American journal of rhinology & allergy
-
Am J Rhinol Allergy · Jan 2011
Comparative StudyHigh-definition imaging in endoscopic transsphenoidal pituitary surgery.
The transsphenoidal approach to sellar lesions has evolved enormously since its first description in the early 20th century. Endoscopic surgical strategies have become an integral part of the surgical armamentarium. More recently, high-definition (HD) digital cameras with better image resolution were introduced, although their value for the surgical procedure remains equivocal. The purpose of this study was to compare the image quality of a standard-definition (SD) camera with a new HD camera. ⋯ HD imaging in endoscopic transsphenoidal pituitary surgery accounts for significantly better identification of anatomic structures in comparison with SD images. Additionally, the subjective impression of video quality is significantly better in HD. This improved intraoperative orientation by better digital image quality might contribute to reduce the gap in intraoperative visual accuracy between microsurgery and endoscopy in pituitary surgery.
-
Am J Rhinol Allergy · Sep 2010
Randomized Controlled Trial Comparative StudyComparison of local anesthesia with articaine and lidocaine in septoplasty procedure.
Only a few studies have so far compared the use of different local anesthetic agents in septoplasty procedure with regard to reduction in pain, effectiveness, and related complications. The aim of this study was to compare articaine and lidocaine as local anesthetics for septoplasty surgery, in terms of their efficacy and safety. ⋯ Articaine is a safe local anesthetic agent with rapid onset of action. When compared with lidocaine, it is associated with improved tissue diffusion, rare postoperative complications, and less postoperative pain, thus, representing a safe and effective local anesthetic agent for septoplasty procedure.
-
Am J Rhinol Allergy · May 2010
Cilia motility and structure in primary and secondary ciliary dyskinesia.
Primary ciliary dyskinesia (PCD) is a clinically uniform entity, although cilia motility and structure can vary among patients, making diagnosis difficult. Chronic sinusitis, bronchiectasis, sinus hypoplasia, secretory otitis media, and low fertility are common in PCD patients. The aim of this work was to correlate nasal ciliary activity with clinical and structural abnormalities in PCD. A secondary aim was to evaluate the usefulness of high-resolution digital high-speed video (DHSV) in the diagnosis of PCD. ⋯ Nasal mucociliary transport showed a sensitivity of 100% for the diagnosis of PCD but has low specificity. High-resolution DHSV imaging has high sensitivity and specificity for the diagnosis of PCD. Video analysis is probably more useful than the study of mucociliary transport and cilia ultrastructure in screening for PCD. The absence of dynein was correlated with ciliary immotility and was more common in KS patients.
-
Am J Rhinol Allergy · Mar 2010
Case ReportsConcentrated topical epinephrine is safe in endoscopic sinus surgery.
The safety of topical epinephrine (1:1000 concentration) has recently been called into question. No objective data have been presented examining this issue. ⋯ Concentrated epinephrine has the potential for complications when used during endoscopic sinus surgery. Nevertheless, with appropriate safeguards described in this study, its topical use is safe.
-
Am J Rhinol Allergy · Sep 2009
Nasoseptal flap reconstruction of high flow intraoperative cerebral spinal fluid leaks during endoscopic skull base surgery.
Over the past 10 years, significant anatomic, technical, and instrumentation advances have facilitated the exposure and resection of intradural lesions via a fully endoscopic expanded endonasal approach (EEA). The vascularized nasoseptal flap (based on the posterior nasoseptal artery) has become our primary endoscopic reconstructive technique. The goals of this study are to prospectively evaluate the nasoseptal flap and high-risk cerebral spinal fluid (CSF) leak variables. ⋯ The nasoseptal flap is an excellent anterior skull base reconstructive technique. Patients with high-flow intraoperative CSF leaks had a 94% successful reconstruction rate. Patients with skull base proton radiation therapy are at higher risk for flap failure and preparation for nonradiated tissue reconstruction should be discussed with the patient.