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

{"title":"Removal of the Posterior Wall of the Sphenoid Sinus During Trans-sellar Skull Base Surgery: The Meniscus Sign","authors":"Pranit R. Sunkara ,&nbsp;Courtney B. Shires MD, FACS ,&nbsp;Karuna Dewan MD, FACS","doi":"10.1016/j.otot.2021.11.002","DOIUrl":"10.1016/j.otot.2021.11.002","url":null,"abstract":"<div><p>Trans-sellar surgical approaches can be difficult and unpredictable. Tumors can distort the appearance of the posterior wall of the sphenoid sinus and a surgeon's concerns for avoiding the proximal vascular structures of the region may compromise access for the neurosurgical portion of the operation. Bone removal from the sellar dura is sometimes suboptimal. The meniscus sign is a convenient and reliable method for removal of the posterior wall of the sphenoid sinus during trans-sellar skull base surgery. It is a safe technique that maximizes bone removal and surgical access between the cavernous sinuses and internal carotid arteries. The senior author has employed the meniscus sign in trans-sellar surgery for over 15 years, noting that the technique has been free of surgical complications, reproducible amongst trainees, and reliable in safely providing maximum exposure for the intradural portion of the operation.</p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e9-e11"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46492999","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 rational of trans superior meatal posterior ethmoidectomy","authors":"Roee Landsberg MD ,&nbsp;Muhamed Masalha MD ,&nbsp;Shay Schneider MD ,&nbsp;Ariel Margulis MD ,&nbsp;Muhammad Masarwa MD, PhD","doi":"10.1016/j.otot.2022.09.002","DOIUrl":"10.1016/j.otot.2022.09.002","url":null,"abstract":"<div><p><span><span>Functional endoscopic sinus surgery<span> has become the preferred surgery for a variety of sinonasal pathologies. Lesions confined to the posterior ethmoid sinuses or to the posterior sphenoethmoidal complex are usually treated by the conventional \"anterior to posterior\" approach. This procedure requires removal of the anterior ethmoids, which might impair the anatomical and functional integrity of the ostiomeatal complex (OMC). Here we describe our experience with an effective and minimally invasive surgical approach to treat these posterior lesions while preserving the OMC. </span></span>Medical records<span><span><span> of patients who underwent trans-superior meatal posterior ethmoidectomy<span> or posterior sphenoethmoidectomy with OMC preservation during functional endoscopic sinus surgery between 2016 and 2021 were analyzed. Twelve patients were included in the study. Their diagnosis included sinusitis (5 patients), </span></span>fungus ball (3), </span>inverted papilloma<span> (2), allergic fungal sinusitis<span> (1) and mucocele (1). No intraoperative or </span></span></span></span>postoperative complications occurred, and all patients recovered rapidly. Lesions confined to the posterior ethmoids or posterior sphenoethmoidal complex can be treated with trans-superior meatal posterior ethmoidectomy or posterior sphenoethmoidectomy.</p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e51-e56"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48308731","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":"Anatomy of pediatric obstructive sleep apnea","authors":"Nicole Molin MD ,&nbsp;Glenn Isaacson MD, FAAP","doi":"10.1016/j.otot.2023.09.002","DOIUrl":"10.1016/j.otot.2023.09.002","url":null,"abstract":"<div><p><span><span><span>Pediatric </span>obstructive sleep apnea<span><span> is most commonly caused by adenotonsillar hypertrophy, for which </span>adenotonsillectomy<span><span> remains one of the mainstays of treatment<span>. For patients with persistent obstructive sleep apnea following adenotonsillectomy, or for patients in whom the adenoid and tonsils are not contributing to airway obstruction, individualized treatment is centered around identifying the site of obstruction. Obstruction can occur anywhere along the upper airway and is often multilevel. These sites can include the </span></span>nasal cavity, </span></span></span>nasopharynx<span>, velum, oropharynx<span>, tongue base, and/or supraglottis. Knowledge of this </span></span></span>anatomy is essential.</p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages 147-151"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135255479","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":"Eponyms: A historical pathway to safe thyroidectomy","authors":"Marina L. Parapini MD,&nbsp;Sam M. Wiseman MD, FRCSC, FACS","doi":"10.1016/j.otot.2022.01.001","DOIUrl":"10.1016/j.otot.2022.01.001","url":null,"abstract":"<div><h3>Objective</h3><p>This historical review aims to discuss not only the surgical significance of eponyms commonly encountered during thyroid operations but also about the people behind them who have lent their names to anatomical structures and surgical landmarks important for completing a safe and effective thyroidectomy.