Results Of Endoscopic Surgery Research Articles

Tổng quan về hình thái lâm sàng và kết quả phẫu thuật nội soi u nhầy xoang trán sàng

Objectives: To describe manifestation of fronto-ethmoid sinus mucocele and results of endoscopic surgery. Methods: The research method was carried out according to PRISMA-ScR guidelines. The PubMed/Medline database was used to search for studies around the world. Results: Out of 1017 search results, there were 21 studies that matched the selection criteria. The results of a review of 21 studies showed that frontal mucocele had 10 studies with 265 cases, followed by fronto-ethmoid mucocele had 9 studies with 108 cases and ethmoidal mucocele had 2 studies with 74 cases. The common types of sinus surgery methods included endoscopic marsupialization, followed by endoscopic frontal recess surgery, Frontoethmoid surgery and Ethmoidectomy. Conclusion: Frontal mucocele were most mucocele, followed by fronto-ethmoid mucocele and the ethmoid mucocele. The methods showed few complications and were effective in treatment mucocele. The choice of the appropriate surgical method should still be individualized. Keywords: Fronto-ethmoid sinus mucocele, endoscopic surgery.

Assessing the surgical outcome of the "chopsticks" technique in endoscopic transsphenoidal adenoma surgery.

The "chopsticks" technique is a 3-instrument, 2-hand mononostril technique that has been recently introduced in endoscopic neurosurgery. It allows a dynamic surgical view controlled by one surgeon only while keeping bimanual dissection. Being a mononostril approach, it requires manipulation of the mucosa of one nasal cavity only. The rationale of the technique is to reduce nasal morbidity without compromising surgical results and complication rates. There are, however, no data available on its results in endoscopic surgery (transsphenoidal surgery [TSS]) for pituitary adenoma. The authors performed a cohort analysis of prospectively collected data on 144 patients (156 operations) undergoing TSS using the chopsticks technique with 3T intraoperative MRI. All patients had at least 3 months of postoperative neurosurgical, endocrinological, and rhinological follow-up (Sino-Nasal Outcome Test-20 [SNOT-20] and Sniffin' Sticks). The surgical technique is described, and the achieved gross-total resection (GTR) and extent of resection (EOR) together with patients' clinical outcomes and complications are descriptively reported. On 3-month postoperative MRI, GTR was achieved in 71.2% of patients with a mean EOR of 96.7%. GTR was the surgical goal in 122 of 156 cases and was achieved in 106 of 122 (86.9%), with a mean EOR of 98.7% (median 100%, range 49%-100%). There was no surgical mortality. At a median follow-up of 15 months (range 3-70 months), there was 1 permanent neurological deficit. As of the last available follow-up, 11.5% of patients had a new pituitary single-axis deficit, whereas 26.3% had improvement in endocrinological function. Three patients had new postoperative hyposmia. One patient had severe impairment of sinonasal function (SNOT-20 score > 40). The operation resulted in endocrine remission in 81.1% of patients with secreting adenomas. This study shows that the chopsticks technique confers resection and morbidity results that compare favorably with literature reports of TSS. This technique permits a single surgeon to perform effective endoscopic bimanual dissection through a single nostril, reducing manipulation of healthy tissue and thereby possibly minimizing surgical morbidity.

Cirugía endoscópica en un niño con atresia unilateral de coana

Introduction and objective: Choanal atresia is rare, being twice as common in women than in men, and in 50% of cases approximately it is associated with other congenital anomalies. Although there has been some controvesia about the treatment of choice of this malformation, in the last decade, the introduction of endoscopes in sinus surgery has improved the outcome. Case description: We report the case of a child who has left chronic rhinorrhea with persistent nasal obstruction. By endoscopy and CT diagnosis, left choanal atresia is confirmed. Unilateral choanal atresia endoscopic surgery is performed by creating flaps with intranasal mucosa, preventing nasal packing. Discussion: Different techniques have been considered for the treatment of choanal atresia, which include traditional and endoscopic approach. The results of endoscopic surgery in the choanal atresia vary according to different authors. The two most important aspects of these results are the creation of nasal mucosa flaps and avoiding nasal packing. Conclusions: Surgical treatment of unilateral choanal atresia by endoscopic surgery can reduce the risk of restenosis.

Complication avoidance and its management in endoscopic neurosurgery

Endoscopic techniques are increasingly being used in recent times for various spinal and brain pathologies. Although endoscopic neurosurgical technique holds the potential for reducing morbidity, it is also associated with limitations such as steep learning curve, obstruction in manipulation of instruments by telescope in an already limited exposure, proximal blind spot, visual obscuration, disorientation, loss of stereoscopic image and others. Neuroendoscopy is distinct from micro-surgery and a thorough understanding of the technique and its limitations is required to get maximal benefit. Difficulties in controlling bleeding, longer operative time are common obstacles with this technique, especially in early learning curve. Higher complication rate during initial learning curve can be reduced by attending live workshops, practice on models and hands on cadaveric workshops. Large vascular lesions should be avoided and a thorough knowledge of possible complications and techniques to avoid such complications can improve results in endoscopic surgery.

