European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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Eur Arch Otorhinolaryngol · May 2004
Individual prefabricated titanium implants and titanium mesh in skull base reconstructive surgery. A report of cases.
Titanium implants can be shaped by traditional hand forming, press shaping, modular construction by welding, construction on full-size models shaped from CT coordinates and, most recently, by computer-assisted design and computer-assisted manufacturing (CAD/CAM) that consist in the direct prefabrication of individual implants by milling them out of a solid block of titanium. The aim of our study was to present a set of preliminary cases of an ongoing program of reconstructive procedures of the skull base using titanium implants. The subjects underwent ablative procedures of the skull base with reconstruction either by titanium mesh or individual prefabricated CAD/CAM implants. ⋯ The intraoperative design, shaping and adjustment characteristic of titanium mesh can be dispensed with when CAD/CAM implants are used. The 3-D data set used in the CAD/CAM process also operates in the navigated simulation and planning of the ablation contours, the latter being of great assistance in establishing the optimal future defect. As a disadvantage, CAD/CAM technology is more expensive than titanium mesh, and the process is time-consuming as it is carried out in advance of surgery.
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Eur Arch Otorhinolaryngol · May 2004
The role of 70-degree telescopic examination during direct laryngoscopic evaluation of laryngeal cancers.
Endoscopy has currently been an indispensable method in many areas of otorhinolaryngology, especially in paranasal sinus surgery. Telescopic evaluation of the larynx has not drawn much attention. In this study, a 70-degree angled rigid telescope was used along with computerized tomography (CT), indirect and direct laryngoscopy in the evaluation of laryngeal cancer. ⋯ The scores for CT and 70-degree telescopy were 70-100%. In the subglottic region telescopy was superior to CT. We believe that, when it is used in association with CT, telescopy provides better insight when deciding between partial or total laryngectomy and a healthier evaluation of the resection margin.