International forum of allergy & rhinology
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Int Forum Allergy Rhinol · May 2012
Effect of lumbar drain placement on recurrence of cerebrospinal rhinorrhea after endoscopic repair.
Lumbar drain (LD) use in the management of cerebrospinal fluid (CSF) rhinorrhea remains controversial. We analyzed the relationship between LD placement and CSF leak recurrence after endoscopic repair. ⋯ In our study, there was no association identified between LD placement and recurrence rates after endoscopic repair of CSF rhinorrhea.
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Int Forum Allergy Rhinol · Mar 2012
Endoscopic skull base surgery and its impact on sinonasal-related quality of life.
Endoscopic skull base surgery (ESBS) is considered a minimally-invasive surgical modality with less morbidity and patient discomfort. Quality-of-life (QOL) assessments provide a patient-reported estimate of well-being that may be clinically relevant. Although the sinonasal tract is integral to ESBS, the change in sinonasal-related QOL with ESBS has not been well studied. The aim of this study was to prospectively assess QOL before and after ESBS using validated outcome measures. ⋯ ESBS does not have a detrimental long-term effect and is associated with ultimate improvement in sinonasal-related QOL. Short-term impairments of sinonasal-related QOL are predictable and self-limited. Prospective assessment using sinonasal-related and site-specific QOL instruments provide complementary information about ESBS outcomes.
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Int Forum Allergy Rhinol · Jan 2012
Comparative StudyComparison of traditional 2-dimensional endoscopic pituitary surgery with new 3-dimensional endoscopic technology: intraoperative and early postoperative factors.
Traditionally, endoscopic transsphenoidal pituitary surgery is performed using 2-dimensional (2D) endoscopes, which lack depth of field and contribute to image distortion. Recently, a new generation of 3D endoscopes has been introduced for improved endoscopic depth perception. Little data exist comparing surgical outcomes with 2D vs 3D endoscopic systems. This study examines perioperative and postoperative factors in patients undergoing pituitary surgery using 2D vs 3D endoscopes. The objective of this work was to determine the differences in perioperative and postoperative factors in patients undergoing pituitary surgery using 2D vs 3D endoscopy. ⋯ 3D endoscopy affords the surgeon improved depth of field and stereoscopic vision. Our data demonstrate that 3D endoscopy does not result in significantly different perioperative or postoperative outcomes vs 2D endoscopic surgery.
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Surgical access to the cavernous sinus (CS) has proven a challenge for the skull base surgeon. Traditional approaches include the transcranial route, which broaches the lateral wall of the CS and has a high risk of cranial nerve weakness. A medial approach is more logical but the microscopic transsphenoidal approach has a restricted view. The endoscopic endonasal approach provides an alternative medial approach with improved visualization to that provided with the microscope. We describe our results using this approach for resection of CS tumors. ⋯ The endoscopic endonasal approach is a safe and effective option for tumor resection in the CS using a medial to lateral route for selected cases. Morbidity is low and a variety of reconstructive options are available.
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Int Forum Allergy Rhinol · May 2011
Randomized Controlled TrialThe effectiveness of preemptive sphenopalatine ganglion block on postoperative pain and functional outcomes after functional endoscopic sinus surgery.
The sphenopalatine ganglion block (SPGB) with local anesthetic is used to treat facial pain and headache of various etiologies; it has been widely used during functional endoscopic sinus surgery (FESS). The purpose of this study was to investigate whether preemptive SPGB may positively impact postoperative pain and functional outcomes after FESS. ⋯ A limited trend toward reduced postoperative pain after FESS was noted with bupivacaine compared to saline, but statistical significance was not achieved. Preemptive SPGB may offer sinonasal symptomatic benefits for patients undergoing FESS, but larger studies are warranted.