with a neck mass associated with dysphagia. Computer Tomography neck scan showed a midline cyst extending to the pre (...) -epiglottic space with partial obliteration of the right pyriform sinus and narrowing of the larynx. The cyst was excised en-bloc via Sistrunk procedure. Intra-laryngeal TDC are surgically challenging due to risk of perforation into the aerodigestive tract.Copyright © 2019 Elsevier Inc. All rights reserved.

2019 American Journal of Otolaryngology

143. Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining. (PubMed)

Preventing Restenosis of Marsupialized Rathke Cleft Cysts Using a Nasoseptal Flap Lining. Rathke cleft cysts (RCCs) are rare, benign lesions formed from remnants of Rathke pouch during embryologic development. However, following marsupialization, maintaining tract patency remains a challenge. Several techniques for decreasing stenosis have been described, including free mucosal grafting, silastic spacing, and using steroid-eluting stents. Nasoseptal flaps (NSFs) have a reliable vascular supply (...) symptomatic control, surgical complications, and RCC cavity patency.Seven patients underwent RCC marsupialization with no intraoperative cerebrospinal fluid leak, followed by circumferential lining of the marsupialized cavity with an NSF. In each case, no cyst re-accumulation or recurrent symptoms were noted, and the NSF lining provided long-term patency of the tract in all cases to a mean of 6.7 ± 10.1 months of follow-up, including one patient with sustained patency at 29 months follow-up.Utilization

2019 Laryngoscope

144. Laparoscopic management for aberrant hepatic duct in children with choledochal cysts. (PubMed)

Laparoscopic management for aberrant hepatic duct in children with choledochal cysts. The aim of the current study is to evaluate efficacy of laparoscopic treatment for aberrant hepatic duct (AHD) in children with cholecochal cysts (CDC).CDC children with AHDs who successfully underwent laparoscopic ductoplasties and hepaticojejunostomies between October 2001 and October 2017 were reviewed. The AHD variations were categorized into four subtypes and the surgical management varied according (...) patients with giant cysts had fluid collections, and were cured by drainages. One patient encountered duodenal injury at perforation site, and underwent laparoscopic repair. None of the patients had anastomotic stenosis, bile leak, cholangitis, intrahepatic reflux, pancreatic leak, pancreatitis, Roux-loop obstruction, or adhesive intestinal obstruction. Postoperative liver function tests and serum amylase level normalized within 1 year.Recognition and treatment based on different subtypes of AHDs

2019 Surgical endoscopy

145. The histopathological correlation of Bosniak 3 cyst sub-classification. (PubMed)

The histopathological correlation of Bosniak 3 cyst sub-classification. To evaluate the histopathological correlation of recently described subclassification of Bosniak category 3 cysts (3s and 3n).A total of 106 patients who underwent partial/radical nephrectomy due to a complex renal cyst (≥Bosniak 3) were retrospectively reviewed. All the scans of the patients were reevaluated by two experienced uroradiologists. Bosniak 3 cysts were reclassified as 3n (nodularity on the cyst wall/septae (...) ) and 3s (septated cysts without nodularity) as described in a recently published paper. Group 1 consisted of patients with Bosniak 3s, Group 2 consisted of patients with Bosniak 3n and Group 3 consisted of patients with Bosniak 4 cysts. Three groups were compared according to patients characteristics, radiological findings, histopathological results and survival outcomes.There were 52 patients in Bosniak 3 group and 54 patients in Bosniak 4 group. Mean follow up was 35.3 months. Among Bosniak 3 cysts

2019 Urology

146. An animal model of cutaneous cyst development enables the identification of three QTLs including the homologue of a human locus (TRICY1). (PubMed)

An animal model of cutaneous cyst development enables the identification of three QTLs including the homologue of a human locus (TRICY1). Using inbred BN and LE/Stm rats susceptible and resistant, respectively, to chemically induced cutaneous cyst development we were able to further unveil the genetic architecture of inherited multiple cyst formation. N-methyl-N-nitrosourea-treated (BN x LE) F2 intercross rats proved to develop differential numbers of cutaneous cysts, demonstrating epidermal (...) , trichilemmal and verrucous keratinization types. Male rats developed significantly more cysts per animal than females. QTL interval mapping yielded three loci on rat chromosomes 1, 8 and 11 (Ccd1, Ccd2, Ccd3) linked to cutaneous cyst formation. Ccd2 proved to be homologous to the human TRICY1 region which could further be narrowed down by genome comparison in both species. It contains 11 genes with evidence of expression in human keratinocytes.Copyright © 2019 The Authors. Published by Elsevier Inc. All

