รศ.ดร.นพ.ภาธร ภิรมย์ไชย ได้รับเชิญเป็นบรรณาธิการร่วมในวารสาร Journal of Medical Case Reports ในเครือ Springer Nature
https://jmedicalcasereports.biomedcentral.com/about/editorial-board
รศ.ดร.นพ.ภาธร ภิรมย์ไชย ภาควิชาโสต ศอ นาสิกวิทยา โรงพยาบาลศรีนครินทร์ คณะแพทยศาสตร์ มหาวิทยาลัยขอนแก่น ได้คิดค้นเทคนิคการผ่าตัดไทรอยด์ผ่านกล้องแบบใหม่ โดยซ่อนรอยแผลไว้ใต้คางและ/หรือหลังใบหู เรียกว่า post-auricular submental approach thyroidectomy หรือ PSA
เทคนิคใหม่นี้จะมีแผลขนาดประมาณ 1 เซนติเมตรที่ใต้คาง เซาะแผลใต้ผิวหนังน้อยลงกว่าเดิมครึ่งหนึ่ง ไม่มีแผลในช่องปาก จึงลดความเสี่ยงการติดเชื้อและการหายของแผลจะเร็วกว่า คนไข้สามารถรับประทานอาหารปกติตั้งแต่วันแรกหลังผ่าตัด อีกทั้งไม่มีแผลที่ทรวงอกหรือรักแร้ซึ่งไม่สวยงาม
อาจารย์ได้เริ่มผ่าตัดเทคนิคใหม่นี้ตั้งแต่ปี 2559 และได้รับการยอมรับตีพิมพ์ในวารสารของราชวิทยาลัยโสต ศอ นาสิกแพทย์แห่งประเทศอังกฤษ (the British Association of Otorhinolaryngology- Head & Neck Surgery) และสมาคมโสต ศอ นาสิกแพทย์เพื่อการวิจัยแห่งประเทศอังกฤษ (The Otorhinolaryngological Research Society)
สำหรับแพทย์ที่สนใจเทคนิคใหม่นี้ สามารถอ่านรายละเอียดได้ตาม link ด้านล่าง
https://onlinelibrary.wiley.com/doi/10.1111/coa.12791
#ผ่าตัดต่อมไทรอยด์ผ่านกล้อง #ผ่าตัดไทรอยด์แบบส่องกล้อง #โรงพยาบาลศรีนครินทร์ #มหาวิทยาลัยขอนแก่น #ขอนแก่น
ติดต่อโรงพยาบาลศรีนครินทร์
โทร. 043-366311, 043-366313
วารสาร British Journal of Medicine and Medical Research เป็นวารสารทางการแพทย์นานาชาติ ที่เปิดให้อ่านได้ฟรีไม่ต้องสมัครสมาชิก วารสารได้รับการจัดเก็บไว้ในฐานข้อมูล US National Library of Medicine (NLM) Catalog, ISI Web of Science citations, Index Medicus, ProQuest, EBSCOhost, DOAJ และอื่น ๆ
บรรณาธิการของวารสารนี้มาจากทั้งสหรัฐอเมริกา ยุโรปและเอเชีย โดยผศ.ดร.นพ.ภาธร ภิรมย์ไชย เป็นบรรณาธิการที่เป็นคนไทยเพียงผู้เดียว ท่านสามารถเข้าดูรายชื่อบรรณาธิการได้ตาม link ด้านล่าง
http://www.sciencedomain.org/journal/12/editorial-board-members
Piromchai P, Wijewickrema S, Smeds H, Kennedy G, O’Leary S.
Otol Neurotol. 2015 Jul 17.
Abstract:
The internal anatomy of a temporal bone could be inferred from external landmarks.
Mastoid surgery is an important skill that ENT surgeons need to acquire. Surgeons commonly use CT scans as a guide to understanding anatomical variations before surgery. Conversely, in cases where CT scans are not available, or in the temporal bone laboratory where residents are usually not provided with CT scans, it would be beneficial if the internal anatomy of a temporal bone could be inferred from external landmarks.
We explored correlations between internal anatomical variations and metrics established to quantify the position of external landmarks that are commonly exposed in the operating room, or the temporal bone laboratory, before commencement of drilling. Mathematical models were developed to predict internal anatomy based on external structures.
