Operative Techniques in Otolaryngology - Head and Neck Surgery最新文献

{"title":"The pharynx in three dimensions: a digital anatomical model derived from radiology, peer-reviewed literature, and medical illustration","authors":"Dante J. Merlino MD, PhD ,&nbsp;Caitlin J. Vander Wert MA ,&nbsp;Lazaro R. Peraza MD ,&nbsp;George B. Sankar BS ,&nbsp;Linda X. Yin MD ,&nbsp;Eric J. Moore MD ,&nbsp;Victoria J. Palacios BS ,&nbsp;Jonathan M. Morris MD ,&nbsp;Kathryn M. Van Abel MD","doi":"10.1016/j.otot.2023.09.019","DOIUrl":"10.1016/j.otot.2023.09.019","url":null,"abstract":"<div><p><span><span>Development of an anatomically accurate 3-dimensional (3D) digital model of the human nasopharynx<span><span><span>, oropharynx, and </span>hypopharynx derived from published literature and radiographic imaging. Muscles of the </span>pharynx<span>, including the palatopharyngeus, superior, middle, and inferior constrictor, salpingopharyngeus and stylopharyngeus were manually segmented from a head and neck CT angiogram of a healthy 29-year-old female. Data derived from published anatomical studies were compiled to provide additional anatomical detail to each muscle. The eustachian tube<span><span> and supporting structures, adjacent supporting structures, and adjacent major neurovasculature were also segmented. These anatomical details were then incorporated into the model by a 3D medical illustrator. A total of 6 muscles were segmented from CT angiography data as were the </span>hyoid bone<span>, thyroid and cricoid cartilage, epiglottis, </span></span></span></span></span>skull base, course of the eustachian tube, and nearby major arteries and veins. Meshes were further refined in digital 3D space based on data from peer-reviewed anatomical studies. The left trigeminal, glossopharyngeal, and hypoglossal nerves were incorporated into the model to highlight important anatomical relationships relevant for surgery. Finally, the model was uploaded to a publicly available 3D repository, which can be accessed here (</span><span>https://shorturl.at/qJO16</span><svg><path></path></svg><span><span>). The pharynx is a complex 3D structure that plays a critical role in swallowing, speaking, and airway protection. By combining radiographic data with published anatomical descriptions, and through the collaboration between neuroradiology, </span>head and neck surgery, and medical illustration, we developed an anatomically accurate, detailed 3D model of the pharynx for education and training purposes.</span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 4","pages":"Pages 250-262"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134978998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The masticator space in 3 dimensions: combining radiographic imaging, peer-reviewed literature, and medical illustration to create an anatomically-accurate digital model","authors":"Dante J. Merlino MD, PhD ,&nbsp;Lazaro R. Peraza MD ,&nbsp;George B. Sankar BS ,&nbsp;Caitlin J. Vander Wert MA ,&nbsp;Gabriela A. Calcano BS ,&nbsp;Linda X. Yin MD ,&nbsp;Eric J. Moore MD ,&nbsp;Lindsey Howlett BS ,&nbsp;Kathryn M. Van Abel MD ,&nbsp;Jonathan M. Morris MD","doi":"10.1016/j.otot.2023.09.018","DOIUrl":"10.1016/j.otot.2023.09.018","url":null,"abstract":"<div><p><span><span><span><span>Development of an anatomically accurate, digital, 3-dimensional (3D) model of the masticator space, including the muscles of mastication and </span>temporomandibular joint<span>, by combining data from radiographic imaging and published literature, and augmenting this with medical illustration. The present study involved the manual segmentation of the muscles of mastication, namely the masseter, temporalis, medial pterygoid, and lateral pterygoid muscles<span>, as well as the buccinator muscle from a head and neck CT angiogram of a healthy 29-year-old female. The </span></span></span>skull base<span><span><span>, supporting structures, and adjacent major arteries were also segmented from the same study. The segmentation was then refined based on a compilation of data from published anatomical studies, which were utilized to provide additional anatomical detail for each muscle. Published studies were also used to incorporate structures unable to be segmented by this imaging technique<span>, specifically major cranial nerves and the temporomandibular joint. The resulting anatomical details were subsequently incorporated into a 3D model by a professional medical illustrator. A total of 5 left-sided muscles were segmented from CT angiography data and were incorporated with segmentations of the skull base and </span></span>mandible. Meshes were further refined in digital 3D space based on data from peer-reviewed anatomical studies. The left temporomandibular joint, sphenomandibular ligament, and stylomandibular ligament, as well as the left </span>trigeminal nerve and </span></span>maxillary artery and its branches were incorporated into the model to highlight important surgical anatomical relationships. Finally, the model was uploaded to a publicly available 3D repository, available at </span><span>https://shorturl.at/hnrVZ</span><svg><path></path></svg><span>. This 3D study serves to demonstrate, in a layered fashion, the complex anatomy<span> of the muscles of mastication, including their relationship with important cranial base and neurovascular structures relevant to common surgical procedures and approaches to the infratemporal fossa. Moreover, it serves as an adjunct to the other studies published in this issue.