Otolaryngologic clinics of North America
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Otolaryngol. Clin. North Am. · Oct 2009
Intraoperative imaging for otorhinolaryngology-head and neck surgery.
The applications of endoscopic techniques have expanded beyond the treatment of inflammatory sinus disease and toward the resection of anterior and middle skull base lesions. Image-guided surgery has emerged as an important tool that compensates for the limitations of surgical endoscopy. The disadvantage of image-guided surgery, however, is its dependence on preoperative imaging data. ⋯ It has had an impact on surgical decision-making during functional endoscopic sinus surgery and the resection of anterior skull base neoplasia. Advances in portable MRI and volumetric CT technology have enhanced the efficiency and safety of intraoperative imaging. Although further studies are required to quantify the precise utility of this new technology, it appears that intraoperative imaging will be an important tool for rhinologic surgery.
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Otolaryngol. Clin. North Am. · Aug 2009
ReviewNeoplastic transformation after radiosurgery or radiotherapy: risk and realities.
In recent years, the use of radiosurgery or radiotherapy for benign brain tumors has increased significantly. Although long-term follow-up from several centers suggests that radiosurgery or radiotherapy is effective and safe, there are particular concerns regarding development of radiation-induced tumors. ⋯ All patients should be informed about the risks and consequences of radiation and microsurgery. The current practice standards for radiosurgery should not be modified because of this very low risk.
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Otolaryngol. Clin. North Am. · Aug 2009
Historical ArticleThe history of stereotactic radiosurgery and radiotherapy.
Stereotactic neurosurgery originated from the pioneering work of Horsley and Clarke, who developed a stereotactic apparatus to study the monkey brain in 1908. Spiegel and Wycis applied this technology to the human brain in 1947, which ultimately lead to the development of multiple stereotactic neurosurgical devices during the 1950s. ⋯ Leksell developed the gamma knife to treat intracranial lesions in a noninvasive fashion. His work stimulated worldwide interest and created the field of stereotactic radiosurgery.
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Otolaryngol. Clin. North Am. · Jun 2009
ReviewTreatment of nasal obstruction in the posttraumatic nose.
The sequelae of trauma to the nose include nasal deformity and nasal obstruction that can have a long-term negative impact on patient quality of life. Successful management of posttraumatic nasal obstruction relies on a detailed history, careful analysis, and accurate diagnosis. ⋯ Adequate treatment of posttraumatic nasal obstruction must address deflection of the bony nasal pyramid, septal deformities (especially caudal or dorsal), turbinate hypertrophy, and incompetence of internal and external nasal valves. Treatment must balance the seemingly disparate goals of re-establishing structure, improving contour and esthetics, as well as restoring the nasal airway.
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Otolaryngol. Clin. North Am. · Apr 2009
ReviewSurgical management of polyps in the treatment of nasal airway obstruction.
In addition to their role in chronic rhinosinusitis and nasal congestion, sinonasal polyps are associated with significant nasal obstruction. Effective long-term treatments remain difficult to pinpoint. Management of these polyps is a difficult challenge for the contemporary otolaryngologist. ⋯ Surgical options include polypectomy and functional endoscopic sinus surgery (FESS). In addition, novel treatments for polyps are introduced with some frequency. This article presents an overview of management options for sinonasal polyps, focusing on the indications, efficacy, and complications of the more common interventions.