From an operating room view, the distances between the following external landmarks were observed to have statistically significant correlations with the internal anatomy of a temporal bone: temporal line, external auditory canal, mastoid tip, occipitomastoid suture, and Henle’s spine. These structures can be used to infer a low lying dura mater (p = 0.002), an anteriorly located sigmoid sinus (p = 0.006), and a more lateral course of the facial nerve (p < 0.001). In the temporal bone laboratory view, the mastoid tegmen and sigmoid sinus were also regarded as external landmarks. The distances between these two landmarks and the operating view external structures were able to further infer the laterality of the facial nerve (p < 0.001) and a sclerotic mastoid (p < 0.001). Two nonlinear models were developed that predicted the distances between the following internal structures with a high level of accuracy: the distance from the sigmoid sinus to the posterior external auditory canal (p < 0.001) and the diameter of the round window niche (p < 0.001).
The prospect of encountering some of the more technically challenging anatomical variants encountered in temporal bone dissection can be inferred from the distance between external landmarks found on the temporal bone. These relationships could be used as a guideline to predict challenges during drilling and choosing appropriate temporal bones for dissection.
http://dx.doi.org/10.1097/MAO.0000000000000824
Invasive fungal rhinosinusitis is an uncommon disease with high mortality rates. There is currently no consensus on the best treatment timing. We studied the impact of the treatment timing on the survival of patients experiencing invasive fungal rhinosinusitis.
We conducted a retrospective study of patients suffering from invasive fungal rhinosinusitis. The duration of symptoms, clinical presentations, clinical signs, diagnoses, treatments, and outcomes were collected.
It was observed that more than 70% of the mortalities occurred within the subgroup of patients who exhibited symptoms of the disease within 14 days before admission. After adjusting for the confounders, the time taken to treat the patients was the most statistically significant predictor for mortality (P = 0.045). We found no significant relationships between mortality and its significant covariates, which included the underlying diseases (P = 0.91) or complications (P = 0.55).
Our study demonstrates that the time taken to treat the patients is an important determinant for the survival of patients who are afflicted with invasive fungal rhinosinusitis. The appropriate treatments should be administered within 14 days from the time the symptoms begin to manifest.
http://www.ncbi.nlm.nih.gov/pubmed/25288891
We introduce a rating tool that objectively evaluates the skills of surgical trainees performing cochlear implant surgery.
Seven residents and seven experts performed cochlear implant surgery sessions from mastoidectomy to cochleostomy on a standardized virtual reality temporal bone. A total of twenty-eight assessment videos were recorded and two consultant otolaryngologists evaluated the performance of each participant using these videos.
Interrater reliability was calculated using the intraclass correlation coefficient for both the global and checklist components of the assessment instrument. The overall agreement was high. The construct validity of this instrument was strongly supported by the significantly higher scores in the expert group for both components.
Our results indicate that the proposed assessment tool for cochlear implant surgery is reliable, accurate, and easy to use. This instrument can thus be used to provide objective feedback on overall and task-specific competency in cochlear implantation.
http://www.ncbi.nlm.nih.gov/pubmed/25114897
| Author(s) |
| Patorn Piromchai, Teeraporn Ratanaanekchai, Pornthep Kasemsiri |
| KEYWORDS |
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Anaplastic Thyroid Carcinoma; Thyroid; Cancer
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| ABSTRACT |
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Anaplastic thyroid carcinoma (ATC) is a poorly differentiated thyroid cancer. It cannot uptake iodine or synthesis thyroglobulin. The incidence is low; about 2% – 5% of thyroid cancer. The peak age incidence is 60 – 70 years and it is more common in females (55% – 77% of all patients). In recent years, the incidence has declined; however, it may be higher in areas of endemic goiter. ATC may occur with a coexisting carcinoma and may represent transformation of a well-differentiated thyroid cancer. Patients typically present with a rapidly growing anterior neck mass and aggressive symptoms. The most reliable tool in detecting thyroid malignancies is fine-needle aspiration cytology (FNAC). Sensitivity of FNAC for thyroid malignancy ranged from 61% to 97.7%. Fine-needle aspiration can diagnose ATC by the demonstration of spindled or giant cells, bizarre neoplastic cells that may be multinucleated, or atypical cells with high mitotic activity. A syncytial pattern is the predominant cellular pattern of anaplastic thyroid carcinoma. Other laboratory tests, including tumor markers (cytokeratin, vimentin, and carcinoembryogenic antigen) are helpful in diagnosis and follow-up of the patients. Multimodality therapy (surgery, external beam radiation, and chemotherapy) is the recommended treatment and it seems to have slightly improved outcomes. The prognosis is not as bad in younger patients with smaller tumors. The most common cause of death is lung metastasis. The mean survival time is less than 6 months from the time of diagnosis. The prompt diagnosis and aggressive treatment are essential modality to achieve optimal outcomes.
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