2019 Journal of Investigative Dermatology

147. The prevalence, clinico-demographics and outcomes of incidental and symptomatic renal cysts in a paediatric cohort undergoing ultrasonography. (PubMed)

The prevalence, clinico-demographics and outcomes of incidental and symptomatic renal cysts in a paediatric cohort undergoing ultrasonography. The growing availability of modern day imaging has resulted in an increase in the number of renal cysts detected in the paediatric population. Few publications have reported outcomes of these childhood cysts. The objective of our study was to assess the prevalence and evolution of renal cysts in children, and to describe clinical characteristics, mode (...) of presentation, and ultimate outcomes Methods: Our institutional ultrasound (US) database was searched for all abdominal US reports from 2006-2017. These were then cross-referenced with a manual retrospective chart review. Clinical characteristics including mode of presentation, cyst characteristics, and outcomes were analyzed using descriptive and non-parametric statistical methods Results: Of 70,500 abdominal US scans during the study period, 1,531 (2.2%) scans met inclusion criteria. 26% of cysts were

2019 Journal of Urology

148. A modified technique of single-incision laparoscopic hepaticojejunostomy for children with choledochal cysts. (PubMed)

A modified technique of single-incision laparoscopic hepaticojejunostomy for children with choledochal cysts. To present a modified laparoscopic surgical technique that works to optimize the surgical view in laparoscopic total excision of choledochal cyst in pediatric patients.From June 2015 to June 2017, a total of 48 pediatric cases of choledochal cyst were admitted. Their age ranged from 15 month to 8 years (average 3.5 years). The Todani types were: type I (n = 32) and type IVa (n = 16 (...) ultrasound reported no abdominal effusion, when the intraperitoneal drainage tube was removed. There was no postoperative complication during the 6 months of follow-up.We accomplished the same postoperative outcome in laparoscopic total cyst excision with our modified method as that with conventional laparoscopic surgery. This technique allows the operator to have a stabilized surgical view without needing to rely on an assistant to hold up the liver lobe for larger operative space.

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2019 BMC Surgery

149. Endoscopic removal of recurrent colloid cysts. (PubMed)

Endoscopic removal of recurrent colloid cysts. OBJECTIVERemoval of colloid cysts of the third ventricle using a purely endoscopic method has been established as a safe and advantageous technique. It is hypothesized that endoscopic removal in recurrent cases might pose more technical challenges and result in less success. The objective of this study was to assess the feasibility and outcomes of using a purely endoscopic approach for the management of recurrent colloid cysts compared to primary (...) cysts.METHODSA retrospective cohort study was performed on patients who underwent purely endoscopic removal of their colloid cyst. Descriptive statistics were compared for patients undergoing surgery for a recurrent cyst and those for a control cohort undergoing surgery for a primary cyst. Bivariate analysis was conducted using a Fisher's exact test for categorical variables and Mann-Whitney U-test for continuous variables.RESULTSIn total, 121 patients had a primary colloid cyst endoscopically removed and 10

2019 Journal of Neurosurgery

150. Aneurysmal bone cysts of the clavicle: a comparison of extended curettage and segmental resection with bone reconstruction. (PubMed)

Aneurysmal bone cysts of the clavicle: a comparison of extended curettage and segmental resection with bone reconstruction. Although curettage of an aneurysmal bone cyst (ABC) of the clavicle has a high rate of local recurrence, segmental resection is often avoided for treatment as it causes functional impairment and shoulder deformity. We evaluated the rate of local recurrence and functional outcomes of extended curettage vs. segmental resection with bone reconstruction for the treatment

2019 Journal of Shoulder and Elbow Surgery

151. Editorial Commentary: All-Inside Meniscal Repair Devices: Should We Cease and De-Cyst? (PubMed)

Editorial Commentary: All-Inside Meniscal Repair Devices: Should We Cease and De-Cyst? All-inside meniscal repair devices have the potential to simplify a technically difficult procedure, reduce the need for a skilled surgical assistant, reduce surgical times, improve cosmetic results, and decrease postoperative pain for the patient. On the other hand, the devices are more expensive than sutures, have technical issues of their own, and may have complications that are not associated with suture

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2019 Arthroscopy

152. Thyroid Rosai-Dorfman disease with infiltration of IgG4-bearing plasma cells associated with multiple small pulmonary cysts. (PubMed)

Thyroid Rosai-Dorfman disease with infiltration of IgG4-bearing plasma cells associated with multiple small pulmonary cysts. Rosai-Dorfman disease (RDD) is a rare histiocytosis which involves principally lymph nodes. Thyroid involvement in RDD is a very rare situation, and lung involvement is even rarer.We report the case of a 46-year-old woman presenting a painless mass in the right side of the neck and subacute dyspnoea. Computerised tomography (CT) scans of the neck and thorax showed a large (...) indicates a benign course of nodal RDD with thyroid and tracheal infiltration following surgical resection, association of typical histological signs of RDD (emperipolesis) with IgG4-related disease features, and that lung cysts might be a manifestation of RDD.

