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Almeida PRL, Person OC, Puga ME, Atallah ÁN, Trevisani VF. Surgery for nasal polyposis in cystic fibrosis. Cochrane Database Syst Rev 2023; 12:CD014084. [PMID: 38063253 PMCID: PMC10704557 DOI: 10.1002/14651858.cd014084.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
BACKGROUND Cystic fibrosis (CF) is a life-shortening, autosomal recessive disease that leads to abnormal electrolyte concentration in exocrine secretions. Secretion stasis in paranasal sinuses determines chronic rhinosinusitis (CRS) and nasal polyposis. Endoscopic sinus surgery is used to open the sinuses and allow medical treatment to work properly. OBJECTIVES To determine the effects of sinus surgery alone or in combination with medical treatment (non-surgical) compared to medical treatment (non-surgical) alone on both nasal and pulmonary function in people with CF diagnosed with CRS with nasal polyposis. Further, to evaluate the impact of sinus surgery (with or without medical treatment) on hospitalization rates, use of antibiotics and pulmonary exacerbation rates. SEARCH METHODS We searched the Cochrane Cystic Fibrosis Trials Register, compiled from electronic database searches and hand searching of journals and conference abstract books. Date of last search: 4 July 2022. We also searched other databases (Pubmed, Embase, World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), Virtual Health Library and ClinicalTrials.gov). Date of last search: 18 September 2022. SELECTION CRITERIA Randomized controlled trials (RCTs) comparing groups who underwent endoscopic sinus surgery and groups with medical treatment alone. DATA COLLECTION AND ANALYSIS The review authors independently selected studies, extracted data, assessed the risk of bias and evaluated the certainty of the evidence using GRADE. They contacted the authors of the included study for additional information. MAIN RESULTS We identified 66 publications relating to 50 studies from electronic searches. Only one study fulfilled the inclusion criteria, and only limited information was available. In this study, 28 participants aged 19 to 28 years were randomized in equal numbers to either nasal irrigation alone or nasal irrigation with surgery (endoscopic polypectomy with extended sinusotomy). The certainty of the evidence was very low according to the GRADE approach. We are uncertain whether, compared to medical treatment alone, the addition of surgical intervention improves nasal symptoms, or reduces bacterial colonization, the use of antibiotics and pulmonary exacerbations. We are also uncertain whether the addition of surgery to medical treatment leads to changes in pulmonary function. There was one episode of bleeding during surgery that was corrected during the procedure with no further consequences. The study did not report on survival. AUTHORS' CONCLUSIONS Very low-certainty evidence means we are not certain if endoscopic sinus surgery to treat chronic rhinosinusitis with nasal polyposis in cystic fibrosis is effective. Future research should be multicentric to increase the number of participants and increase statistical power. Adequate randomization and allocation concealment are important to guarantee that the groups are similar. Blinding, however, may not be possible in an ethical trial; even without blinding, results can achieve high-level evidence if the outcomes used are objective parameters. Future research should follow participants of all ages for at least 12 months to evaluate the evolution of nasal polyposis, its recurrence and how symptoms may return. We also consider mortality an important outcome to be assessed. Future clinical research should consider the effects of cystic fibrosis transmembrane conductance regulators, a new group of drugs that may affect the development of nasal polyps.
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Affiliation(s)
- Paula Ribeiro Lopes Almeida
- Collaborator of the Department of Otorhinolaryngology at Mario Covas State Hospital, School of Medicine ABC, Santo André - São Paulo, Brazil
- Postgraduate student at the Department of Emergency Medicine and Evidence-Based Medicine of the Federal Universitiy of São Paulo - UNIFESP, São Paulo, Brazil
| | - Osmar C Person
- Collaborator of the Department of Otorhinolaryngology at Mario Covas State Hospital, School of Medicine ABC, Santo André - São Paulo, Brazil
| | - Maria Es Puga
- Cochrane Brazil, Center for Studies in Evidence-Based Medicine and Health Technology Assessment, São Paulo, Brazil
| | - Álvaro N Atallah
- Cochrane Brazil, Center for Studies in Evidence-Based Medicine and Health Technology Assessment, São Paulo, Brazil
| | - Virginia Fm Trevisani
- Cochrane Brazil, Center for Studies in Evidence-Based Medicine and Health Technology Assessment, São Paulo, Brazil
- Head Professor at the Department of Rheumatology, University of Santo Amaro, São Paulo, Brazil
- Assistant Professor at the Department of Emergency Medicine and Evidence-Based Medicine, Federal University of São Paulo - UNIFESP, São Paulo, Brazil
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Schapher M, Bruegel J, Guener F, Volbers B, Eichhorn P, Agaimy A, Berger M, Mardin C, Doerfler A, Hock SW. Toxic retrobulbar neuritis due to recurrent nonsteroidal antiinflammatory drug-exacerbated respiratory disease-based chronic sinusitis in the left sphenoid sinus: a case report. J Med Case Rep 2023; 17:331. [PMID: 37537663 PMCID: PMC10401847 DOI: 10.1186/s13256-023-04060-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/26/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Abrupt visual impairment constitutes a medical urgency, necessitating an interdisciplinary diagnostic and therapeutic approach owing to the broad spectrum of potential etiologies, thereby engaging numerous medical specialties. CASE PRESENTATION A 21-year-old Mixed White and Asian female patient, with medical history of nonsteroidal antiinflammatory drug-exacerbated respiratory disease necessitating previous sinus surgery, reported sudden monocular vision loss. Unremarkable ophthalmological examination of the fellow eye and hematological parameters, save for a slight elevation in lymphocytes and eosinophils, were observed. Imaging studies indicated recurrence of bilateral chronic rhinosinusitis with nasal polyps and a mucocele in the left sphenoid sinus, accompanied by bony structural deficits. Emergency revision sinus surgery, guided by navigation, was promptly performed. The patient received treatment with methylprednisolone, ceftriaxone, cyanocobalamin, pyridoxine, thiamine, and acetylsalicylic acid. During the hospital stay, she developed steroid-induced glaucoma, which was subsequently managed successfully. Negative microbiological swabs, along with pathohistological evidence of increased tissue eosinophilia and the patient's clinical history, led to the diagnosis of toxic retrobulbar neuritis secondary to recurrent nonsteroidal antiinflammatory drug-exacerbated respiratory disease-associated chronic rhinosinusitis of the left sphenoid sinus. CONCLUSIONS In cases of acute unilateral vision loss, optic neuritis is a highly probable differential diagnosis and may be induced by pathologies of the paranasal sinuses. Nonsteroidal antiinflammatory drug-exacerbated respiratory disease, a subtype of chronic rhinosinusitis, is associated with type 2 inflammation, which is increasingly recognized for its role in the pathogenesis of bronchial asthma, eosinophilic esophagitis, and atopic eczema. Clinicians should consider chronic rhinosinusitis as a potential differential diagnosis in unilateral visual loss and be cognizant of the rising significance of type 2 inflammations, which are relevant to a variety of diseases.
