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1.
Ann R Coll Surg Engl ; 104(4): e122-e124, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34939843

RESUMO

A 49-year-old patient with a history of aspirin-exacerbated respiratory disease presented with carotid artery injury following revision functional endoscopic sinus surgery. Carotid artery injury is a rare but catastrophic complication of this surgery. The patient was transferred to our tertiary facility with interventional radiology for immediate management of the carotid artery injury. This case reaffirms that any surgery can have disastrous complications and highlights the importance of multidisciplinary management of complications such as carotid artery injury.


Assuntos
Lesões das Artérias Carótidas , Sinusite , Lesões das Artérias Carótidas/diagnóstico por imagem , Lesões das Artérias Carótidas/etiologia , Lesões das Artérias Carótidas/cirurgia , Artéria Carótida Interna/diagnóstico por imagem , Artéria Carótida Interna/cirurgia , Endoscopia/efeitos adversos , Humanos , Pessoa de Meia-Idade
2.
PLoS One ; 17(8): e0272371, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35913939

RESUMO

BACKGROUND: Continuous comprehensive treatment is still needed after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) to promote the recovery of sinus mucosal morphology and function. Traditional Chinese medicine (TCM) nasal irrigation is a promising external treatment of TCM, but at present, the application of TCM nasal irrigation after ESS for CRS has not been recommended by the guidelines. Therefore, this article aims to develop a systematic overview and meta-analysis protocol to assess the effectiveness and safety of Chinese herbal nasal rinse for CRS recovery after ESS. METHODS: Seven databases shall be retrieved from their inception until December 2021. Eligible randomized controlled trials will be covered in the study. The outcome indicators of the survey will consist of efficacy, visual analogue scale score, Lund-Kennedy score for nasal endoscopy, Lund-Mackay score for sinus computed tomography and other secondary outcome indicators. The selection of literature, extraction of data, and methodological quality evaluation of literature shall be conducted by two researchers separately. If there is any dispute, it can be discussed and solved by a third researcher. Review Manager 5.3 software will be applied to data analysis. RESULTS: The article will make a detailed research programme to explore the efficacy and safety of TCM nasal irrigation on CRS recovery after ESS. CONCLUSION: This protocol is suitable for evaluating the effectiveness and safety of TCM nasal rinse for CRS recovery after ESS, and can provide corresponding evidence-based medical evidence. SYSTEMATIC REVIEW REGISTRATION: Open Science Framework Registration DOI: 10.17605/OSF.IO/ZV73Q.


Assuntos
Rinite , Sinusite , Doença Crônica , Endoscopia/métodos , Humanos , Medicina Tradicional Chinesa , Metanálise como Assunto , Lavagem Nasal , Rinite/complicações , Rinite/cirurgia , Sinusite/complicações , Sinusite/cirurgia , Revisões Sistemáticas como Assunto , Resultado do Tratamento
3.
Neurosurg Focus ; 52(6): E9, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35921184

RESUMO

OBJECTIVE: Communication between neurosurgeons and pathologists is mandatory for intraoperative decision-making and optimization of resection, especially for invasive masses. Handheld confocal laser endomicroscopy (CLE) technology provides in vivo intraoperative visualization of tissue histoarchitecture at cellular resolution. The authors evaluated the feasibility of using an innovative surgical telepathology software platform (TSP) to establish real-time, on-the-fly remote communication between the neurosurgeon using CLE and the pathologist. METHODS: CLE and a TSP were integrated into the surgical workflow for 11 patients with brain masses (6 patients with gliomas, 3 with other primary tumors, 1 with metastasis, and 1 with reactive brain tissue). Neurosurgeons used CLE to generate video-flow images of the operative field that were displayed on monitors in the operating room. The pathologist simultaneously viewed video-flow CLE imaging using a digital tablet and communicated with the surgeon while physically located outside the operating room (1 pathologist was in another state, 4 were at home, and 6 were elsewhere in the hospital). Interpretations of the still CLE images and video-flow CLE imaging were compared with the findings on the corresponding frozen and permanent H&E histology sections. RESULTS: Overall, 24 optical biopsies were acquired with mean ± SD 2 ± 1 optical biopsies per case. The mean duration of CLE system use was 1 ± 0.3 minutes/case and 0.25 ± 0.23 seconds/optical biopsy. The first image with identifiable histopathological features was acquired within 6 ± 0.1 seconds. Frozen sections were processed within 23 ± 2.8 minutes, which was significantly longer than CLE usage (p < 0.001). Video-flow CLE was used to correctly interpret tissue histoarchitecture in 96% of optical biopsies, which was substantially higher than the accuracy of using still CLE images (63%) (p = 0.005). CONCLUSIONS: When CLE is employed in tandem with a TSP, neurosurgeons and pathologists can view and interpret CLE images remotely and in real time without the need to biopsy tissue. A TSP allowed neurosurgeons to receive real-time feedback on the optically interrogated tissue microstructure, thereby improving cross-functional communication and intraoperative decision-making and resulting in significant workflow advantages over the use of frozen section analysis.


