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endoscopic surgery and frontal sinus

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https://www.readbyqxmd.com/read/27935264/improved-delivery-of-sinus-irrigations-after-middle-turbinate-resection-during-endoscopic-sinus-surgery
#1
Sarah M Kidwai, Arjun K Parasher, Mohemmed N Khan, Jean Anderson Eloy, Anthony Del Signore, Alfred Marc Iloreta, Satish Govindaraj
BACKGROUND: Improvement in topical delivery to nasal mucosa is a fundamental goal of endoscopic sinus surgery (ESS). This study compares the penetration of irrigation before and after middle turbinate resection (MTR) to assess the efficacy of topical delivery. METHODS: ESS was performed on 4 cadaver heads, followed by MTR. Each head was irrigated with fluorescein-dyed water using a squeeze bottle both before and after MTR. Videos were recorded by rigid nasal endoscopy...
December 9, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27930469/frontal-sinus-pneumatization-affects-height-of-the-lateral-lamella-and-position-of-anterior-ethmoidal-artery
#2
Şenol Çomoğlu, Bayram Şahin, Said Sönmez, Kemal Değer
Preoperative evaluation of the frontal sinus (FS) and associated anatomical structures may reduce the risk of intraoperative complications and facilitate the management of potential complications. In this study, the authors aimed to evaluate relationship between FS pneumatization and critical anatomical structures. Paranasal sinus computerized tomography scans of 350 sides of 175 patients were evaluated. The pneumatization pattern of the FS, FS dimensions (on the axial, coronal, and sagittal slices), anterior ethmoidal artery, and depth of the of olfactory fossa were evaluated for every patient on both sides...
December 7, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27888912/extended-endoscopic-and-open-sinus-surgery-for-refractory-chronic-rhinosinusitis
#3
REVIEW
Jean Anderson Eloy, Emily Marchiano, Alejandro Vázquez
This review discusses extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Extended maxillary sinus surgery including endoscopic maxillary mega-antrostomy, endoscopic modified medial maxillectomy, and inferior meatal antrostomy are described. Total/complete ethmoidectomy with mucosal stripping (nasalization) is discussed. Extended endoscopic sphenoid sinus procedures as well as their indications and potential risks are reviewed. Extended endoscopic frontal sinus procedures, such the modified Lothrop procedure, are described...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27869357/the-impact-of-endoscopic-sinus-surgery-on-paranasal-physiology-in-simulated-sinus-cavities
#4
Ravi Jain, Haribalan Kumar, Merryn Tawhai, Richard Douglas
BACKGROUND: Surgery improves symptoms for the majority of chronic rhinosinusitis (CRS) patients; however, physiological changes in the sinus cavities remain poorly characterized. Direct measurement of changes in airflow, pressure, temperature, humidity, and intranasal spray distribution following surgery is technically challenging. Accordingly, we have used computational fluid dynamic modeling to quantify how these parameters change postoperatively. METHODS: Computed tomography images from a normal control, a patient with CRS preoperatively and postoperatively, and a patient following an endoscopic Lothrop procedure (ELP) were used to create 4 three-dimensional models of the sinus cavities...
November 21, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27833876/a-short-term-subjective-and-objective-analysis-of-modified-endoscopic-lothrop-s-procedure-and-its-functional-outcome-our-experience
#5
D R Nayak, K Pai, S Nair, B Ramaswamy, H Sabhahit
To study the short-term functional outcomes of the endoscopic modified Lothrop procedure with well defined subjective and objective criteria. It's a retrospective cohort study with chart review carried out at a tertiary referral center. 31 patients with chronic frontal sinusitis who underwent endoscopic modified Lothrop's procedure with uncinate preservation during the period Jan 2011-2014 were followed up for a period of minimum 6 months. Assessment was done post-operatively based on subjective severity score and Kennedy's 5 point endoscopic criteria...
December 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/27758142/evaluation-of-the-propel-%C3%A2-mini-sinus-implant-for-the-treatment-of-frontal-sinus-disease
#6
Griffin D Santarelli, Joseph K Han
Propel and Propel Mini sinus implants are mometasone furoate-coated bioabsorbable stents used as an adjunct in the management of chronic rhinosinusitis after endoscopic sinus surgery. The original sinus implant was deployed in the ethmoid sinuses to provide medialization of the middle turbinate, decrease scarring and mucosal adhesions, limit polyp regrowth, and reduce mucosal inflammation. A structurally smaller version of the Propel, the Propel Mini, was developed and now has been approved for endoscopic placement in the frontal sinuses...
November 6, 2016: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/27754596/educational-utility-of-advanced-three-dimensional-virtual-imaging-in-evaluating-the-anatomical-configuration-of-the-frontal-recess
#7
Abib Agbetoba, Amber Luong, Jin Keat Siow, Brent Senior, Claudio Callejas, Kornel Szczygielski, Martin J Citardi
BACKGROUND: Endoscopic sinus surgery represents a cornerstone in the professional development of otorhinolaryngology trainees. Mastery of these surgical skills requires an understanding of paranasal sinus and skull-base anatomy. The frontal sinus is associated with a wide range of variation and complex anatomical configuration, and thus represents an important challenge for all trainees performing endoscopic sinus surgery. METHODS: Forty-five otorhinolaryngology trainees and 20 medical school students from 5 academic institutions were enrolled and randomized into 1 of 2 groups...