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Affiliation(s)
- Mirco Schapher
- Department of Otorhinolaryngology-Head and Neck Surgery, Erlangen University Hospital, University of Erlangen-Nuremberg, Waldstraße 1, 91054, Erlangen, Germany
| | - Jacob Bruegel
- Department of Otorhinolaryngology-Head and Neck Surgery, Erlangen University Hospital, University of Erlangen-Nuremberg, Waldstraße 1, 91054, Erlangen, Germany
| | - Fabian Guener
- Department of Neurology, Erlangen University Hospital, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Bastian Volbers
- Department of Neurology, Erlangen University Hospital, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Philip Eichhorn
- Department of Pathology, Erlangen University Hospital, University of Erlangen-Nuremberg, Krankenhausstraße 8-10, 91054, Erlangen, Germany
| | - Abbas Agaimy
- Department of Pathology, Erlangen University Hospital, University of Erlangen-Nuremberg, Krankenhausstraße 8-10, 91054, Erlangen, Germany
| | - Magdalena Berger
- Department of Ophthalmology, Erlangen University Hospital, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Christian Mardin
- Department of Ophthalmology, Erlangen University Hospital, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, Erlangen University Hospital, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Stefan W Hock
- Department of Neuroradiology, Erlangen University Hospital, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany.
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Tzelnick S, Rampinelli V, Sahovaler A, Franz L, Chan HHL, Daly MJ, Irish JC. Skull-Base Surgery—A Narrative Review on Current Approaches and Future Developments in Surgical Navigation. J Clin Med 2023; 12:jcm12072706. [PMID: 37048788 PMCID: PMC10095207 DOI: 10.3390/jcm12072706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/10/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023] Open
Abstract
Surgical navigation technology combines patient imaging studies with intraoperative real-time data to improve surgical precision and patient outcomes. The navigation workflow can also include preoperative planning, which can reliably simulate the intended resection and reconstruction. The advantage of this approach in skull-base surgery is that it guides access into a complex three-dimensional area and orients tumors intraoperatively with regard to critical structures, such as the orbit, carotid artery and brain. This enhances a surgeon’s capabilities to preserve normal anatomy while resecting tumors with adequate margins. The aim of this narrative review is to outline the state of the art and the future directions of surgical navigation in the skull base, focusing on the advantages and pitfalls of this technique. We will also present our group experience in this field, within the frame of the current research trends.
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Affiliation(s)
- Sharon Tzelnick
- Division of Head and Neck Surgery, Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2M9, Canada
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Vittorio Rampinelli
- Unit of Otorhinolaryngology—Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiologic Sciences and Public Health, University of Brescia, 25121 Brescia, Italy
- Technology for Health (PhD Program), Department of Information Engineering, University of Brescia, 25121 Brescia, Italy
| | - Axel Sahovaler
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
- Head & Neck Surgery Unit, University College London Hospitals, London NW1 2PG, UK
| | - Leonardo Franz
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, 35122 Padua, Italy
| | - Harley H. L. Chan
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Michael J. Daly
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Jonathan C. Irish
- Division of Head and Neck Surgery, Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2M9, Canada
- Guided Therapeutics (GTx) Program, TECHNA Institute, University Health Network, Toronto, ON M5G 2C4, Canada
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Reyes Orozco F, Ulloa R, Lin M, Xepoleas M, Paoletti M, Liu X, Hur K. Adverse Events Associated With Image-Guided Sinus Navigation in Endoscopic Sinus Surgery: A MAUDE Database Analysis. Otolaryngol Head Neck Surg 2023; 168:501-505. [PMID: 35727630 DOI: 10.1177/01945998221107547] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/28/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The utilization of image-guided navigation during endoscopic sinus surgery (ESS) has increased significantly since its introduction. However, the most common associated complications are still unknown. This study describes and analyzes adverse events related to image-guided ESS. STUDY DESIGN Cross-sectional analysis. SETTING The Food and Drug Administration's 2018-2022 MAUDE database (Manufacturer and User Facility Device Experience). METHODS The MAUDE database was searched for all reports on adverse events involving sinus navigation systems used in ESS from 2018 to 2022. Reported events were reviewed and categorized. RESULTS During the study period, there were 1857 adverse events from 1565 reports, which were divided into device-related (n = 1834, 98.8%) and patient-related (n = 23, 1.2%) complications. The most common device-related complications were nonfunctionality of the system (n = 512, 27.9%), device imprecision (n = 427, 23.3%), and device sensing problems (n = 277, 15.1%). The most common patient-related complications were cerebrospinal fluid (CSF) leak (n = 14, 60.9%), intracranial injury (n = 4, 17.4%), and bleeding/hemorrhage (n = 3, 13.1%). Imprecision was associated with increased risk of navigation abortion by the surgeon (odds ratio, 1.50 [95% CI, 1.38-1.65]; P < .001) and increased risk of CSF leak (odds ratio, 16.5 [95% CI, 3.66-74.0]; P < .001) as compared with other device-related complications. CONCLUSIONS The most commonly reported device- and patient-related adverse events associated with image-guided sinus navigation systems were device nonfunction, imprecision, device sensing difficulties, and CSF leak. When imprecise navigation occurred, there was an increased likelihood of CSF leak and navigation abortion by the surgeon. Health care providers should be mindful of these possible complications when electing to use image-guided sinus navigation during ESS.
