1,721,009 research outputs found
Transcanal Endoscopic Lateral Skull Base Surgery
No full textPresutti and Marchioni's transcanal exclusive endoscopic transpromontorial approach represents a new surgical technique to remove diseases that involve cochlea and fundus of internal auditory canal in selected cases, thus avoiding extensive bone drilling, brain, meningeal, and neurovascular manipulation. The advantage of this endoscopic technique is that direct access to internal auditory canal allows the creation of a minimally invasive route through the cochlea with a consequent improved safety during intraoperative and postoperative management. Surgeons who start with this surgical procedure must possess some fundamental prerequisites, like confidence with other inner ear techniques and previous experience with endoscopic middle ear surgery and endoscopic cadaveric dissections. Owing to the reduced invasiveness of the transpromontorial transcanal approach, there is no need for an intensive care unit stay after the operation and patient hospitalization is shorter
Endoscopic Middle Ear Anatomy
No full textThe anatomy of the middle ear is very complex. The otologist must have a good knowledge of the structures comprising the tympanic cavity; a clear view of all the subsites of this region is essential to ensure the complete removal of all pathology. The development of endoscopic techniques to access the middle ear has offered the possibility to “look around corners” and explore hidden recesses the microscope cannot reach. Moreover, by leading to a better understanding of the different ventilation pathways of the tympanic cavity, alterations of which may cause pathologies such as cholesteatoma, endoscopy represents a surgical approach aimed toward restoring normal physiology as well as eradicating disease. In this article, we discuss the state of the art of middle ear endoscopic anatomy, describing the different subsites of this small but challenging region
Anatomia endoscopica della “cochlear hook region” e del fustis: importanza per la chirurgia
Full text linkThe cochlear hook region can be considered as the interface between the middle and inner ear. The identification of surgically-relevant endoscopic landmarks of this anatomical entity and assessment of their clinical value is still lacking in the literature. Procedures like cholesteatoma surgery and minimal invasive endoscopic approaches to the lateral skull base may particularly benefit from these considerations. We hypothesize that the spatial orientation of anatomical landmarks in the cochlear hook can be expressed in angles and are reproducibly identifiable by transcanal otoendoscopy. Therefore, endoscopic dissection of the cochlear hook region was performed in 32 temporal bone specimens. Topographic anatomy was documented and analysed. We performed computed tomography of 28 specimens to assess the region in three-dimensional reconstructions. The mean angle between the round window and the basal scala tympani was assessed 25.9° in endoscopic and 28.2° in three-dimensionally reconstructed models. The fustis was recognised as a reliable landmark for the basal turn. A mean angle of 155.4° to the basal scala tympani was assessed. A slight bulging without obstruction of the basal turn was observed in 5 cases. The utility of the revealed anatomical details was assessed in minimal invasive endoscopic lateral skull base approaches. In conclusion, we described the angles between anatomical landmarks of the cochlear hook region. Moreover, the angle as recorded through an endoscope was found to be reliable compared to three-dimensional reconstructions from computed tomography.La “cochlear hook region” (CHR) può essere considerata come una interfaccia tra l’orecchio medio e l’orecchio interno. L’identificazione endosco-pica dei reperi chirurgici della CHR e la valutazione della loro rilevanza clinica non sono ancora state descritte in letteratura. Specialmente la chi-rurgia del colesteatoma e gli approcci mini-invasivi al basicranio laterale possono beneficiare di queste considerazioni. Ipotizziamo in questo lavoro che l’orientamento spaziale dei reperi chirurgici nella CHR possono essere espressi in forma di angoli e risultano essere riproducibili in approcci otoendoscopici. 32 dissezioni di ossa temporali sono state condotte in questo lavoro. L’anatomia topografica è stata documentata e analizzata. Una TC è stata eseguita in 28 temporali per valutare l’anatomia attraverso ricostruzioni 3D. L’angolo medio tra la finestra rotonda e il giro basale della chiocciola (scala tympani) è risultato essere di 25,9° in endoscopia, e di 28,2° nelle ricostruzioni 3D. Il fustis ha rappresentato un repere affidabile per il giro basale della chiocciola, con un angolo medio di 155,4° con il giro basale della scala tympani. Una lieve prominenza senza ostruzione del giro basale della chiocciola è stata osservata in 5 casi. L’utilità di questi rilievi anatomici è stata confermata negli approcci mini-invasivi al basicra-nio laterale. In conclusione gli angoli tra i reperi anatomici della CHR così come descritti attraverso gli approcci endoscopici forniscono un orienta-mento utile per procedure come impianti cocleari, approcci mini-invasivi all’apice petroso o accessi transpromontoriali al condotto uditivo interno
Comparative Atlas of endoscopic ear surgery
No full textThis unique, richly illustrated atlas offers a how-to reference guide to the most common and innovative endoscopic surgical procedures for the middle and inner ear, based on an ex vivo ovine model. Moreover, it compares this model to the same approaches in humans, underlying the essential surgical tips and tricks. The transcanal endoscopic approach for the management of middle and inner ear pathologies is being increasingly used, but in some countries the lack of human specimens makes adequate training in this field difficult: in response, the book introduces a novel method performed on the animal model, which allows trainees to improve their skills, while reducing the cost of surgical training. It provides a full description of specimen preparation, and comparative anatomical and radiological analyses of the human and ovine models, guides readers through the main otologic operative techniques (e.g. canalplasty, miringoplasty and ossiculoplasty) step by step, and illustrates the best approach to the internal auditory canal. Written by prominent experts in the field, this atlas serves as a unique reference resource for residents and young surgeons wishing to acquire first-hand the skills needed for endoscopic procedures and to improve their learning curves
Atypical mycobacteriosis involving parotid and para-retropharyngeal spaces
No full textThe incidence of retro-parapharyngeal localization of cervical adenitis due to non-tuberculous mycobacteria is very rare. We present a case of an 18-months-old child with an involvement of parapharyngeal and retropharyngeal areas, right parotid and submandibular regions by atypical mycobacteriosis in the CT and MRI scan. The masses were surgically removed and the frozen-section histological exam upheld their atypical mycobacterial origin
Endoscopic Incudo-Malleolar Arthrodesis: A New Surgical Treatment for Incudo-Malleolar Subluxation
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Novel Dissection Station for Endolaryngeal Microsurgery and Laser Surgery: Development and Dissection Course Experience
No full textObjective: We aimed to develop and validate an ex vivo dissection station for endolaryngeal surgery suitable for different kinds of laryngeal specimen and any type of operating technique (CO2 laser, cold instruments by endoscopic or microscopic techniques). Study Design: Experimental construction and validation of a highly specialized dissection station. Setting: Laboratory and international dissection course. Methods: We designed a lightweight dissection station made of polycarbonate resin approved for use with a CO2 laser. The cylindrical box hosts an articulated laryngeal support. The laryngoscope is positioned on an articulated arm, which is fixed on the construction’s footplate. Validation of the larynx box was performed during an international dissection course on laryngeal surgery held in January 2016. Results: We assessed the suitability of our novel dissection station among specialized laryngologists with a mean experience of 14 years. Feedback from the participants was very positive, with a mean general impression of 9.5 (out of 10 points) and a recommendation score of 9.6 for further use. Its utility in transforming the taught surgical steps into daily practice has been highly recognized, with a score of 9.5. Conclusion: The lightweight and transparent larynx box is suitable for any kind of laryngeal specimen, and any surgical intervention can be taught at reasonable cost. It is safe and suitable for use with CO2 lasers. Validation among experienced surgeons revealed its suitability in the teaching of endolaryngeal microsurgery and laser surgery
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