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2019 BMC pulmonary medicine

153. Cyst Ventilation Heterogeneity and Alveolar-Airspace Dilation as Early Disease Markers in Lymphangioleiomyomatosis. (PubMed)

Cyst Ventilation Heterogeneity and Alveolar-Airspace Dilation as Early Disease Markers in Lymphangioleiomyomatosis. Lymphangioleiomyomatosis (LAM) is a rare disease associated with cystic destruction of the pulmonary parenchyma and chronic respiratory failure, and there are trials underway to determine if early intervention can prevent disease progression. An imaging technique that is sensitive to early regional disease would therefore be valuable for patient care and clinical trials.We (...) postulated that hyperpolarized 129Xe MRI would be sensitive to ventilation abnormalities and alveolar-airspace dilation in patients with mild LAM disease and normal pulmonary function and that 129Xe MRI would reveal important features of cyst ventilation.129Xe ventilation and diffusion-weighted MR images were acquired in 22 LAM patients during two breath-holds of hyperpolarized 129Xe. 129Xe ventilation defect percentage (VDP; percentage of voxels <60% of the mean whole-lung 129Xe MRI signal) and apparent

2019 Annals of the American Thoracic Society

154. Renal cell carcinoma originating in the free wall of simple renal cyst: Two unusual case reports with literature review. (PubMed)

Renal cell carcinoma originating in the free wall of simple renal cyst: Two unusual case reports with literature review. Simple renal cyst (SRC) is a benign disease. However, rarely renal cell carcinoma (RCC) may be raised at the wall of a preexisting SRC. We herein describe 2 unusual cases of RCC arising from the outer surface of the free wall of the renal cyst.A 75-year-old female and a male were admitted to our department because of an asymptomatic renal cystic mass. Although the case (...) history, preoperative imaging, and intraoperative examination of the cyst were carefully evaluated, no concerns were raised with respect to the underlying malignancy.RCC of the clear cell type was diagnosed based on the histology and pathological examination.With an initial diagnosis of SRC, the retroperitoneal laparoscopic de-roofing of the SRC was performed in both of the patients. When the diagnoses were confirmed 7 days postoperative, both of them were readmitted to our department for a radical

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2019 Medicine

155. Development and evaluation of a patient-specific surgical simulator for endoscopic colloid cyst resection. (PubMed)

Development and evaluation of a patient-specific surgical simulator for endoscopic colloid cyst resection. Endoscopic resection of third-ventricle colloid cysts is technically challenging due to the limited dexterity and visualization provided by neuroendoscopic instruments. Extensive training and experience are required to master the learning curve. To improve the education of neurosurgical trainees in this procedure, a synthetic surgical simulator was developed and its realism, procedural (...) content, and utility as a training instrument were evaluated.The simulator was developed based on the neuroimaging (axial noncontrast CT and T1-weighted gadolinium-enhanced MRI) of an 8-year-old patient with a colloid cyst and hydrocephalus. Image segmentation, computer-aided design, rapid prototyping (3D printing), and silicone molding techniques were used to produce models of the skull, brain, ventricles, and colloid cyst. The cyst was filled with a viscous fluid and secured to the roof of the third

2019 Journal of Neurosurgery

156. Physiologic Ovarian Cysts versus Other Ovarian and Adnexal Pathologic Changes in the Preadolescent and Adolescent Population: US and Surgical Follow-up. (PubMed)

Physiologic Ovarian Cysts versus Other Ovarian and Adnexal Pathologic Changes in the Preadolescent and Adolescent Population: US and Surgical Follow-up. Background Ovarian and adnexal cysts are frequently encountered at US examinations performed in preadolescent and adolescent patients, yet there are few published studies regarding the outcomes of cysts in this population. Purpose To identify characteristics at US that help to distinguish physiologic ovarian cysts from nonphysiologic entities (...) . Materials and Methods Female patients who underwent pelvic US with or without Doppler from January 2009 through December 2013 were identified by using a centralized imaging database. Patients older than 7 years and younger than 18 years with ovarian or adnexal cysts at least 2.5 cm were included. Demographic characteristics, date of surgery, surgical notes, and pathologic reports were extracted from the electronic medical record. Initial and follow-up dates of US, cyst size and complexity, imaging