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Affiliation(s)
- Francis Reyes Orozco
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Ruben Ulloa
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Matthew Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Meredith Xepoleas
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Marcus Paoletti
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Xuan Liu
- Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Kevin Hur
- Tina and Rick Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
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Three-Dimensional Evaluation of the Frontal Sinus in Koreans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159605. [PMID: 35954963 PMCID: PMC9368756 DOI: 10.3390/ijerph19159605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/03/2022] [Accepted: 08/03/2022] [Indexed: 12/10/2022]
Abstract
(1) Background: Among the four paranasal sinuses, the frontal sinus is in the frontal bone. Recent research trends have been focusing on identifying sex based on the frontal sinus. Thus, this study aimed to provide reference data for the frontal sinus in Korean adults by comparing their sizes using a 3D program. Moreover, this study examined the correlation between the size of the frontal sinus and the length of cranial bone. (2) Methods: Cone-beam computed tomography (CBCT) data were obtained from 60 (male 30, female 30) patients in their 20 s who visited the Department of Dankook University Hospital (DKUDH IRB 2020-01-007). The provided patient CBCT data were utilized to reconstruct the patients’ frontal sinuses and cranial bones in 3D using the Mimics (version 22.0, Materialise, Leuven, Belgium) 3D program. All measurements were analyzed using SPSS (ver. 23.0, IBM Corporation, Armonk, NY, USA). (3) Results: By comparing the frontal sinus size of Korean adults according to sex using a 3D program, this study revealed that males had larger frontal sinuses than females. (4) Conclusions: The findings of this study could help in preventing complications that occur in various clinical treatments and analyzing the growth of the frontal sinus in the future.
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A Simple Clinical Application for Locating the Anterior Ethmoidal Artery Using the Anterior Ethmoidal Foramen and the Anterior Nasal Spine. J Craniofac Surg 2022; 33:2665-2669. [PMID: 35882252 PMCID: PMC9612728 DOI: 10.1097/scs.0000000000008733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 03/31/2022] [Indexed: 11/26/2022] Open
Abstract
The anatomy and variations of the anterior ethmoidal artery (AEA) are clinically relevant. The anterior ethmoidal foramen (AEF) can be used to locate the initial site of the AEA, and the anterior nasal spine (ANS) is a constant bony marker in the anterior nasal atrium. However, there is no relevant research on AEF and ANS targeting the AEA. Hence, this study aimed to accurately locate the AEA through AEF and ANS using computed tomography.
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Hassanin SW, Kshirsagar RS, Eide JG, Chang J, Liang J, Palmer JN, Adappa ND. Image-Guided Surgical Device Failures in Functional Endoscopic Sinus Surgery: A MAUDE Analysis. Laryngoscope 2022; 133:1310-1314. [PMID: 35833501 DOI: 10.1002/lary.30296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/24/2022] [Accepted: 06/29/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Image-guided surgery (IGS) devices have become widely used for anatomic localization during functional endoscopic sinus surgery (FESS). However, there are no studies that analyze the post-market complications associated with IGS device use during FESS. The objective of this study was to better characterize post-market complications associated with the use of IGS devices during sinus surgery. METHODS The US Food and Drug Administration's Manufacturer and User Facility Device Experience database was queried for event reports associated with neurological stereotaxic devices utilized in IGS between the dates of January 1, 2016 and December 31, 2020. Medical device reports that were analyzed for this study pertained strictly to FESS. RESULTS There were 1873 reports involving IGS devices for FESS included in this study. Fifty-five reports involved adverse events to patients (2.9%) and 1818 (97.1%) involved device malfunctions. Of the adverse events to patients, the most common included cerebrospinal fluid leakage (45.6%), tissue damage (12.7%), and nervous system injury (3.6%). The most commonly reported device malfunction was imprecision (21.1%). CONCLUSION IGS devices are widely utilized in FESS. Of the medical device reports between 2016 and 2020, less than 3% resulted in adverse events. Further studies of the infrequent post-market complications of IGS devices used in FESS can help guide surgeons on the risks of their clinical use. LEVEL OF EVIDENCE 4-Retrospective database survey without controls Laryngoscope, 2022.
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Affiliation(s)
- Samir W Hassanin
- Department of Medical Education, Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, U.S.A
| | - Rijul S Kshirsagar
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Jacob G Eide
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Jeremy Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Jonathan Liang
- Department of Head and Neck Surgery, Kaiser Permanente Oakland Medical Center, Oakland, California, U.S.A
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, U.S.A
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Carvalho dos Santos P, Costa P, Carvalho I, Sousa C. Complicaciones de la rinosinusitis aguda. Una revisión clínica radiológica. RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To determine the effects of sinus surgery alone or in combination with medical treatment (non‐surgical) compared to medical treatment (non‐surgical) alone on both nasal and pulmonary function in people with cystic fibrosis diagnosed with CRS with nasal polyposis. Further, to evaluate the impact of sinus surgery (with or without medical treatment) on hospitalization rates, use of antibiotics and pulmonary exacerbation rates.