Assuntos
Glioma , Telepatologia , Endoscopia/métodos , Humanos , Lasers , Microscopia Confocal/métodos
4.
Rhinology ; 60(4): 261-269, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35934318

RESUMO

BACKGROUND: Evidence regarding long-term postoperative follow-up of chronic rhinosinusitis with nasal polyps (CRSwNP) patients is scarce in the literature. The objective of the present study was to report long-term 12-year postoperative outcomes for CRSwNP patients. METHODS: CRSwNP patients were prospectively followed after endoscopic sinus surgery. Sinonasal symptoms, nasal polyp score (NPS), Barcelona Smell Test 24 (BAST-24), Lund-Mackay Score (LMS), and Medical Outcome Study Short Form-36 (SF-36) questionnaire were assessed before and 12 years after surgery. RESULTS: At long-term follow-up (median, 12 years), a strong improvement was noted for all patients (N=76) in nasal symptoms score, NPS, BAST-24, and LMS scores compared with baseline. No long-term improvement in SF-36 was found. CONCLUSION: Patients with CRSwNP have a long-term 12-year postoperative improvement in nasal symptoms, polyp size, computed tomography, and olfaction.


Assuntos
Pólipos Nasais , Rinite , Sinusite , Doença Crônica , Endoscopia/métodos , Humanos , Pólipos Nasais/complicações , Pólipos Nasais/cirurgia , Rinite/complicações , Rinite/cirurgia , Sinusite/complicações , Sinusite/cirurgia
5.
Artigo em Chinês | MEDLINE | ID: mdl-35959577

RESUMO

Objective:According to the characteristics of endoscopic transnasal and transoral surgery for infratemporal fossa tumors, we divided and named subzones of the infratemporal fossa, to explore the approaches of endoscopic transnasal and transoral surgery for infratemporal fossa tumors, and to analyze their advantages and disadvantages. Methods:We retrospectively analyzed the clinical data of 36 patients with benign tumors of infratemporal fossa successfully resected through nose or mouth under endoscope, summarized and analyzed the localization characteristics of these tumors in infratemporal fossa, and made a subzone naming rule of infratemporal fossa. We also summarized the selection principles, advantages and disadvantages of endoscopic transnasal and transoral surgical approaches. Results:The infratemporal fossa area is divided into ABC area. Area A is the fat pad area posterolateral of maxillary sinus. Area B is further divided into B1 (above the plane of maxillary sinus floor, anterior styloid process), B2 (below the plane of maxillary sinus floor, anterior styloid process), and B3 (posterior styloid process to anterior vertebra); Area C is retropharyngeal and eustachian tube area. The location of the tumor in the infratemporal fossa determines the choice of transnasal and transoral approaches. All tumors were completely removed, and no tumor recurred during the follow-up. A few patients had temporary local sensory function decline, and recovered during the follow-up. Conclusion:The infratemporal fossa region naming rule according to the characteristics of endoscopic transoral and transnasal surgery approach is simple and practical, which can effectively guide the operation of the infratemporal fossa region and has clinical application value.