October 18, 2016: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/27694535/sinus-penetration-of-a-pulsating-device-versus-the-classic-squeeze-bottle-in-cadavers-undergoing-sinus-surgery
#8
Philip G Chen, Jae Murphy, Les M Alloju, Sam Boase, Peter-John Wormald
OBJECTIVES: Nasal irrigation is standard in the management of chronic rhinosinusitis both before and after surgical intervention. Numerous irrigation devices are commercially available. The aim of this study was to compare the efficacy of a handheld pulse irrigation device against the gold standard manual squeeze bottle after endoscopic sinus surgery (ESS). METHODS: Five cadaveric specimens were prepared with video visualization ports into each sinus. Endoscopic sinus surgery was performed on each cadaver from minimal to maximal dissection...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27588056/endoscopic-agger-nasi-type-draf-iib-treatment-for-frontal-sinus-lesions
#9
Linggai Shi, Jun Liu, Jiqing Ma, Fei Liu, Guangke Wang
Treatment of frontal sinus using surgery is complicated owing to the complex anatomical structure of the sinus region. The aim of the present study was to investigate the efficacy and safety of Draf IIb endoscopic frontal sinus surgery treatment for frontal sinus lesions using the agger nasi approach on 19 patients (28 left or and right nasal cavities). A 10-12 mm excision of the upper frontal maxilla was performed for endoscopic resection between the middle turbinate and lateral nasal wall. No serious complications in frontal sinus surgery treatment for the removal of the frontal sinus were observed...
September 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27489711/rhinogenic-intracranial-complication-with-postoperative-frontal-sinus-pyocele-and-inverted-papilloma-in-the-nasal-cavity-a-case-report-and-literature-review
#10
Michitsugu Kawada, Hidenori Yokoi, Keisuke Maruyama, Yuma Matsumoto, Hidetaka Yamanaka, Tetsuya Ikeda, Yoshiaki Shiokawa, Koichiro Saito
We report a patient who had rhinogenic intracranial complication with postoperative frontal sinus pyocele and inverted papilloma in the nasal cavity. A 72-year-old woman had undergone surgery for frontal sinusitis via external incision at another hospital 13 years previously. Left-sided hemiparesis appeared in the patient and gradually worsened. Five days later, she exhibited disorientation, abnormal behavior, poor articulation, and difficulty in standing. Therefore, she was taken to the neurosurgery department by ambulance...
2016: SAGE open medical case reports
https://www.readbyqxmd.com/read/27466857/advances-in-surgery-extended-procedures-for-sinonasal-polyp-disease
#11
Jessica E Southwood, Todd A Loehrl, David M Poetker
In the standard functional endoscopic sinus surgery (FESS) procedure, the amount of dissection is often determined by the extent of disease with the goal to preserve as much normal mucosa as possible while restoring ventilation and reestablishing mucociliary clearance. A subset of patients with chronic rhinosinusitis with nasal polyposis (CRSwNP), however, may continue to have persistent mucosal inflammatory and aggressive polyp regrowth despite standard FESS and maximal pharmacology therapy, leading to recurrent and recalcitrant disease...
2016: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27456601/a-comparison-of-radiographic-evidence-of-frontal-sinusitis-in-middle-turbinate-sacrificing-versus-middle-turbinate-sparing-approaches-to-the-sella
#12
Leigh J Sowerby, Sumeer Mann, Yves Starreveld, Trevor Kotylak, Brad Mechor, Erin D Wright
BACKGROUND: Initial descriptions of endoscopic approaches to the sella and pituitary involved resecting the middle turbinate (MT) to help improve access and visualization. Modifications of these procedures to preserve the MT have since been described, one rationale being to reduce the incidence of frontal sinusitis. The objective of this study was to establish the incidence of postoperative frontal sinusitis in MT sparing (MTsp) and MT sacrificing (MTsc) approaches to the sella. OBJECTIVE: A retrospective cohort study that compared radiographic evidence of frontal rhinosinusitis or frontal recess obstruction after skull base surgery in patients who underwent MTsc and MTsp endonasal approaches to the sella...
July 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/27450618/outcomes-after-frontal-sinus-surgery-an-evidence-based-review
#13
REVIEW
Adam S DeConde, Timothy L Smith
Endoscopic sinus surgery is an effective intervention at improving quality of life for patients with medically refractory chronic rhinosinusitis. The evidence supporting frontal sinusotomy is limited to single institution case series. However, the data for Draf IIa frontal sinusotomy do demonstrate that most patients experience lasting frontal sinus patency on postoperative endoscopic examination and improvements in quality of life. Salvage endoscopic frontal sinus surgery via a Draf III shows high rates of neo-ostium patency and subjective improvements in symptoms at a 2-year time point in case series...