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Nobre ML, Sarmento ACA, Nobre MG, Bedaque HDP, Medeiros KS, Cobucci RN, Gonçalves AK. Image guidance for endoscopic sinus surgery in patients with chronic rhinosinusitis: a systematic review and meta-analysis protocol. BMJ Open 2022; 12:e053436. [PMID: 35459663 PMCID: PMC9036459 DOI: 10.1136/bmjopen-2021-053436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Endoscopic sinus surgery (ESS) is a current procedure for treating patients with chronic rhinosinusitis (CRS). Image-guided surgery (IGS) for ESS may help reduce complications and improve precision. However, it is uncertain in which cases IGS is beneficial. This work aims to compare ESS with and without IGS in patients with CRS. METHODS AND ANALYSIS PubMed, Embase, Scopus, Web of Science, Scielo, Cochrane Central Register of Controlled Trials, CINAHL, LILACS and Clinicaltrials.gov will be searched for reported clinical trials comparing the quality of life and perioperative outcomes of ESS with and without navigation. The search is planned for 20 April 2022. Three independent authors will select eligible articles and extract their data. The risk of bias will be assessed using the Cochrane Handbook for Systematic Reviews of Interventions. The Grading of Recommendation Assessment, Development and Evaluation method will evaluate the strength of the evidence. Data synthesis will be performed using the Review Manager software V.5.4.1. To assess heterogeneity, I2 statistics will be computed. Additionally, meta-analysis will be performed if the included studies are sufficiently homogenous. ETHICS AND DISSEMINATION This study reviews published data, and thus it is not necessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020214791.
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Affiliation(s)
- Maria Luisa Nobre
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Surgery, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | | | | | - Kleyton Santos Medeiros
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil
- Instituto de Ensino, Pesquisa e Inovação, Liga Contra o Câncer, Natal, Brazil
| | | | - Ana Katherine Gonçalves
- Health Sciences Postgraduate Program, Federal University of Rio Grande do Norte, Natal, Brazil
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Avrunin OG, Nosova YV, Abdelhamid IY, Pavlov SV, Shushliapina NO, Bouhlal NA, Ormanbekova A, Iskakova A, Harasim D. Research Active Posterior Rhinomanometry Tomography Method for Nasal Breathing Determining Violations. SENSORS 2021; 21:s21248508. [PMID: 34960601 PMCID: PMC8708127 DOI: 10.3390/s21248508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 12/11/2022]
Abstract
This study analyzes the existing methods for studying nasal breathing. The aspects of verifying the results of rhinomanometric diagnostics according to the data of spiral computed tomography are considered, and the methodological features of dynamic posterior active rhinomanometry and the main indicators of respiration are also analyzed. The possibilities of testing respiratory olfactory disorders are considered, the analysis of errors in rhinomanometric measurements is carried out. In the conclusions, practical recommendations are given that have been developed for the design and operation of tools for functional diagnostics of nasal breathing disorders. It is advisable, according to the data of dynamic rhinomanometry, to assess the functioning of the nasal valve by the shape of the air flow rate signals during forced breathing and the structures of the soft palate by the residual nasopharyngeal pressure drop. It is imperative to take into account not only the maximum coefficient of aerodynamic nose drag, but also the values of the pressure drop and air flow rate in the area of transition to the turbulent quadratic flow regime. From the point of view of the physiology of the nasal response, it is necessary to look at the dynamic change to the current mode, given the hour of the forced response, so that it will ensure the maximum possible acidity in the legend. When planning functional rhinosurgical operations, it is necessary to apply the calculation method using computed tomography, which makes it possible to predict the functional result of surgery.
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Affiliation(s)
- Oleg G. Avrunin
- Department of Biomedical Engineering, Faculty of Electronic and Biomedical Engineering, National University of Radio Electronics, 61166 Kharkiv, Ukraine; (Y.V.N.); (I.Y.A.)
- Correspondence: (O.G.A.); (D.H.); Tel.: +380-505980086 (O.G.A.); +48-815384313 (D.H.)
| | - Yana V. Nosova
- Department of Biomedical Engineering, Faculty of Electronic and Biomedical Engineering, National University of Radio Electronics, 61166 Kharkiv, Ukraine; (Y.V.N.); (I.Y.A.)
| | - Ibrahim Younouss Abdelhamid
- Department of Biomedical Engineering, Faculty of Electronic and Biomedical Engineering, National University of Radio Electronics, 61166 Kharkiv, Ukraine; (Y.V.N.); (I.Y.A.)
| | - Sergii V. Pavlov
- Department of Biomedical Engineering, Vinnytsia National Technical University, 21021 Vinnytsia, Ukraine;
| | - Natalia O. Shushliapina
- Department of Otorhinolaryngology, Stomatological Faculty, Kharkiv National Medical University, 61022 Kharkiv, Ukraine;
| | - Natalia A. Bouhlal
- Azov Maritime Institute, National University “Odessa Maritime Academy”, 65000 Odessa, Ukraine;
| | - Ainur Ormanbekova
- Faculty of Information Technology, Al-Farabi Kazakh National University, Al-Farabi Avenue 71, Almaty 050040, Kazakhstan;
| | - Aigul Iskakova
- Institute of Automation and Information Technologies, Satbayev University, Satpaev Street 22, Almaty 050000, Kazakhstan;
| | - Damian Harasim
- Faculty of Electrical Engineering and Computer Science, Institute of Electronic and Information Technologies, Lublin University of Technology, 20-618 Lublin, Poland
- Correspondence: (O.G.A.); (D.H.); Tel.: +380-505980086 (O.G.A.); +48-815384313 (D.H.)
