Otolaryngologia polska. The Polish otolaryngology
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Intraoperative navigation systems have been developed to increase the safety and efficiency of endoscopic sinus surgery. The objective of this study was to compare the application and utilization of optical and electromagnetical navigation systems in our own experience during the endoscopic surgery. ⋯ Intraoperative navigation systems assist the surgeon with anatomical localization during endoscopic sinus surgery and improve its safety and efficacy. The choice of optical or electromagnetic system should be compared of effective costs and surgeon's preferences.
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Five patients were surgically treated for intraorbital foreign body: a 14-year-old girl had a door glass splinter, a 23-year-old man a metallic foreign body--gunshot pellet, a 55-year-old man a splinter from a metallic bar, a 48-year-old patient the splinters of circular saw and 61-year-old man with shot. Two foreign bodies were removed using the Krönlein-Reese-Berk lateral orbitotomy, two others by Sewell medial orbitotomy and one with superior orbitotomy of Dandy-Naffziger. Radiographs and CT scans were used to identify and localize intraorbital foreign bodies. ⋯ The Krönlein-Reese-Berk orbitotomy provides a satisfactory access to the lateral and posterior orbit, which is of particular importance in the case of a deeply penetrating foreign body (metallic or glass). Surgical removal of intraorbital foreign bodies is a classic example of an interdisciplinary therapeutic approach. Best outcome is usually a result of a team of an ophtalmologist, ENT surgeon, maxillary surgeon and possibly also neurosurgeon performing the operation.
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Kartagener's syndrome is a rare autosomal recessive disorder presenting a triad of sinusitis, bronchicetasis and situs inversus with dextrocardia. It occurs in 50% of patients with situs inversus. The most important anesthetic implications of Kartegener's syndrome surgery are assessement of pulmonary and cardiac structure and function. ⋯ Kartagener's syndrome is a rare disease and when the patient need an operation we have to consider surgery with regional or general anesthesia. The general anesthesia would be safe after complete preanaesthetic examination of the patient. The ECG, chest CT scans, spirometry and echocardiography are mandatory before the operation.
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Comparative Study
[The comparison of the influence of various types of anaesthesia on perioperative bleeding control in endoscopic paranasal sinus surgery].
The study aimed at evaluating the influence of targeted hypotension with three types of anaesthetics on the amount of blood loss in extensive endoscopic operations of polyps of the nose and paranasal sinuses. ⋯ In TIVA the advanced technologically control of a drug dose allows for a better control of hypotension, which, finally, results in lower haemorrhage within the operation area, a favourable condition for both a patient and a physician. Perioperative bleeding was independent on sex in every type of anaesthesia.
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Penetrating neck injuries constitute 5-10% of all trauma cases. Such injuries are dangerous because of the high risk of injury to the vital structures in the neck and hence demand an immediate surgical exploration. We present a case of a penetrating injury of the neck caused by the broken metallic fragment of a saw.