Transurethral microwave therapy of the prostate.

Benign prostatic hypertrophy (BPH) is a medical condition causing obstructive urinary symptoms that will inevitably affect the majority of the male population. Treatments for BPH have traditionally included invasive surgical intervention to resect a portion of the prostate as a relief of obstructive symptoms or medications that act in several ways to open the urinary channel and relieve symptoms. A new, less invasive treatment for BPH has now been developed and approved. Transurethral microwave therapy is discussed in this article. A case study is presented.

Acoustic neuroma.

This article reviews the definition of acoustic neuroma, prevalence, growth, symptoms, diagnosis, multiple treatment options, postoperative complications, alternative therapies, and patient and health care provider resources.

Surgical treatment of dacryocystitis.

Dacryocystitis is a common infection of the lacrimal sac. In adults, dacryocystitis results from an obstruction (ie, dacryostenosis) of the nasolacrimal duct. Dacryocystitis can be either an acute or chronic infection, and both forms usually are unilateral in nature. The hallmark symptom of both forms of dacryocystitis is epiphora (ie, excessive tearing). An obstruction of the lacrimal duct also can cause dacryocystitis. This article discusses the surgical treatment of dacryocystitis and provides a case study that illustrates perioperative nursing care of a patient who required surgical treatment of this lacrimal duct disorder.

A guide to salivary gland disorders.

This article discusses salivary gland disorders and provides nurses with a broad base of knowledge for use in planning and implementing perioperative patient care. Salivary gland disorders may be caused by nonneoplastic conditions or neoplasms. Nonneoplastic conditions generally are related to inflammatory processes or are secondary to existing disease processes. Neoplasms manifest themselves as benign or malignant tumors of the salivary glands. Patients with nonneoplastic conditions may undergo surgical procedures for health problems unrelated to their salivary gland disorders; however, patients with salivary gland neoplasms usually undergo surgical excisions of their tumors and affected glands. Patients in both categories require skilled perioperative nursing care.

Managing patients with pancreatic cancer.

The diagnosis of pancreatic cancer is devastating for patients and family members because of the high morbidity and mortality rates associated with the disease. Regardless of the stages of their illnesses or the treatments they receive, only 3% of patients diagnosed with pancreatic cancer survive five years or more after diagnosis. Compassionate, knowledgeable, supportive nursing care is necessary throughout all stages of pancreatic cancer. This article provides perioperative nurses with information about the diagnosis, treatment, and palliative care for patients diagnosed with pancreatic cancer.

Management of alcoholic cirrhosis of the liver.

Patients with liver disease require skilled, complex management of the inevitable complications associated with hepatic dysfunction. Portal hypertension, a major consequence of cirrhosis of the liver, causes ascites and esophageal variceal hemorrhages. Many clinical and surgical treatment options are available to manage these complications; however, they often produce only temporary symptom control and may beget further morbidity. This article focuses on the etiology, complications, and treatment of alcoholic cirrhosis. Perioperative nursing care of patients with alcoholic cirrhosis is based on an understanding of normal hepatic functions and the systemic effects of cirrhosis.

Complications associated with excision of a submandibular salivary gland tumor.

Recognition and timely correction of serious postoperative complications is essential for an optimal patient outcome. Rapid assessment and prompt treatment prevent irreversible patient complications. In Mr C's case, he has successfully returned to his full level of preoperative activities. His endocrinologist continues to monitor him on a regular basis for the nonpalpable masses found in his thyroid gland. Mr C considers his symptoms of Frey's syndrome only a minor annoyance.

Intraoperative positioning of surgical patients.

All perioperative team members are responsible for the safe positioning of surgical patients. Circulating nurses coordinate the positioning of patients during intraoperative periods of care. Skilled perioperative nursing interventions afford patients safe and comfortable positioning during surgery, ensure optimal exposures of surgical sites, and prevent postoperative complications (e.g., pressure injuries, neuropathies, cardiovascular and respiratory compromises). Perioperative nurses should have a working knowledge of anatomy and physiology, patient risk factors, injury mechanisms, potential complications, and positioning devices before placing patients in required perioperative positions.

Surgical treatment for intranasal squamous cell carcinoma.

Surgical treatment for aggressive intranasal squamous cell carcinoma (SCC) requires a multidisciplinary team approach to ensure optimal patient outcomes. Surgical procedures for the removal of intranasal malignancies may include rhinectomy, palatectomy, and maxillectomy. These procedures leave patients with significant facial defects that are corrected with staged surgical reconstructions or applications of facial prostheses. This article describes the etiology of intranasal SCC, discusses treatment options, and presents a case study that chronicles the events from diagnosis through rehabilitation of a patient undergoing rhinectomy, partial bilateral maxillectomy, and partial palatectomy.

Dental restorations using titanium osseointegrated dental implants.

Dental implantology (ie, the science of replacing teeth) has evolved from the use of crude, unstable, natural materials to the use of titanium osseointegrated dental implants and sophisticated prosthetic appliances. Dental prosthetics are used in an increasing number of routine dental restorations. Postoperative patients who have undergone dental restorations using titanium osseointegrated dental implants enjoy results that approximate the look and feel of natural teeth. Optimal patient outcomes are best accomplished through a multidisciplinary team approach, and perioperative goals of patient commitment and compliance are achieved through comprehensive education.

Transsphenoidal adenomectomy.

The pituitary gland is a complex organ controlling many of the body's hormonal and metabolic functions. The gland's complexity and location in the brain have a serious impact on the diagnosis and treatment of pituitary pathology. Several surgical approaches are available to treat pituitary tumors; however, the transsphenoidal approach allows the surgeon to remove the tumor with minimal damage to surrounding intracranial structures. Perioperative nurses should be knowledgeable about pituitary pathology (ie, mass effect, hormonal involvement), patient treatment options, surgical approaches, and possible postoperative complications to provide quality nursing care.

Arteriovenous fistula. Vascular access for long-term hemodialysis.

Long-term hemodialysis remains the most important support for patients with ESRD, and reliable vascular access is an essential component of this management plan. Recent refinements in AV fistula surgical techniques have produced this dependable, well-tolerated, long-term access route for hemodialysis.

Diaphragmatic pacing. An option for patients with quadriplegic respiratory paralysis.

Recent advances in design, increased reliability, and computerized pacing provide an exciting alternative to mechanical ventilation for the quadriplegic patient. Research into the development of totally implantable, demand-type respiratory pacemakers is ongoing. Careful patient selection, meticulous surgical technique, adequate training in the use of the device, and conscientious follow-up contribute to a successful outcome--increased mobility and independence for the ventilator-dependent quadriplegic patient.