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Galletti C, Freni F, Ciodaro F, Galletti B. Congenital bilateral choanal atresia: an endoscopic approach with multi-flaps supported by neuronavigated CT. BMJ Case Rep 2021; 14:e245815. [PMID: 34728511 PMCID: PMC8565542 DOI: 10.1136/bcr-2021-245815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2021] [Indexed: 11/04/2022] Open
Abstract
We present a case of a 2-month-old patient with CHARGE syndrome, cerebral haemorrhage and bilateral congenital choanal atresia (CCA). He was admitted to our otorhinolaryngology unit to solve his congenital bilateral choanal atresia proposing a transnasal endoscopic surgery. A study of CT of the skull showed that the air column was interrupted on both sides of nasal cavities; a nasal endoscopy with neonatology flexible optics showed the presence of a membrane and bony structure obstructing the passage into the nasopharynx. Preoperative brain magnetic resonance (MRN) has been made. We decided to carry out a transnasal endoscopic neuronavigation approach with multi-flaps without stenting apposition to solve the CCA, using a 0° 2.7-millimetre rigid endoscopic and Skeeter-type drill with a 2.3-millimetre microblade cutter. Postoperative nasal care was essential to avoid recurrences. Endoscopic follow-up was performed; a large uni-neochoane was residual at 3 months, all raw surfaces were covered by multiple mucosal flaps welded with fibrin.
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Affiliation(s)
- Cosimo Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Freni
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | | | - Bruno Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
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13
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Use of Lacrimal Symptoms Questionnaire After Punctoplasty Surgery: Retrospective Data of Technical Strategy. J Craniofac Surg 2021; 32:2848-2850. [PMID: 34231511 DOI: 10.1097/scs.0000000000007813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT The goal of this study is to evaluate postpunctoplasty symptoms with lacrimal symptoms questionnaire (Lac-Q). A retrospective study was conducted on 31 patients (14 men and 17 woman) with a diagnosis of canalicular stenosis: 26 patients with unilateral occlusion and 5 patients with bilateral occlusion. The Lac-Q was administered preoperative and at 1, at 3, and at 6 months following the surgery. Moreover, the Lac-Q questionnaire was administered by an independent observer (SI). The mono-lateral and bilateral postoperative Lac-Q score showed a significant improvement of symptoms at 1, 3, and 6 months than the preoperative results. The Lac-Q questionnaire is a way to evaluate the quality of outcomes after punctoplasty surgery. In this study, all patients showed a significant improvement of symptoms after surgery.
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14
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Bessen SY, Wu X, Sramek MT, Shi Y, Pastel D, Halter R, Paydarfar JA. Image-guided surgery in otolaryngology: A review of current applications and future directions in head and neck surgery. Head Neck 2021; 43:2534-2553. [PMID: 34032338 DOI: 10.1002/hed.26743] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/20/2021] [Accepted: 05/04/2021] [Indexed: 02/06/2023] Open
Abstract
Image-guided surgery (IGS) has become a widely adopted technology in otolaryngology. Since its introduction nearly three decades ago, IGS technology has developed rapidly and improved real-time intraoperative visualization for a diverse array of clinical indications. As usability, accessibility, and clinical experiences with IGS increase, its potential applications as an adjunct in many surgical procedures continue to expand. Here, we describe the basic components of IGS and review both the current state and future directions of IGS in otolaryngology, with attention to current challenges to its application in surgery of the nonrigid upper aerodigestive tract.
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Affiliation(s)
- Sarah Y Bessen
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Xiaotian Wu
- Massachussetts General Hospital, Boston, Massachusetts, USA
| | - Michael T Sramek
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Yuan Shi
- Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, USA
| | - David Pastel
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Department of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.,Department of Radiology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Ryan Halter
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, USA
| | - Joseph A Paydarfar
- Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.,Thayer School of Engineering at Dartmouth, Hanover, New Hampshire, USA.,Department of Otolaryngology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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15
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Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU, Poetker DM, Soler Z, Welch KC, Wise SK, Adappa N, Alt JA, Anselmo-Lima WT, Bachert C, Baroody FM, Batra PS, Bernal-Sprekelsen M, Beswick D, Bhattacharyya N, Chandra RK, Chang EH, Chiu A, Chowdhury N, Citardi MJ, Cohen NA, Conley DB, DelGaudio J, Desrosiers M, Douglas R, Eloy JA, Fokkens WJ, Gray ST, Gudis DA, Hamilos DL, Han JK, Harvey R, Hellings P, Holbrook EH, Hopkins C, Hwang P, Javer AR, Jiang RS, Kennedy D, Kern R, Laidlaw T, Lal D, Lane A, Lee HM, Lee JT, Levy JM, Lin SY, Lund V, McMains KC, Metson R, Mullol J, Naclerio R, Oakley G, Otori N, Palmer JN, Parikh SR, Passali D, Patel Z, Peters A, Philpott C, Psaltis AJ, Ramakrishnan VR, Ramanathan M, Roh HJ, Rudmik L, Sacks R, Schlosser RJ, Sedaghat AR, Senior BA, Sindwani R, Smith K, Snidvongs K, Stewart M, Suh JD, Tan BK, Turner JH, van Drunen CM, Voegels R, Wang DY, Woodworth BA, Wormald PJ, Wright ED, Yan C, Zhang L, Zhou B. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol 2021; 11:213-739. [PMID: 33236525 DOI: 10.1002/alr.22741] [Citation(s) in RCA: 357] [Impact Index Per Article: 119.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
I. EXECUTIVE SUMMARY BACKGROUND: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document. METHODS ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. RESULTS ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided. CONCLUSION This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS.