</p></div><div><h3>Finding</h3><p>Kocher describes anomalous venous anatomy, proper patient positioning and incision placement. Reeve and Joll define anatomical spaces relevant to the dissection of the upper pole of the thyroid that assist with identification and preservation of the nerve of Galli-Curci. The Glands of Owen must also be carefully identified and preserved during thyroidectomy. Identification and protection of the recurrent laryngeal nerve, is guided by anatomical landmarks described by Berry and Zuckerkandl, as well as triangles named after Lore, Beahrs, and Simon.</p></div><div><h3>Conclusion</h3><p>The elegant simplicity and efficiency in describing complex surgical anatomy and surgical concepts continue to make utilization of eponyms useful during thyroid operations<strong>.</strong></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e1-e8"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43869179","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":"Outcomes of the facelift incisional approach to neck dissection without endoscopic or robotic assistance","authors":"Benjamin T. Ostrander MD, MSE ,&nbsp;Matthew N. Harmon MD ,&nbsp;Vanessa K. Yu BS ,&nbsp;Joseph Califano MD","doi":"10.1016/j.otot.2023.02.001","DOIUrl":"10.1016/j.otot.2023.02.001","url":null,"abstract":"<div><p>The facelift incisional approach to neck dissection offers several advantages including improved cosmesis, increased patient satisfaction, and decreased morbidity. This approach has been previously described using robotic or endoscopic instrumentation, but the clinical outcomes of this approach using standard instrumentation have not been reported. The objective of this study was to determine if the facelift incisional approach to neck dissection can be performed without endoscopic or robotic assistance and achieve improved oncologic and cosmetic outcomes. This was a retrospective cohort study over 4 years at a national comprehensive cancer center. A total of 104 subjects received 113 oncologic neck dissections, of which 35 were performed using a facelift approach. Primary outcomes included rate of negative margins, recurrence, incidence of nerve weakness, and incidence of lymphedema. The mean age of the cohort was 60.1 ± 12.7 years and 72.6% were male. Mean follow up was 23.1 ± 19.1 months (<em>P =</em> 0.21). The 104 subjects (92.9%) had negative margins on final pathology, with no difference between approaches (88.2% vs 94.9% respectively, <em>P =</em> 0.24). Thirty-four subjects (97.1%) in the facelift group had no evidence of disease at study conclusion. There was no difference in marginal mandibular nerve weakness (<em>P =</em> 0.10) nor shoulder weakness (<em>P =</em> 0.59) between groups. There was no difference between postoperative lymphedema (38.2% vs 29.2% for the facelift vs standard incision groups, <em>P =</em> 0.35). A facelift approach to neck dissection using standard instrumentation without robotic or endoscopic assistance achieves acceptable clinical and oncologic outcomes compared to the standard incisional approach with an additional benefit of improved cosmesis.</p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e42-e50"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S104318102300012X/pdfft?md5=6353420982dabad2bd02b14cf83af03d&pid=1-s2.0-S104318102300012X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42798329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The modified mini direct bone-anchored browlift for frontal paralysis","authors":"Christopher D. Pool MD,&nbsp;Jessyka G. Lighthall MD, FACS","doi":"10.1016/j.otot.2021.04.004","DOIUrl":"10.1016/j.otot.2021.04.004","url":null,"abstract":"<div><p>A myriad of techniques have been described to correct brow ptosis<span><span><span> via a blepharoplasty </span>incision<span>, mid-forehead incision, endoscopic approach, pretrichial incision, coronal approach or direct brow lift. There are varying risks and results for each technique including paresthesia, </span></span>facial nerve injury<span>, alopecia<span>, and unsightly scars. In this article we describe the mini-direct browlift technique that utilizes bone anchored sutures and allows for good cosmesis and control of brow height with minimal morbidity. A myriad of techniques have been described to correct brow ptosis via a blepharoplasty incision, mid-forehead incision, endoscopic approach, pretrichial incision, coronal approach or direct brow lift. There are varying risks and results for each technique including paresthesia, facial nerve injury, alopecia, and unsightly scars. In this article we describe the mini-direct browlift technique that utilizes bone anchored sutures and allows for good cosmesis and control of brow height with minimal morbidity.</span></span></span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e20-e22"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.otot.2021.04.