</span></span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 4","pages":"Pages 236-249"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134933994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oropharynx: 3D anatomy","authors":"Cheyanne M. Silver MD,&nbsp;Lazaro R. Peraza MD,&nbsp;Gabriel A. Hernandez-Herrera BS,&nbsp;Matthew L. Carlson MD,&nbsp;Linda X. Yin MD,&nbsp;Kathryn M. Van Abel MD,&nbsp;Kendall K. Tasche MD","doi":"10.1016/j.otot.2023.09.015","DOIUrl":"10.1016/j.otot.2023.09.015","url":null,"abstract":"<div><p><span><span><span><span><span>Surgical approaches to the oropharynx have trended over the years from more invasive to more </span>minimally invasive procedures, with the advent of </span>transoral laser microsurgery and transoral </span>robotic surgery. With less invasive procedure, visualization of critical structures may be more limited, necessitating a robust understanding and working knowledge of the underlying </span>anatomy to avoid </span>surgical complications<span><span> and errors. Herein, we review pertinent anatomical structures in the oropharynx through use of a sagittally split cadaveric model in 2D and </span>3D imaging, with a focus on surgical relevance.</span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 4","pages":"Pages 207-211"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134937303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary management of pediatric obstructive sleep apnea","authors":"Michele Carr DDS, MD, PhD ,&nbsp;Marta Kulich MD ,&nbsp;Nicole Molin MD","doi":"10.1016/j.otot.2023.09.012","DOIUrl":"10.1016/j.otot.2023.09.012","url":null,"abstract":"","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Page 141"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of odontogenic mediastinitis","authors":"Kelvin Zhou MD ,&nbsp;Marc Levin MD ,&nbsp;Sarfaraz Banglawala MD, FRCSC","doi":"10.1016/j.otot.2022.03.001","DOIUrl":"10.1016/j.otot.2022.03.001","url":null,"abstract":"<div><p><span><span>Odontogenic descending necrotizing mediastinitis (DNM) is a rare but sometimes fatal complication of </span>tooth infections. The mortality rate remains high, up to 40%, and there is no consensus on optimal workup and management currently. This review aims to summarize cases of odontogenic DNM in the literature to optimize management strategies and aid physicians in its early recognition. A </span>systematic review<span><span> of the Ovid Medline, EMBASE Classic and Pubmed databases was conducted using PRISMA guidelines. Original research studies reporting an odontogenic etiology of DNM were included. Our search identified 226 articles. Final inclusion consisted of 60 studies describing 204 cases. Most patients were male (80.4%) with a mean age of 47.64 ± 15.96 years old. Patients primarily presented with edema (57.7%), fever (42.3%), trismus (37.2%), dyspnea, (26.9%), </span>dysphagia<span><span> (26.9%). Common radiologic findings were abscesses or fluid collection in the mediastinum (53.1%), air in the soft tissues (50.0%), pleural effusion or empyema (37.5%), mediastinal widening (32.8%), and pericardial effusion (7.8%). Patients were treated with intravenous antibiotics and a variety of surgical techniques such as cervicotomy only (51.2%), </span>thoracotomy<span> only (15.9%), cervicotomy and chest tube (3.5%). The mortality rate was 14.2% with a mean length of hospital stay of 30.1 ± 20.2 days. This systematic review reports and analyzes epidemiological, clinical and treatment-related data regarding patients with odontogenic DNM. Effective disease recognition and patient-specific targeted treatment are needed to ensure treatment success. Further research is needed to promote implementation of such data into clinical practice, with potential to reduce the associated mortality rate.</span></span></span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e62-e69"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42900923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of epiglottopexy for pediatric OSA","authors":"Adam R. Szymanowski MD,&nbsp;Mary Frances Musso DO","doi":"10.1016/j.otot.2023.09.011","DOIUrl":"10.1016/j.otot.2023.09.011","url":null,"abstract":"<div><p><span><span><span><span>Epiglottopexy is an uncommon, but effective procedure for pediatric patients with obstructive sleep apnea. It is important to establish retroflexion and collapse of the </span>epiglottis at the base of </span>tongue<span> prior to surgery. Preoperative polysomnogram, flexible fiberoptic laryngoscopy, and sometimes </span></span>drug induced sleep </span>endoscopy<span> are critical components of the workup as many patients who benefit from epiglottopexy have already failed primary adenotonsillectomy. The surgery involves demucosalizing the base of tongue and lingual surface of the epiglottis and securing the 2 structures to one another. Patients tolerate the procedure well and can often be discharged home the following day.