Assuntos
Fossa Infratemporal , Procedimentos Cirúrgicos Bucais , Levantamento do Assoalho do Seio Maxilar , Endoscopia , Humanos , Seio Maxilar , Recidiva Local de Neoplasia , Estudos Retrospectivos
6.
Artigo em Chinês | MEDLINE | ID: mdl-35959578

RESUMO

Objective:To explore a safe and effective surgical approach to locate and cut the vidian nerves with the sphenoid process of the palatine bone as a landmark. Methods: The landmarks of locating the external opening of the vidian canal were confirmed by the dissection of the cadaveric heads, and the feasibility of locating the vidian nerves with the determined landmarks was verified during operation. Results:The anatomical landmarks, which are the anterior opening of palatovaginal canal, the posterior opening of palatovaginal canal, palatovaginal canal and the nasal pharyngeal crest of the root of the pterygoid process can be used as the important landmarks of locating vidian nerve. In the cases of 10 patients with refractory allergic rhinitis and vasomotor rhinitis, the vidian nerves were successfully located and sectioned, and one patient was complicated with short-term unilateral palatal numbness after surgery. Conclusion:The anterior opening of palatovaginal canal, the posterior opening of palatovaginal canal, palatovaginal canal and the nasal pharyngeal crest of the root of the pterygoid process can be used as surgical markers for vidian neurectomy with the sphenoid process of the palatine bone as landmarks.


Assuntos
Palato Duro , Seio Esfenoidal , Denervação , Endoscopia , Humanos , Palato Duro/cirurgia , Osso Esfenoide/inervação , Osso Esfenoide/cirurgia , Seio Esfenoidal/cirurgia
7.
Artigo em Chinês | MEDLINE | ID: mdl-35959581

RESUMO

Objective:To analyze the CT manifestations, clinical features, and endoscopic management and outcome of nasosinusitis in non-traumatic dehiscence of the lamina papyracea with herniation of orbital contents. Methods:From January 2019 to October 2020, a total of 686 cases with chronic nasosinusitis or nasal septum deviation were admitted to our department, including 448 male cases and 238 female cases. No patient had prior maxillofacial or orbital trauma as well as surgery related to nose and eyes. The clinical data were retrospectively analyzed. Results:Twelve patients were diagnosed as dehiscence of the lamina papyracea. Preoperative CT revealed that the location of dehiscence was only in the ethmoid sinus. Conclusion:For nasosinusitis patients with non-traumatic dehiscence of the lamina papyracea, all ethmoid cells should be opened during FESS. Precise and skillful operation, good bleeding control and clear visual field were critical. no damage to the herniated periorbital fat during the operation and appropriate cavity packing after the operation are essential, which could avoid the orbital-related complications as well as improve the symptom resolution. No recurrence was found during the follow-up period.


Assuntos
Osso Etmoide , Tomografia Computadorizada por Raios X , Endoscopia , Osso Etmoide/cirurgia , Feminino , Humanos , Masculino , Septo Nasal , Estudos Retrospectivos
8.
Artigo em Chinês | MEDLINE | ID: mdl-35959586

RESUMO

Chronic sinusitis (CRS) is one of the most common nasal diseases, and FSDP is a risk factor for CRS. The variation of the frontal recess cell obstructs the frontal sinus drainage pathway, which makes the frontal sinus surgery more difficult and a higher recurrence rate than other sinus surgeries. Therefore, before surgery, a thin-slice CT scan is performed on the patient to fully evaluate the anatomical structure and drainage pathway of the frontal sinus, and to understand the variation of FSDP cell is crucial for accurate opening of the frontal sinus. In this paper, A case of large supra bulla frontal cell infection was summarized and analyzed. The anatomical structure of the frontal recess was fully understood by preoperative radiographs, the spatial relationship between the cells was identified, and the appropriate surgical plan was developed, which was beneficial for the surgeon to accurately open the frontal cortex during surgery and avoid postoperative recurrence.