August 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27450617/standard-endoscopic-approaches-in-frontal-sinus-surgery-technical-pearls-and-approach-selection
#14
REVIEW
Zeina R Korban, Roy R Casiano
The mainstay of frontal sinus surgery for chronic rhinosinusitis is to achieve and maintain an adequate frontal outflow tract. Using a stepwise approach and identifying critical endoscopic anatomic landmarks, to minimize complications and obtain long-term good endoscopic surgical results, should achieve this. The goal is to relieve the patient's symptoms, restore functional mucociliary flow, achieve a wide frontal sinus ostium and prevent long-term scarring and stenosis. Meticulous dissection and appropriate use of instrumentation and techniques aids in preventing unnecessary damage to normal mucosa while achieving one's goal of an adequate surgical ostium...
August 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27423641/classification-of-suprabullar-pneumatization-according-to-the-skull-base-attachment-of-the-second-lamella
#15
Keng Lu Tan, Woo Hyun Lee, Jeong-Whun Kim
The skull base attachment of the second lamella and suprabullar pneumatization are likely to be consistent landmarks if they are systematically classified. This study aimed to classify the pneumatization pattern according to the second lamella skull base attachment. A total of 202 computed tomography sides of 101 patients who underwent endoscopic sinus surgery were studied. Suprabullar pneumatization was defined as air cells present above the ethmoid bulla between the second and third lamellae. Its pattern was classified according to the air cell number and location as in the frontal cell classification...
July 16, 2016: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/27405576/-intermittent-swelling-of-the-eyelid
#16
T Nguyen, D Kuijpers, J Companjen, A Erceg
BACKGROUND: Mucoceles are benign mucous-containing cysts that can occur in the sinuses. They arise as a result of an obstruction of the sinus ostium. There is often a delay in diagnosis because symptoms are so variable. CASE DESCRIPTION: A 52-year-old woman had intermittent swelling of the eyelid. A CT scan of the sinuses showed a mucocele in the frontal sinus with breakthrough to the left orbit. Treatment consisted of marsupialisation by means of functional endoscopic sinus surgery with septum correction...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27363723/randomized-controlled-trial-of-a-bioabsorbable-steroid-releasing-implant-in-the-frontal-sinus-opening
#17
Timothy L Smith, Ameet Singh, Amber Luong, Randall A Ow, Steven D Shotts, Nathan B Sautter, Joseph K Han, James Stambaugh, Aarthi Raman
OBJECTIVES/HYPOTHESIS: To assess safety and efficacy of a steroid-releasing implant in improving surgical outcomes when placed in the frontal sinus opening (FSO) following endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). STUDY DESIGN: Prospective, multicenter, randomized, blinded trial using an intrapatient control design. METHODS: Eighty adult (≥ 18 years) CRS patients who underwent successful bilateral frontal sinusotomy were randomized to receive a steroid-releasing implant in one FSO, whereas the contralateral control side received no implant...
July 1, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27329983/endoscopic-approaches-to-the-frontal-sinus-modifications-of-the-existing-techniques-and-proposed-classification
#18
REVIEW
Jean Anderson Eloy, Alejandro Vázquez, James K Liu, Soly Baredes
Frontal sinus surgery has long been technically challenging in terms of access and chronic disease management. Decades of experience and advances in technology have led to the widespread use of various surgical approaches to the frontal sinus. Modifications to these existing procedures have been described to minimize unnecessarily invasive approaches. The lack of a classification that incorporates the newly described modifications prompts the proposal of a new classification. Eloy I-III incorporates all the previously described approaches as well as 3 recently published, and 1 newly described, procedures...
August 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27329979/utility-of-image-guidance-in-frontal-sinus-surgery
#19
REVIEW
Gretchen M Oakley, Henry P Barham, Richard J Harvey
The frontal sinus can present a challenging surgical dissection for the endoscopic surgeon. Image guidance as a surgical adjunct has become widely accepted for surgeries in this area. It can help verify vital structures and manage disorienting surgical conditions, improving surgeon confidence in performing safer and more complete surgery. It is relied upon heavily for placement of limited external frontal sinusotomies for disease beyond the endoscopic reach, and for mapping the frontal sinus for osteoplastic flap bony cuts...
August 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27255595/the-effect-of-middle-turbinate-resection-on-topical-drug-distribution-into-the-paranasal-sinuses
#20
Ashleigh A Halderman, Janalee Stokken, Raj Sindwani
BACKGROUND: During sinus surgery, partial or complete resection of the middle turbinate (MT) is sometimes necessary because of polypoid changes or demineralization. Topical drug delivery to the paranasal sinuses is an integral component in managing chronic rhinosinusitis (CRS) with and without nasal polyposis. The purpose of this study was to examine the role of the MT and MT resection in topical drug distribution into the sinuses via nebulization. We report on a novel technique of quantitatively evaluating the delivery of nebulized dye in cadavers...
June 3, 2016: International Forum of Allergy & Rhinology
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