</span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages 195-198"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Midline Glossectomy","authors":"Steven Coutras MD, FACS","doi":"10.1016/j.otot.2023.09.009","DOIUrl":"10.1016/j.otot.2023.09.009","url":null,"abstract":"<div><p><span><span>Surgical treatment of obstructive sleep apnea<span><span> in children who fail tonsillectomy and </span>adenoidectomy<span>, or in those children with small nonobstructing tonsils is performed infrequently. Further evaluation including </span></span></span>drug induced sleep </span>endoscopy<span> may uncover residual upper airway obstruction<span> at the tongue<span> base. When this finding is identified, targeted treatment of tongue base obstruction can be performed. A straight forward easy to perform tongue reduction procedure with minimal complications and good clinical outcomes when part of a multi-level approach is described.</span></span></span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages 185-189"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135297973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing techniques for in-office endoscopic transnasal sphenopalatine ganglion block injections","authors":"Patricia T. Jacobson BSN ,&nbsp;Nathan Yang MD, MSc, FRCSC ,&nbsp;Francesco F. Caruana MD,&nbsp;David A. Gudis MD, FACS,&nbsp;Jonathan B. Overdevest MD, PhD","doi":"10.1016/j.otot.2023.06.001","DOIUrl":"10.1016/j.otot.2023.06.001","url":null,"abstract":"<div><p><span>Otolaryngologists play a central role in diagnosing and treating facial pain syndromes and headache disorders. Although sphenopalatine </span>ganglion<span><span> block is a recognized treatment option, literature on transnasal injection techniques is limited. This study's objective is to refine </span>anatomic landmarks<span> and optimize a technique for in-office transnasal sphenopalatine ganglion blocks. Eight cadaveric head specimens were dissected to record 16 measurements of critical anatomic landmarks and surgical instruments for sphenopalatine ganglion block<span>. On average, the sphenopalatine foramen<span> center was 5.94 mm (±1.65 mm) superior to the inferior border of the middle turbinate's basal lamella attachment to the lateral nasal wall. We describe the reliability of using a 20G spinal needle bent at 70-degree to perform a transnasal injection technique for sphenopalatine ganglion block. The inferior border of the middle turbinate basal lamella attachment to the lateral nasal wall may be used as an intranasal landmark in transnasal injection of the sphenopalatine ganglion. Further testing in the clinical setting is required to assess efficacy.</span></span></span></span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e27-e30"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46121326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic inferior meatal antrostomy (EIMA) for the removal of dental implants displaced into the maxillary sinus","authors":"Roee Landsberg ,&nbsp;Shay Schneider ,&nbsp;Muhamed Masalha ,&nbsp;Ariel Margulis ,&nbsp;Yoav Leiser ,&nbsp;Muhammad Masarwa","doi":"10.1016/j.otot.2022.09.001","DOIUrl":"10.1016/j.otot.2022.09.001","url":null,"abstract":"<div><p><span><span>Over the last 40 years, dental implants<span> have become popular. Despite being a safe procedure with few reported complications, dental implants may become displaced into the maxillary sinus. We analyzed the outcomes of endoscopic inferior meatal antrostomy (EIMA) for implant removal. </span></span>Medical records of all patients who had EIMA for dislocated dental implants at our institution during 2016-2021 were retrospectively reviewed. Ten patients were included in the analysis; most of them were asymptomatic at presentation. Implants, displaced into the lower, central, or upper parts of the maxillary sinus, were removed by EIMA, which provided excellent access and view. The ostiomeatal complex remained untouched. The average operation time (including administration of general anesthesia) was 42 minutes. No intraoperative or </span>postoperative complications occurred. Recirculation was not detected. All patients healed without requiring further interventions. EIMA should be considered for removal of dislocated dental implants from the maxillary sinus, since it provides better access and view, while maintaining the integrity of the ostiomeatal complex.</p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e57-e61"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41832501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cartilage butterfly graft to repair temporal bone CSF leak","authors":"Traeden Wilson BS ,&nbsp;Yekaterina Koshkareva MD ,&nbsp;Alan Turtz MD ,&nbsp;Linda Zhang BS ,&nbsp;Donald Solomon MD","doi":"10.1016/j.otot.2023.03.001","DOIUrl":"10.1016/j.otot.2023.03.001","url":null,"abstract":"<div><p>Temporal bone<span><span> cerebral spinal fluid (CSF) leak is a condition characterized by continuous CSF leakage from the intracranial cavity into the middle ear space. Prompt surgical management is warranted as temporal bone CSF leaks may lead to serious infections such as meningitis and encephalitis. There are several methods and materials utilized to repair tegmen defects that cause CSF leaks. Herein, we describe a novel technique to repair the tegmen </span>in patients<span> with temporal bone CSF leak utilizing a tragal cartilage butterfly graft. Cartilage is a readily available, generously biocompatible, resistant to deformation and an inherently pliable graft material. Butterflied cartilage grafts provide unique benefit allowing both intracranial and extracranial support to seal tegmen defects with the placement of a single piece of graft material.</span></span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e31-e35"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41420644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}