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Affiliation(s)
| | | | | | | | | | - Amber U Luong
- University of Texas Medical School at Houston, Houston, TX
| | | | - Zachary Soler
- Medical University of South Carolina, Charleston, SC
| | - Kevin C Welch
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | | | | | | | - Claus Bachert
- Ghent University, Ghent, Belgium.,Karolinska Institute, Stockholm, Sweden.,Sun Yatsen University, Gangzhou, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - David A Gudis
- Columbia University Irving Medical Center, New York, NY
| | - Daniel L Hamilos
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Richard Harvey
- University of New South Wales and Macquarie University, Sydney, New South Wales, Australia
| | | | | | | | | | - Amin R Javer
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | | | | | - Valerie Lund
- Royal National Throat Nose and Ear Hospital, UCLH, London, UK
| | - Kevin C McMains
- Uniformed Services University of Health Sciences, San Antonio, TX
| | | | - Joaquim Mullol
- IDIBAPS Hospital Clinic, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | - Alkis J Psaltis
- University of Adelaide, Adelaide, South Australia, Australia
| | | | | | | | - Luke Rudmik
- University of Calgary, Calgary, Alberta, Canada
| | - Raymond Sacks
- University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | - De Yun Wang
- National University of Singapore, Singapore, Singapore
| | | | | | | | - Carol Yan
- University of California San Diego, La Jolla, CA
| | - Luo Zhang
- Capital Medical University, Beijing, China
| | - Bing Zhou
- Capital Medical University, Beijing, China
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16
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Abstract
Hairy polyps are histological benign lesions derived from 2 germinal layers which arise during fetal period, they can occur anywhere in the body. When they are localized in the oropharynx or nasopharynx can lead to upper airway obstruction in infants.We describe a case of a 2-days-old full-term female with intermittent upper airway obstruction, stridor, and feeding difficulty. Endoscopic and radiologic exams show a mass localized in nasopharynx, which was excised with a transnasal endoscopic approach resolving her respiratory difficulties.Histology confirmed the diagnosis of hairy polyp, a mass composed by an external layer of mature skin and a core with subcutaneous mature fibro fatty tissue, mature skeletal muscle, and cartilage.This report has an important value for the readers because, for a good functional result and an excellent prognosis, an accurate clinic and radiologic diagnose, with subsequent surgical complete resection should be performed.
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17
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Gao Z, Matin F, Weber C, John S, Lenarz T, Scheper V. High Variability of Postsurgical Anatomy Supports the Need for Individualized Drug-Eluting Implants to Treat Chronic Rhinosinusitis. Life (Basel) 2020; 10:life10120353. [PMID: 33348668 PMCID: PMC7766873 DOI: 10.3390/life10120353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/04/2020] [Accepted: 12/15/2020] [Indexed: 01/21/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is a common disease in the general population that is increasing in incidence and prevalence, severely affecting patients’ quality of life. Medical treatment for CRS includes self-management techniques, topical and oral medical treatments, and functional endoscopic sinus surgery (FESS). FESS is a standard procedure to restore sinus ventilation and drainage by physically enlarging the inflamed sinus passageways. Nasal drug-releasing stents are implanted to keep the surgically expanded aperture to the sinus frontalis open. The outcome of such an intervention is highly variable. We defined the anatomical structures which should be removed, along with ‘no-go areas’ which need to be preserved during FESS. Based on these definitions, we used cone beam computed tomography (CBCT) images to measure the dimensions of the frontal neo-ostium in 22 patients. We demonstrate anatomical variability in the volume and diameter of the frontal sinus recess after surgery. This variability could be the cause of therapy failure of drug-eluting implants after FESS in some patients. Implants individually made to fit a given patient’s postsurgical anatomy may improve the therapeutic outcome.
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Affiliation(s)
- Ziwen Gao
- Department of Otorhinolaryngology, Head and Neck Surgery, Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Hannover Medical School, 30625 Hannover, Germany; (Z.G.); (F.M.); (C.W.); (T.L.)
- Cluster of Excellence ‘Hearing4all’ EXC 1077/1, 30625 Hannover, Germany
| | - Farnaz Matin
- Department of Otorhinolaryngology, Head and Neck Surgery, Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Hannover Medical School, 30625 Hannover, Germany; (Z.G.); (F.M.); (C.W.); (T.L.)
| | - Constantin Weber
- Department of Otorhinolaryngology, Head and Neck Surgery, Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Hannover Medical School, 30625 Hannover, Germany; (Z.G.); (F.M.); (C.W.); (T.L.)
| | | | - Thomas Lenarz
- Department of Otorhinolaryngology, Head and Neck Surgery, Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Hannover Medical School, 30625 Hannover, Germany; (Z.G.); (F.M.); (C.W.); (T.L.)
- Cluster of Excellence ‘Hearing4all’ EXC 1077/1, 30625 Hannover, Germany
| | - Verena Scheper
- Department of Otorhinolaryngology, Head and Neck Surgery, Lower Saxony Center for Biomedical Engineering, Implant Research and Development (NIFE), Hannover Medical School, 30625 Hannover, Germany; (Z.G.); (F.M.); (C.W.); (T.L.)