Assuntos
Seio Frontal , Sinusite Frontal , Sinusite , Vesícula , Doença Crônica , Endoscopia , Seio Frontal/cirurgia , Sinusite Frontal/cirurgia , Humanos , Tomografia Computadorizada por Raios X
9.
Am J Mens Health ; 16(4): 15579883221115615, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35959959

RESUMO

This study aimed to compare the success rates of two approaches for seminal vesiculoscopy: through the interior of the prostatic utricle and through the neck of the prostatic utricle. The patients were divided into two groups based on the seminal vesiculoscopy used. Group A was an interior of the prostatic utricle group (152 cases), and group B was a neck of the prostatic utricle group (146 cases). The general clinical data, intraoperative conditions and surgical results of the two groups were compared. Compared with group A, group B had a higher surgical success rate (94.5% vs. 62.5%, p < .001), a shorter operation time (33 min vs. 45 min, p < .001), less blood loss (0.5 ml vs. 2 ml, p < .001), a higher pain relief rate (86.6% vs. 52.3%, p < .001), a higher remission rate of haemospermia (82.2% vs. 58.5%, p = .011), a lower recurrence rate of pain (10.4% vs. 35.4%, p < .001), a lower recurrence rate of haemospermia (15.6% vs. 37.7%, p = .014), a higher symptom remission rate of the lower urinary tract (90.9% vs. 50.0%, p = .030), a higher remission rate of scrotal moisture (84.6% vs. 45.5%, p = .042) and a higher remission rate of frequent spermatorrhea (80.0% vs. 55.6%, p = .033). Seminal vesiculoscopy undertaken through the neck of the prostatic utricle has the characteristics of high success rate, short operation time and good surgical effect and is worthy of promotion and application.


Assuntos
Hemospermia , Ductos Ejaculatórios , Endoscopia/métodos , Hemospermia/diagnóstico , Hemospermia/cirurgia , Humanos , Masculino , Dor , Glândulas Seminais/cirurgia
10.
Artigo em Russo | MEDLINE | ID: mdl-35942842

RESUMO

One of the main problems of transsphenoidal surgery is the risk of infectious complications. Nosocomial meningitis (NCM) can lead to increased length of hospital stay and financial costs, poor treatment outcomes and even mortality. This complication is an indicator of the quality of medical care for patients with neurosurgical diseases. The purpose of the review was to study the main risk factors of NCM, modern schemes for antibiotic prophylaxis and treatment of this complication after endoscopic transsphenoidal surgery. The main risk factors of meningitis are intra- and postoperative CSF leakage, overweight, diabetes mellitus, previous transsphenoidal surgeries and radiotherapy. To date, there are no generally accepted periods for antibiotic prophylaxis in nasal CSF leakage, installed external ventricular / lumbar drains or tampons in nasal cavity. Antibiotic prophylaxis should not exceed 3 postoperative days due to the risk of cultivating the drug-resistant organisms. If NCM is detected, treatment should be initiated immediately with a broad spectrum of antibiotics.


Assuntos
Infecção Hospitalar , Meningite , Neoplasias Hipofisárias , Vazamento de Líquido Cefalorraquidiano , Infecção Hospitalar/complicações , Endoscopia/efeitos adversos , Humanos , Meningite/complicações , Neoplasias Hipofisárias/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos
11.
Nat Commun ; 13(1): 4469, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918348

RESUMO

Ultrathin lensless fibre endoscopes offer minimally invasive investigation, but they mostly operate as a rigid type due to the need for prior calibration of a fibre probe. Furthermore, most implementations work in fluorescence mode rather than label-free imaging mode, making them unsuitable for general medical diagnosis. Herein, we report a fully flexible ultrathin fibre endoscope taking 3D holographic images of unstained tissues with 0.85-µm spatial resolution. Using a bare fibre bundle as thin as 200-µm diameter, we design a lensless Fourier holographic imaging configuration to selectively detect weak reflections from biological tissues, a critical step for label-free endoscopic reflectance imaging. A unique algorithm is developed for calibration-free holographic image reconstruction, allowing us to image through a narrow and curved passage regardless of fibre bending. We demonstrate endoscopic reflectance imaging of unstained rat intestine tissues that are completely invisible to conventional endoscopes. The proposed endoscope will expedite a more accurate and earlier diagnosis than before with minimal complications.


Assuntos
Endoscópios , Holografia , Animais , Endoscopia , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Ratos
12.
Curr Opin Gastroenterol ; 38(5): 429, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35916319
13.
J Med Life ; 15(6): 805-809, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35928363

RESUMO

The pre-lacrimal recess approach is modernly used for lesions of the anterior maxillary wall and for reaching paramedian cranial base regions. In this computed-tomography study, we assessed the pre-lacrimal recess types as well as the angles between the anterior and medial maxillary walls and between the anterior maxillary wall and the lateral margin of the nasolacrimal canal to show the feasibility of the pre-lacrimal recess approach in reaching lesions of the infratemporal and pterygopalatine fossae, using 30 computed-tomography studies (60 sides). A type I pre-lacrimal recess was identified in 22 cases (35%), type II was identified in 31 cases (53.30%), and type III in 7 cases (11.66%). We found that angle 1 (the angle between the anterior maxillary wall and the medial maxillary wall) had a mean value of 80.8° (minimum 75.5°, maximum 85.8°), while angle 2 (the angle between the anterior maxillary wall and the lateral margin of the nasolacrimal canal) had a mean value of 59.1° (minimum 57.6°, maximum 60.1°). We consider the pre-lacrimal recess approach a very good option for the anterior maxillary wall, the alveolar recess, and in reaching the infratemporal fossa and lateral part of the pterygopalatine fossa. In cases where direct visualization of the medial part of the pterygopalatine fossa is needed, the pre-lacrimal recess approach could not be the perfect option.


Assuntos
Seio Maxilar , Base do Crânio , Endoscopia/métodos , Humanos , Maxila , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Tomografia Computadorizada por Raios X/métodos
14.
Khirurgiia (Mosk) ; (8): 31-37, 2022.
Artigo em Russo | MEDLINE | ID: mdl-35920220

RESUMO

OBJECTIVE: To improve treatment outcomes in patients with acute pancreatitis through a differentiated approach to transluminal drainage. MATERIAL AND METHODS: There were 1074 patients with acute pancreatitis between January 2018 and December 2021 at the Sklifosovsky Research Institute for Emergency Care. EUS was used as a final diagnostic method to determine localization, dimensions, shape and contours of fluid collections. We also assessed content, presence or absence of a capsule and connection with pancreatic ductal system, possibility of intraluminal drainage under EUS control. A plastic stent with rounded ends was installed if homogeneous hypo- and anechoic cavity with clear even contours was detected. The same measure was applied in case of aspiration of serous or serous-hemorrhagic fluid. The indication for installation of covered self-expanding endoprosthesis was inhomogeneous anechoic fluid collection with hyperechoic inclusions (sequesters) and cloudy purulent content. Patients with necrotic forms underwent insertion of a cystonasal drainage tube 7Fr for sanitation of the cavity with 0.05% aqueous chlorhexidine solution. Endoscopic sequestrectomy was performed every 24-48 hours. Stent was removed in 6 (for encapsulated peripancreatic fluid collections) or 1 month (for other types of fluid collections) after discharge. RESULTS: According to the EUS data, endoscopic TLD was performed in 63 (46%) out of 136 patients with fluid collections. Among 63 patients with TLD, connection with pancreatic ductal system was found in 5 (7.9%) patients. These ones underwent pancreaticoduodenal stenting. Twenty-two patients underwent elective sequestrectomy after stenting of necrotic types of fluid collections with fully covered self-expanding stents. Additional percutaneous drainage was required in 11 (45.8%) of 24 patients. Complicated postoperative period was observed in 4 (6.3%) patients with acute necrotic fluid collections (bleeding from the area of pancreatogenic destruction). Four (6.3%) patients died. Autopsy revealed resolution of purulent-inflammatory process in all patients. CONCLUSION: Intraluminal surgery is possible not only for homogeneous delimited fluid collections, but also for advanced lesions including infected destructions. This approach allows us to consider endoscopic intraluminal drainage as the final minimally invasive method of surgical treatment of pancreatic necrosis. Its effectiveness is up to 45.8%.