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47695325","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":"Open and endoscopic approaches to the infratemporal fossa","authors":"Robert A. Saadi MD ,&nbsp;Sarah Benyo BS ,&nbsp;Tom Shokri MD ,&nbsp;Huseyin Isildak MD","doi":"10.1016/j.otot.2021.11.001","DOIUrl":"10.1016/j.otot.2021.11.001","url":null,"abstract":"<div><p>The infratemporal fossa is a complex space that both contains and is closely associated with vital neurovascular structures. As such, surgical access of the infratemporal fossa presents a definitive challenge requiring complete understanding of ventral skull base anatomy and expertise with both open craniofacial and endoscopic techniques. Anterior and lateral approaches to the infratemporal fossa vary greatly and may be individualized to each case in order to optimize visualization and instrumentation. Significant progress has been made in the development of surgical techniques for treatment of tumors involving the infratemporal fossa, including expanded endonasal approaches. Endoscopic, minimally invasive, and open approaches each provide distinct advantages and disadvantages. In the present article, we will review indications and limitations of the varied methodology for approaching the infratemporal fossa.</p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 3","pages":"Pages e12-e19"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43497234","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":"Interventional Pulmonology: Approaches to the Treatment of Benign Subglottic and Tracheal Stenosis","authors":"Pankit Patel MD,&nbsp;Jennifer Toth MD","doi":"10.1016/j.otot.2023.05.011","DOIUrl":"https://doi.org/10.1016/j.otot.2023.05.011","url":null,"abstract":"<div><p><span>Benign subglottic/tracheal stenosis is a condition that negatively impacts patient quality of life<span><span> and often morbidity. In cases of benign tracheal stenosis<span>, a multidisciplinary and multimodal approach to treatment has been shown to result in the best outcomes with respect to successful management and recurrence rate. Interventional </span></span>Pulmonology<span> (IP) physicians work in conjunction with other specialties to manage these conditions. The procedures employed by IP physicians incorporate techniques via rigid bronchoscopy, flexible bronchoscopy, and occasionally hybrid approaches. Often, multiple modalities are utilized during a case, including mechanical dilation (rigid scope and balloon), </span></span></span>laser therapies<span><span><span>, electrocautery, spray </span>cryotherapy, and pharmacologic therapies. The goal is to reduce the risk of </span>restenosis<span> and/or palliate symptoms in patients who may not be operative candidates for short-segment tracheal stenosis or laryngotracheal resection and reconstruction.</span></span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 2","pages":"Pages 136-140"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49793607","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":"Evolving trends in airway management for laryngeal stenosis","authors":"Taylor G Lackey MD ,&nbsp;Benjamin H. Cloyd MD MPH ,&nbsp;Daniel S. Fink MD","doi":"10.1016/j.otot.2023.05.002","DOIUrl":"10.1016/j.otot.2023.05.002","url":null,"abstract":"<div><p>Laryngotracheal stenosis<span><span><span> management requires surgical visualization and access, while safely oxygenating and ventilating the patient. The objective of this chapter is to review the ventilation techniques for laryngotracheal stenosis including spontaneous ventilation, intermittent apnea, jet ventilation, </span>laryngeal mask airway and transnasal humidified rapid insufflation ventilatory exchange. Multiple modalities for ventilation should be present and available in the operating room prior to the start of the procedure. Planning and communication of the airway plan between the surgeon, anesthesia team, and operating room staff is paramount. Obesity and </span>lung disease continue to be a challenging factor in maintaining safe ventilation, and appropriate precautions must be taken in this setting for rescue ventilation.</span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 2","pages":"Pages 76-84"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44242210","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":"Thoracic surgery techniques in open tracheal surgery for tracheal stenosis","authors":"Rolfy A. Perez Holguin MD MSc ,&nbsp;Michael F. Reed MD","doi":"10.1016/j.otot.2023.05.010","DOIUrl":"10.1016/j.otot.2023.05.010","url":null,"abstract":"<div><p><span><span>Tracheal stenosis is commonly a result of </span>intubation injury. The management of these lesions can be challenging and requires comprehensive knowledge of tracheal </span>anatomy<span> and meticulous surgical technique. This text provides a detailed description of the preoperative assessment and the surgical management of tracheal stenosis. Additionally, outcomes following surgical resection and reconstruction are also discussed.</span></p></div>","PeriodicalId":39814,"journal":{"name":"Operative Techniques in Otolaryngology - Head and Neck Surgery","volume":"34 2","pages":"Pages 129-135"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41916371","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}