- Cluster of Excellence ‘Hearing4all’ EXC 1077/1, 30625 Hannover, Germany
- Correspondence:
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18
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Shemen L, Yan W, Hasanovic A, Tong J. Glomangiopericytoma of the sphenoethmoid complex. BMJ Case Rep 2020; 13:13/12/e236048. [PMID: 33318263 PMCID: PMC7737071 DOI: 10.1136/bcr-2020-236048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Sinonasal glomangiopericytoma is a rare sinonasal tumour accounting for less than. 5% of all sinonasal tumours. This tumour often presents as another, more common type of vascular lesion and is similarly prone to haemorrhage. The optimal treatment includes complete surgical resection. We, herein, present two such cases adding to the world literature of this rare tumour.
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Affiliation(s)
- Larry Shemen
- Surgery, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Wayne Yan
- Otolaryngology-Head and Neck Surgery, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Adnan Hasanovic
- Pathology, Mount Sinai Medical Center, New York, New York, USA
| | - Jiankun Tong
- Pathology, NewYork-Presbyterian Hospital, New York, New York, USA
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19
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Rhino-Orbito-Cerebral Mucormycosis in Diabetic Disease Mucormycosis in Diabetic Disease. J Craniofac Surg 2020; 31:e321-e324. [PMID: 32028364 DOI: 10.1097/scs.0000000000006191] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The authors present their experience about clinical evidences that include patients with an untreated diabetes who developed rhino-orbito-cerebral mucormycosis (ROCM). They were treated with endoscopic sinus surgery and medical treatment with intravenous, intradural therapy, and sinus washes with amphotericin B. The ROCM is a disease with a rapid evolution and an increase in mortality rate, especially if the fungus enters the cranial cavity. Therefore, it would be necessary in all diabetic patients with sinus symptoms, headaches, visual changes, suspect a mucormycosis, and perform a careful radiology assessment and a nasal endoscopy. Often, despite an early diagnosis and rapid treatment for ROCM, it is not possible to stem the disease, which ends with the patient's death.
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20
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Poma S, Modica DM, Cascio F, Mattina G, Lentini VL, Basile GC, Pitruzzella A, Galfano GM. Endoscopic Endonasal Resection of a Schwannoma of the Anterior Cranial Fossa. EAR, NOSE & THROAT JOURNAL 2020; 101:NP41-NP44. [PMID: 32790588 DOI: 10.1177/0145561320943348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Salvatore Poma
- Department of Otorhinolaryngology, 9341Villa Sofia-Cervello Hospital, Palermo, Italy
| | - Domenico Michele Modica
- Department of Otorhinolaryngology, 9341Villa Sofia-Cervello Hospital, Palermo, Italy.,Otorhinolaryngology Section, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
| | - Filippo Cascio
- Department of Otorhinolaryngology, 18597Papardo Hospital, Messina, Italy
| | - Gianfranco Mattina
- Department of Otorhinolaryngology, 9341Villa Sofia-Cervello Hospital, Palermo, Italy.,Otorhinolaryngology Section, Department of Experimental Biomedicine and Clinical Neurosciences (BioNeC), University of Palermo, Italy
| | | | - Giorgio Carmelo Basile
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, 18980University of Messina, Italy
| | - Alessandro Pitruzzella
- Department of Biomedicine Neuroscience and Advanced Diagnostics, University of Palermo, Italy.,Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy
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21
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Pérez Sayáns M, Suárez Quintanilla JA, Chamorro Petronacci CM, Suárez Peñaranda JM, López Jornet P, Gómez García F, Guerrero Sánchez Y. Volumetric study of the maxillary sinus in patients with sinus pathology. PLoS One 2020; 15:e0234915. [PMID: 32555640 PMCID: PMC7302704 DOI: 10.1371/journal.pone.0234915] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/04/2020] [Indexed: 12/18/2022] Open
Abstract
Objectives The aim of this study is 1) to obtain the area and volumes of the maxillary sinuses in patients affected by clinically unilateral sinus pathology by comparing the results to the contralateral sinus and 2) to determine the importance of the volumetric measures when diagnosing the percentage of sinus obliteration. Materials and methods A single-centre observational retrospective clinical study was conducted in 214 patients with clinically unilateral sinus pathologies. Linear (mm), area (mm2) and volume (mm3) measurements were taken from Cone Beam Computed Tomography (CBCT) images of the affected sinus as well as from the contralateral ones. Histopathological study was performed using haematoxylin/eosin and PAS or Groccot stains. The lesions were classified into non-specific sinusitis, polyps, inverted papilloma, fungal sinusitis, cysts, mucocele and other lesions. Chi-squared test, ANOVA for independent samples and Pearson test were used for the statistical analysis. Results A total of 100 sinuses were measured in 50 patients (28 men and 22 women, with an age of 43.6 years (SD = 18.3), 50 pathological and 50 healthy contralateral sinuses. The three-dimensional occupation volume of the affected sinuses was 97.1 mm3 (62.5%) vs. 40.6 mm3 (22.8%) in the healthy ones (p<0.0001). The medial-lateral width of the sinus in the frontal plane was significantly higher in the cysts group (32.4 mm, CI: 23–41.8 mm). Conclusion In medical terms, the global percentage of occupation determined using the classic manual determination method does not differ from the three-dimensional percentage calculated using specific complex software.
