1,721,133 research outputs found
Conservative management of orbital involvement in malignant tumors: Is the paradigm evolving? A critical review
No full textPurpose of reviewReview the recent literature regarding conservative management of orbital invasion in sinonasal cancers.Recent findingsRecent data seem to confirm the possibility to preserve the orbital content in a significant number of patients. MRI is the best available imaging tool for evaluating orbital invasion. Limited periorbital and extraconal fat invasion should not be considered an indication for orbital cleaning. Histology-driven neoadjuvant chemotherapy should be attempted whenever possible, and could act as a prognosticator.SummaryOrbital preservation strategy can be attempted even in case of limited extraconal fat invasion. When extraocular muscles, massive extraconal fat, lateral wall of the lacrimal sac, eyelids or even optic nerve/globe are invaded, a conservative procedure cannot be offered. Induction chemotherapy and postoperative radiotherapy are invaluable tools for maintaining oncological outcome while preserving ocular function. Frozen section should be used for guiding surgical procedures in borderline situations
Is the Da Vinci Xi system a real improvement for oncologic transoral robotic surgery? A systematic review of the literature
No full textIn this paper, we reviewed the current literature about TORS procedures performed with Xi system and we discussed the pros and cons of this robotic system comparing it to the previous Si model. A systematic literature review was conducted using the PubMed, Scopus, Web of Science and Cochrane databases for adequate published studies about TORS procedure performed with da Vinci Si and Xi models. Five papers on the TORS-Xi procedures met our inclusion and exclusion criteria. These papers showed results based on 74 subjects (mean age 60.51 ± 4.55 years old). The most common TORS procedure was performed to address the oropharynx (65 procedures). One case (1.35%) of a tongue base tumor was converted into a transmandibular approach. One subject (1.35%) had a positive margin, while two subjects (2.7%) had close/uncertain margins at final histology. Nine papers on the TORS-Si procedures met our inclusion and exclusion criteria. These papers showed results based on 128 subjects (mean age 59.79 ± 5.93 years old). The most common TORS procedure was performed to address the oropharynx (90 procedures). Three procedures (2.34%) were aborted due to inadequate exposure of the tumor. None of the subject had positive margins, while three subjects (2.34%) had close/uncertain margins at final histology. Despite its improved vision, easier docking and narrower robotic arms, the da Vinci Xi system has structural peculiarities that limit its applications for certain TORS procedures
Experience in Transoral Robotic Surgery in Pediatric Subjects: A Systematic Literature Review
Full text linkPediatric transoral robotic surgery (TORS) has improved from 2007 to 2020, widening
its indications and feasibility. This article aims to systematically analyze the procedures
performed from the first use until the current year, observing their evolution over time. A
systematic literature review was performed using PubMed, Scopus, Web of Science, and
Cochrane databases between March 1, 2000, and April 1, 2020. We selected studies
that were written only in English and were performed in live human subjects. About
16 studies were found with a total of 73 subjects treated, among them 41 were men
and 32 were women with an average age of 6.8 ± 4.99 years. There have been four
(5.47%) conversions. Both functional and benign-malignant diseases have been treated
in the series. Eleven (15.06%) pre-operative tracheostomy and zero post-operative
tracheostomy were performed. The bleeding data was only reported in 9 studies and was
<50 ml. Only one (1.36%) intra-operative complication and 10 (12.32%) postoperative
complications were reported. We consider the TORS procedures in pediatric subjects
safe, feasible and with good surgical outcomes up to the laryngeal region
Surgical and pathogenetic considerations of frontal sinus fungus ball
No full textFungus ball (FB) is an non-invasive form of mycosis, that generally affects immunocompetent and non-atopic subjects. Involvement of the frontal sinus is extremely rare. We report two cases with frontal sinus fungus ball that underwent endoscopic endonasal frontal Draf type IIb or III sinusotomy with complete removal of the cheesy clay-like material. There were no intra-operative or postoperative complications, and no recurrence of disease was evident during the follow-up of 51 and 26 months, respectively. The Draf type IIb or type III frontal sinusotomy seems to be highly effective for the treatment of frontal sinus FB and can represent a valid alternative to the traditional external approaches
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