Assuntos
Drenagem , Pancreatite Necrosante Aguda , Doença Aguda , Drenagem/métodos , Endoscopia/métodos , Endoscopia Gastrointestinal , Endossonografia/métodos , Humanos , Necrose/cirurgia , Pancreatite Necrosante Aguda/etiologia , Stents , Resultado do Tratamento
16.
Arch. argent. pediatr ; 120(4): e171-e174, Agosto 2022. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1378563

RESUMO

La atresia de coanas se caracteriza por la obliteración de la abertura nasal posterior. Es la anomalía congénita más frecuente de las fosas nasales. Tiene una incidencia de 1 cada 5000 a 7000 neonatos, con predominio en el sexo femenino. Puede presentarse en forma aislada o asociada a otros síndromes como el CHARGE (coloboma [C], malformaciones cardíacas [H], atresia de coanas [A], retraso psicomotor y/o en el crecimiento [R], hipoplasia de genitales [G], malformaciones auriculares y/o sordera [E, por su sigla en inglés]). Las manifestaciones clínicas son la obstrucción nasal, cianosis y dificultad respiratoria desde el nacimiento cuando es bilateral. Las atresias unilaterales se caracterizan por insuficiencia ventilatoria nasal y rinorrea unilateral, y pueden pasar inadvertidas. El diagnóstico se realiza mediante endoscopia y estudios por imágenes. El tratamiento es quirúrgico; existen diferentes técnicas y vías de abordaje. Se presenta el caso de un paciente masculino de 7 años con atresia unilateral de coana derecha con resolución microendoscópica, colocación de tutor externo, con buena resolución.


Choanal atresia is characterized by obliteration of the posterior nasal opening. It is the most common congenital anomaly of the nasal passages. It has an incidence of 1 in 5000 to 7000 newborns; predominantly female. It can occur in isolation or in association with other syndromes such as CHARGE (coloboma [C], cardiac malformations [H], choanal atresia [A], psychomotor and/or growth retardation [R], genital hypoplasia [G], atrial malformations and/or deafness [E]. Clinicallypresents nasal obstruction, cyanosis and respiratory distress from birth when bilateral, unilateral atresias are characterized by nasal ventilatory insufficiency and unilateral rhinorrhea, which may go unnoticed. Diagnosis is made by endoscopy and imaging tests. Treatment is surgical, with different techniques and approaches.A 7-year-old male patient is presented with unilateral atresia of the right choana with microendoscopic resolution, placement of an external tutor, with good resolution.


Assuntos
Humanos , Masculino , Criança , Obstrução Nasal/etiologia , Coloboma , Atresia das Cóanas/cirurgia , Atresia das Cóanas/complicações , Atresia das Cóanas/diagnóstico , Nasofaringe , Endoscopia/efeitos adversos , Endoscopia/métodos
18.
Artigo em Inglês | MEDLINE | ID: mdl-35897454

RESUMO

BACKGROUND: To assess the long-term outcomes and independent predictors of surgical success of a one-stage minimally invasive surgical procedure for congenital choanal atresia (C.C.A.). METHODS: a retrospective multicentric study was conducted between 2010 and 2022. An endonasal endoscopic approach was performed in 38 unilateral or bilateral C.C.A. children. All the patients were clinically and radiologically assessed and followed for at least 2 years. Seven outcome measures were applied. Consequently, surgical success was correlated with all the independent variables reported. RESULTS: 18/38 (47.36%) patients presented normal postoperative healing, 8/38 (21.05) had moderate restenosis (<50%), while 12/38 (31.57%) cases were severe (>50%), requiring a surgical revision. No statistical significance was found for average hospital stay between stenosis >50% and <50% patients (p = 0.802) and postoperative pain (p = 0.075); instead, the severe restenosis group demonstrated a higher delay of breast suction (p < 0.001). Among the independent variables predictors of surgical success, the presence of Charge syndrome and rhinopharyngeal stenosis demonstrated higher risks for surgical revision (OR: 4.00, 95% CI: 0.57-28.01, and OR: 2.75, 95% CI: 0.55-13.69, respectively). On the contrary, the hypoplastic inferior turbinate and bilateral C.C.A. showed a lower risk for severe restenosis by a higher endoscopic surgical space and creating a single larger opening (OR: 0.88, 95% CI: 0.22-3.52, and OR: 0.45, 95% CI: 0.10-2.08). CONCLUSION: Several independent variables could influence the surgical success after C.C.A. endoscopic repair; however, more high-quality evidence is needed to generate an effective predictive model.


Assuntos
Atresia das Cóanas/cirurgia , Endoscopia , Criança , Constrição Patológica , Endoscopia/métodos , Endoscopia/normas , Humanos , Recidiva , Estudos Retrospectivos , Resultado do Tratamento
19.
Neurol India ; 70(3): 1137-1141, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35864651

RESUMO

Background: Endoscopic endonasal surgery (EES) requires wide sinonasal dissection to achieve adequate visualisation of anatomical landmarks. This can also result in nasal sequelae like crusting, nasal discharge, and anosmia. Aim: To use the sinonasal outcome test (SNOT) 22 questionnaire to study the postoperative sinonasal morbidity and its recovery in patients who have undergone EES. Materials and Method: Prospective study conducted from November 2017 to May 2018. SNOT-22 questionnaire was administered on patients operated between before EES and then re-administered during outpatient visits at 1 month, 3 months, and 6-12 months following surgery. Results: Results of 46 patients were analyzed. The mean duration of follow-up was 11.8 months. The mean preoperative SNOT-22 score was 2.69 ± 4.95. SNOT-22 score at 1 month was 5.52 ± 6.77, at 3 months follow-up was 0.39 ± 1.02, and after 6 months was 0.30 ± 1.00. In 32 patients with a nasoseptal flap, mean preoperative score was 3.34 ± 5.68 (P = 0.18), one month following surgery it was 6.68 ± 6.88 and at 3 and 6 months following surgery it was 0.56 ± 1.19 and 0.38 ± 1.15. The mean preoperative nasal domain score was 1.022 (±2.13), the postoperative 1 month score was 2.3 ± 3.7, at 3 months following surgery was 0.22 ± 0.82 and after 6 months of surgery was 0.28 ± 0.96. Conclusion: Patients undergoing EES experienced transient worsening of SNOT 22 scores in the first month following surgery and recovered within 3 months of surgery. The improvement was sustained in follow-up visits beyond 6 months of surgery.


Assuntos
Endoscopia , Doenças Nasais , Nariz , Base do Crânio , Endoscopia/efeitos adversos , Endoscopia/métodos , Seguimentos , Humanos , Nariz/lesões , Doenças Nasais/etiologia , Doenças dos Seios Paranasais/etiologia , Seios Paranasais/lesões , Neoplasias Hipofisárias/cirurgia , Estudos Prospectivos , Qualidade de Vida , Recuperação de Função Fisiológica , Base do Crânio/cirurgia , Resultado do Tratamento
20.
Medicine (Baltimore) ; 101(29): e29631, 2022 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-35866811

RESUMO

To investigate the feasibility and efficacy of transcanal endoscopic treatment for congenital middle ear cholesteatoma in children. Eleven children diagnosed with congenital middle ear cholesteatoma, who underwent total ear endoscopic surgery under general anesthesia, were included from the Huazhong University of Science and Technology Union Shenzhen Hospital between January 2016 and December 2020. We retrospectively analyzed their operation process and surgical complications through the surgical video; moreover, we compared the pre- and postoperative hearing outcomes. One child underwent a planned second operation to reconstruct the ossicular chain. At 6 postoperative months, all 11 children underwent reexamination. There was no significant change and a significant decrease in the mean bone and air conduction hearing thresholds, respectively (P > .05 and P < .05); moreover, there was a significant reduction in the air-bone conduction difference (P < .05). Further, the air-bone conduction difference was reduced to >20 dB and >10 dB in 11 and 7 children, respectively. Follow-up of the children did not reveal sensorineural deafness, facial paralysis, and other serious complications; further, there were no cases of recurrence. Transcanal endoscopic treatment for congenital middle ear cholesteatoma in children is feasible, minimally invasive, and functional.


Assuntos
Colesteatoma da Orelha Média , Procedimentos Cirúrgicos Otológicos , Criança , Colesteatoma da Orelha Média/cirurgia , Orelha Média/cirurgia , Endoscopia , Humanos , Estudos Retrospectivos , Resultado do Tratamento
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