The Potential Benefit of Intracarpal Pressure Measurement in Endoscopic Carpal Tunnel Syndrome Surgery – An Analysis of EMG Findings and Pressure Values

Endoscopic carpal tunnel syndrome surgery is a modern minimally invasive method of carpal tunnel decompression. However, the method does also have its critics, who emphasize that there is an increased rate of complications in comparison to open procedures. To further improve and optimize results of endoscopic surgery we used an intracarpal pressure sensor to verify the effect of carpal tunnel decompression. The endoscopic single portal approach was used in all cases. Median nerve conduction studies were performed prior to and 3 months after surgery. Two groups, those with pressure studies and those without, were then compared according to several EMG parameters such as: median nerve distal motor latency, amplitude of motor response, sensory nerve conduction velocity to the index finger, and amplitude of sensory nerve action potential. In both groups, we observed similarly significant improvements in all conduction parameters, except the amplitude of motor response, which did not change in either group, i.e. no difference in postoperative EMG between the two groups was observed. Despite this fact, intracarpal pressure measurement is still useful in localising the point in which the median nerve is compressed and provides valuable functional information on the level decompression achieved.

Results of endoscopic surgery and intralesional steroid therapy for airway compromise due to tracheobronchial Wegener's granulomatosis

Background: Upper airway compromise due to tracheobronchial stenosis commonly occurs in patients with Wegener9s Granulomatosis (WG). There is at present no consensus on the optimal management of this life-threatening condition. Objective: To assess the results of laryngo-tracheo-bronchoscopy, intralesional steroid therapy, laser surgery, and dilatation in managing obstructive tracheobronchial WG. Methods: Records of eighteen previously-untreated stridulous patients with obstructive tracheobronchial WG, treated between 2004 and 2006 were prospectively recorded on an airway database and retrospectively reviewed. Information about patient and lesion characteristics and treatment details were recorded. Treatment progress was illustrated using a timeline plot, and intervention-free intervals were calculated with actuarial analysis. Results: There were nine males and the average age at presentation was 40 (16) years [range 13–74]. There were thirteen patients with tracheal, and five patients with tracheal and bronchial lesions. The average tracheal lesion height was 8 (3) mm, located 23 (9) mm below the glottis. There were 1, 10 and 7 Myer-Cotton grade I, II and III lesions respectively. Mean intervention-free interval following minimally-invasive treatment was 26 (2.8) months. Following endobronchial therapy the median intervention-free interval was 22 months (p>0.8 vs. tracheal lesions). No patient required a tracheostomy or endoluminal stenting. Conclusions: Intralesional steroid therapy and conservative endoluminal surgery is an effective strategy for treating airway compromise due to active tracheal and bronchial WG, obviating the need for airway bypass or stenting. We recommend the combination of endotracheal dilatation, conservative laser surgery and steroid therapy as the standard of care for treating airway compromise due to obstructive tracheobronchial WG.

Results of endoscopic surgery and intralesional steroid therapy for airway compromise due to tracheobronchial Wegener’s granulomatosis

Background:Upper airway compromise due to tracheobronchial stenosis commonly occurs in patients with Wegener’s granulomatosis (WG). There is at present no consensus on the optimal management of this life threatening condition.Objective:To...

Endoscopic Endonasal Treatment of Ostium of the Frontal Sinus and the Results of Endoscopic Surgery

We discuss a procedure for opening the nasofrontal duct and the postoperative findings in endoscopic endonasal surgery. The route of the anterior ethmoidal artery was also studied. The subjects of this study were 57 patients (105 sides) who had frontal sinus disease. The patients all underwent surgery for chronic sinusitis between 1990 and 1992. Patients undergoing revision surgery were excluded. All patients were operated on by the same surgeon. In each patient, following anterior and posterior ethmoidectomy, the frontal sinus ostial region was opened using a 70 endoscope, while carefully monitoring the anterior ethmoidal artery. The agger nasi was left intact. The cells around the ostium were opened using a curved suction tip and upward bent forceps, and the lamellae were removed to achieve the greatest possible communication with the frontal sinus. In 77 sides (73.4%), the communication between the frontal and ethmoidal sinuses was well maintained. The ostium was patent with edematous mucosa in 18 sides (17.1%). The opened ostium could not be confirmed due to presence of polyp, etc., in 10 sides (9.5%). During surgery, the route of the anterior ethmoidal artery was confirmed in 70.8%; and of these cases, it was located anterior to the third ground lamella in about 50%.