1,721,220 research outputs found
Transcanal transpromontorial endoscopic approach for vestibular schwannoma resection
No full textTranscanal transpromontorial endoscopic approach for vestibular schwannoma resectio
Endoscopic Ear Surgery: Redefining Middle Ear Anatomy and Physiology.
No full textMiddle ear anatomy and physiology is highly complex, yet familiarity is important to perform middle ear surgery and understand surgically relevant ventilation pathways of the ear compartments. The middle ear is divided into five subspaces: the mesotympanum, the retrotympanum posteriorly, the epitympanum superiorly, the protympanum anteriorly, and the hypotympanum inferiorly. The Eustachian tube plays a crucial role in maintaining middle ear aeration and atmospheric pressure. There are two independent aeration routes of the epitympanum. Thanks to the advent of the endoscope, this anatomic and physiologic knowledge has allowed one to understand the pathophysiology of ear diseases, improving surgical concepts
3D exoscopic surgery of lateral skull base
No full textPurpose: The aim of the study is to assess whether the 3D exoscopic surgery technique could be used in lateral skull base surgery and if it could ultimately replace the microscope in the future. Methods: This is a retrospective study in which were included 24 patients affected by lateral skull base pathologies, who underwent surgery using the 3D exoscope or the operative microscope at the Department of Otolaryngology-Head and Neck Surgery at the University Hospital of Verona. The exoscope and microscope groups each included 12 cases. The feasibility of all the surgical steps solely using the 3D exoscope was evaluated. The exoscope group and microscope group were compared taking into account the following factors: time of the surgery, facial and hearing functions outcomes, as well as the intraoperative and postoperative complications. Results: No intraoperative complication occurred during all the procedures. Postoperatively, only one minor complication emerged. The average operative time was 289 in the exoscope group and 313 min in the microscope one. No significant statistical differences were identified between the two groups (p > 0.05). The facial and hearing function outcomes were fully comparable. Conclusion: Our experience demonstrated that the exclusive use of the 3D exoscope, as that of the traditional microscope during lateral skull base surgery, is feasible for all open approaches. The use of the 3D exoscopic technique is very promising for future lateral skull base surgeries
Covid-19 and ENT practice: Our experience: ENT outpatient department, ward and operating room management during the SARS-CoV-2 pandemic
Full text linkCoronavirus COVID-19 SARS-CoV-2 ENT Otolaryngolog
Transmeatal microsurgery for intralabyrinthine and intrameatal schwannomas: Literature review
No full textApproccio transmeatale microchirurgico nei neurinomi intralabirintici e intrameatali: revisione della letteratura
Exclusive surgical treatment for vestibular schwannoma regrowth or recurrence: A meta-analysis of the literature
Full text linkVestibular schwannomas can be treated in different ways, but for symptomatic or growing tumors, the gold standard is surgical removal of the lesion. In order to preserve neurovascular structures, partial removal is often performed, leaving a residual that may grow in subsequent years. To date, there is no consensus with regard to surgical treatment of vestibular schwannoma residuals, and so this review focuses on this topic. A structured search was performed on PubMed searching for all articles discussing vestibular schwannoma residuals and recurrences. Only articles discussing surgical treatment were included, focusing on studies which also examined facial nerve outcomes. A total of 51 articles were eligible for review and these included 375 patients. Statistical analysis was performed by correlating the following parameters: patients' gender and age at first surgery, surgical approach adopted at first and subsequent surgeries, tumor and residual size, and extent of resection (gross total, near total, subtotal or others) at first and subsequent surgical procedures. Facial nerve function was also analyzed focusing on its performance when correlated with the different surgical approaches. The data were analyzed by linear regression but there were no correlations between any of the parameters chosen. There was a statistically significant difference between the first approach used (mainly the retrosigmoid route) compared with subsequent approaches (mainly the translabyrinthine route). In total, 8.5 % of patients needed further treatment due to residual regrowth. Facial nerve outcome was independent of the parameters chosen. Exclusive surgical treatment for vestibular schwannoma residuals had a very low failure rate in terms of requiring further treatment. The approach usually chosen for second surgery was the translabyrinthine technique, and this may be explained by the location of the residual, rather than its size. The choice of a particular surgical approach rather than another had no influence on facial nerve function. Complications rates are comparable to Gamma Knife Radiosurgery's as reported in the literature
Transcanal infrapromontorial approach for internal auditory canal surgery and cochlear implantation.
No full textObjective: To demonstrate the feasibility of a transcanal infrapromontorial approach for vestibular schwannoma surgery through an anatomical dissection study and the description of a clinical case. Methods: A microscopic and endoscopic dissection of cadaveric heads was undertaken through a transcanal infrapromontorial approach to the internal auditory canal (IAC), preserving the cochlea and the cochlear nerve. Description of the anatomy and surgical steps is reported as well as presentation of a clinical case in which a transcanal infrapromontorial approach was performed. Results: In all of the cadaveric dissections, a transcanal infrapromontorial route with near total cochlea preservation was performed, removing only the most posterior portion of the basal turn of the cochlea. The IAC was opened through removal of "cochlear-vestibular bone". At the end of the dissection a cochlear implant array was placed. A transcanal infrapromontorial approach was also performed in a patient to allow a concurrent cochlear implant placement, with good postoperative results. Conclusion: The transcanal infrapromontorial approach permits the preservation of the cochlea and the cochlear nerve. This approach may be considered as an option in case of a small intracanalicular schwannoma removal (< 0.5 cm cerebellopontine angle spread), when concurrent cochlear implantation is indicated
The green indocyanine: the meaning of one tracer for the intra-peri operative imaging and vascular evaluation in the reconstructive surgery of head and neck: an experimental multidisciplinary study
No full textThe objective of this study was to evaluate the feasibility and reproducibility of a new diagnostic approach through the flow injection of green indocyanine such as the intraoperative and perioperative vascularization in the reconstruction of various anatomical areas with pedunculated or microsurgical free flaps, the identification of the sentinel lymph node in the latero cervical emptying or the assessment of the quality of anastomoses in organ transplantation. The study involved ten patients who underwent reconstructive procedures with different surgical approaches for reconstructive surgery of head and neck. An intraoperative check was performed in several stages to assess the real perfusion status of the treated area. Indocyanine green was used in all the patients in association with an intraoperative imaging diagnostic system. Indocyanine green showed in all the cases a full highlight of central and peripheral vascularization. Furthermore, this imaging system allowed a satisfactory and rapid intraoperative evaluation of the vascular tree and a high sensitivity in detection of the sentinel lymph node in latero cervical emptying. Despite the limited sample, the results suggest that the intraoperative administration of indocyanine green may represent a valid evaluating system for reconstructed flap perfusion and for sentinel lymph node identification in oncological surger
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