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Affiliation(s)
- Mario Pérez Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes Group), Faculty of Medicine and Dentistry, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute Foundation of Santiago (FIDIS), Santiago de Compostela, Spain
- * E-mail:
| | - Juan A. Suárez Quintanilla
- Area of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - José M. Suárez Peñaranda
- Pathological Anatomy Service, University Hospital Complex of Santiago (CHUS), Santiago de Compostela, Spain
| | - Pía López Jornet
- School of Dentistry, Faculty of Medicine, Research Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, Clínica Odontológica Universitaria Hospital Morales Meseguer, University of Murcia, Murcia, Spain
| | - Francisco Gómez García
- School of Dentistry, Faculty of Medicine, Research Virgen de la Arrixaca Clinical University Hospital, IMIB-Arrixaca, Clínica Odontológica Universitaria Hospital Morales Meseguer, University of Murcia, Murcia, Spain
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22
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Schmale IL, Vandelaar LJ, Luong AU, Citardi MJ, Yao WC. Image-Guided Surgery and Intraoperative Imaging in Rhinology: Clinical Update and Current State of the Art. EAR, NOSE & THROAT JOURNAL 2020; 100:NP475-NP486. [PMID: 32453646 DOI: 10.1177/0145561320928202] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Image-guided surgery (IGS) has gained widespread acceptance in otorhinolaryngology for its applications in sinus and skull base surgery. Although the core concepts of IGS have not changed, advances in image guidance technology, including the incorporation of intraoperative imaging, have the potential to enhance surgical education, allow for more rigorous preoperative planning, and aid in more complete surgery with improved outcomes. OBJECTIVES Provide a clinical update regarding the use of image guidance and intraoperative imaging in the field of rhinology and endoscopic skull base surgery with a focus on current state of the art technologies. METHODS English-language studies published in PubMed, Cochrane, and Embase were searched for articles relating to image-guided sinus surgery, skull base surgery, and intraoperative imaging. Relevant studies were reviewed and critical appraisals were included in this clinical update, highlighting current state of the art advances. CONCLUSIONS As image guidance and intraoperative imaging systems have advanced, their applications in sinus and skull base surgery have expanded. Both technologies offer invaluable real-time feedback on the status and progress of surgery, and thus may help to improve the completeness of surgery and overall outcomes. Recent advances such as augmented and virtual reality offer a window into the future of IGS. Future advancements should aim to enhance the surgeon's operative experience by improving user satisfaction and ultimately lead to better surgical results.
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Affiliation(s)
- Isaac L Schmale
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, TX, USA
| | - Laura J Vandelaar
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, TX, USA
| | - Amber U Luong
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, TX, USA
| | - Martin J Citardi
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, TX, USA
| | - William C Yao
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, TX, USA
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23
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Meduri A, De Maria A, Severo AA, Aragona P. Infectious conjunctivitis caused by Pseudomonas a eruginosa in infected and extrused scleral buckles. BMJ Case Rep 2020; 13:13/1/e232296. [PMID: 31919063 DOI: 10.1136/bcr-2019-232296] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Extrusion of the scleral buckle is one of the complications patients may encounter undergoing the surgical treatment for retinal detachment. We present two cases of persistent Pseudomonas a eruginosa-related conjunctivitis which infected the silicone explant after retinal surgery. One of them is a 73-year-old Caucasian female patient with hyperaemia, intense pain and mucopurulent discharge. After the conjunctival swabs detected a P. aeruginosa infection, she started both topical and systemic treatment without any results; for this reason we opted for the buckle removal always under systemic therapy. The second case is an 84-year-old Caucasian female patient with fever, periorbital oedema, chronic ocular pain, hyperaemia and purulent discharge. P. aeruginosa has also been detected in this case. No improvement with topical and systemic treatment, so this convinced us to remove patient's buckles and to continue systemic therapy. Both cases had the complete resolution after surgery. It is important to quickly recognise exposed scleral buckles because they can be a source of infections and a rare but threatening cause of endophthalmitis.
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Affiliation(s)
- Alessandro Meduri
- U.O.C. Ophthalmology, Università degli Studi di Messina Facolta di Medicina e Chirurgia, Messina, Italy
| | - Antonio De Maria
- U.O.C. Ophthalmology, Università degli Studi di Messina Facolta di Medicina e Chirurgia, Messina, Italy
| | - Alice Antonella Severo
- U.O.C. Ophthalmology, Università degli Studi di Messina Facolta di Medicina e Chirurgia, Messina, Italy
| | - Pasquale Aragona
- U.O.C. Ophthalmology, Università degli Studi di Messina Facolta di Medicina e Chirurgia, Messina, Italy
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24
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Cascio F, Cacciola A, Portaro S, Basile GA, Rizzo G, Felippu AWD, Felippu AWD, Bruschetta A, Anfuso C, Cascio F, Milardi D, Bramanti A. In Vivo Computed Tomography Direct Volume Rendering of the Anterior Ethmoidal Artery: A Descriptive Anatomical Study. Int Arch Otorhinolaryngol 2020; 24:e38-e46. [PMID: 31929832 PMCID: PMC6952292 DOI: 10.1055/s-0039-1698776] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 08/18/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction The clinical relevance of the anatomy and variations of the anterior ethmoidal artery (AEA) is outstanding, considering its role as a landmark in endoscopic surgery, its importance in the therapy of epistaxis, and the high risks related to iatrogenic injuries. Objective To provide an anatomical description of the course and relationships of the AEA, based on direct computed-tomography (CT)-based 3D volume rendering. Methods Direct volume rendering was performed on 18 subjects who underwent (CT) with contrast medium for suspected cerebral aneurism. Results The topographical location of 36 AEAs was assessed as shown: 10 dehiscent (27.8%), 20 intracanal (55.5%), 6 incomplete canals (16.7%). Distances from important topographic landmarks are reported. Conclusion This work demonstrates that direct 3D volume rendering is a valid imaging technique for a detailed description of the anterior ethmoidal artery thus representing a useful tool for head pre-operatory assessments.
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Affiliation(s)
- Filippo Cascio
- Department of Otorhinolaryngology, Papardo Piemonte Reunited Hospitals, Messina, