A Simple Tool to Improve Visualization of the Vocal Cords on Translaryngeal Ultrasound in Male Patients.

INTRODUCTION: Laryngeal ultrasound has been increasingly used for the evaluation of the vocal cords mobility after thyroid and parathyroid surgery. The sensitivity and positive predictive value of the method are reported to be higher than 80%. Nevertheless, the visualization rate in male patients remains low; therefore, ultrasound is not attractive for the perioperative workup in those patients. In the present study, we evaluate the ability to improve the visualization rate for male patients by using a gel pad as an interface between the skin and the ultrasound probe. METHODS AND MATERIALS: Between December 2018 and January 2019, 92 male patients (mean age 49 years; range: 20-80 years) referred to our hospital with different thyroid pathologies received a laryngeal ultrasound without (TLUS) and subsequently with gel pad (G-TLUS). TLUS was performed by B-scan (probe 5-13 MHz, aperture 40 mm). The data were prospectively collected and statistically analyzed. RESULTS: The visualization rate in the TLUS group was 35% (32 out of 92 patients). The use of the gel pad could increase the rate to 78% (p < 0.0001). For both groups, visualization rates are lower in older patients (> 50 years) compared to younger individuals (TLUS: 25% vs. 45%, p < 0.05; G-TLUS: 75% vs 82%, p = 0.45). CONCLUSION: The gel pad significantly improves the vocal cord visualization rate in male patients and should be used routinely.

A simplified surgical technique for recurrent inguinal hernia repair following total extraperitoneal patch plastic.

PURPOSE: To present a new and alternative method for surgical treatment of recurrent inguinal hernia after total extraperitoneal patch plastic (TEP). METHODS: From January 2005 to September 2015, 35 patients (34 male, 1 female; mean age 65 ± 12.6 years) with recurrent inguinal hernia following TEP were operated at the Kliniken Essen-Mitte using a simplified method consisting of re-fixation of the primary mesh to the inguinal ligament by an anterior approach. RESULTS: The mean operating time was 47 ± 22 min. All complications were minor with an overall incidence of 6%. After a mean follow-up of 54 months one re-recurrence was observed. CONCLUSIONS: This Simplified Hernia Repair is safe and avoids additional foreign body implantation. Therefore, it is our method of choice for recurrent inguinal hernias after TEP.