2019 Radiology

157. Sonographic appearance of sebaceous cysts. Our experience and a review of the literature. (PubMed)

Sonographic appearance of sebaceous cysts. Our experience and a review of the literature. Sebaceous cysts are benign enveloped nodules resulting from an obstruction of a hair follicle. Although they are very common, differential diagnosis is not obvious and may include many diseases. Ultrasound examination with high frequency probes, in the hands of a skilled operator, is the gold standard for noninvasive evaluation of these diseases. The aim of our study was to describe sonographic patterns (...) found in our experience with high frequency probes. We decided to reevaluate the sonographic appearance of the last 100 patients with sebaceous cysts that were under our observation through conducting a retrospective study. All lesions were examined by a skilled radiologist with an Esaote MyLab 70 XVG ultrasound unit and a dedicated 18 MHz linear probe, sometimes supplemented by 20 MHz. In these skin lesions, we evaluated morphology, size, vascularity, and especially the visibility of skin pores

2019 International Journal of Dermatology

158. Comparison of curettage and bone grafting combined with elastic intramedullary nailing vs curettage and bone grafting in the treatment of long bone cysts in children. (PubMed)

Comparison of curettage and bone grafting combined with elastic intramedullary nailing vs curettage and bone grafting in the treatment of long bone cysts in children. To compare the efficacy of curettage and bone grafting combined with elastic intramedullary nailing (EIN) vs curettage and bone grafting in the treatment of long bone cysts in children and to clarify the necessity of using EIN in the treatment of bone cysts.Sixty-two patients were involved in this study from Jan. 2009 to Sept (...) . 2017 (43 males, 19 females; 27 humeri, 35 femurs); the patients were assigned to an EIN group, comprising 30 patients who underwent curettage and bone grafting combined with EIN, or to a non-elastic intramedullary nailing (NEIN) group, comprising 32 patients who underwent curettage and bone grafting alone. The prognosis of the 2 groups was assessed with reference to the standard of Capanna.No statistically significant differences in sex, age, location, activity, pathological fracture, cyst volume

2019 Medicine

159. Acute pancreatitis with Cullen's sign presentation in a case of mixed type I and II choledochal cyst. (PubMed)

Acute pancreatitis with Cullen's sign presentation in a case of mixed type I and II choledochal cyst. A 3 year old girl presented initially with acute severe hemorrhagic pancreatitis diagnosed by clinical features including a positive Cullen's sign and raised serum amylase. A contrast enhanced computed tomography (CECT) scan corroborated the same and also reported a type I choledochal cyst. Magnetic resonance cholangiopancreatography (MRCP) 2 months later reported a type II choledochal cyst (...) and a persistent pseudo pancreatic cyst. Intraoperative features and close perusal of the CECT and MRCP films showed the presence of mixed type I and II choledochal cyst. The case is reported for the presence of Cullen's sign, CECT and MRCP features of a mixed type I and II choledochal cyst and successful surgical outcome. It appears to be only the fifth case of mixed type I and II choledochal cyst in world literature in the pediatric age group, following the 4 previous cases in children reported from

2019 Journal of Pediatric Surgery

160. Pineal cyst surveillance in adults - a review of 10 years' experience. (PubMed)

Pineal cyst surveillance in adults - a review of 10 years' experience. Objective: Pineal cysts are common benign incidental findings in adults. There are no commonly accepted criteria for follow up or indications for intervention. We looked at our outcomes for this condition to explore their natural history and review our surveillance criteria. Method: Retrospective review of multidisciplinary team meetings at a tertiary neurosurgical centre over 10 years. Data relating to demographics (...) , presenting symptoms, maximum diameter, duration of surveillance, final diagnosis and overall outcome were extracted from electronic patient records and available MRI. Data were analysed using IBM SPSS version 24. Result: Seventy-seven pineal cysts were identified. Female to male ratio was 1.43, female mean age was 38.6 and male mean age was 50.4. An increase in referral frequency was observed over the study period (mean increase of 1.4 cases per year). Presenting symptoms of headache in 45% and visual

2019 British Journal of Neurosurgery

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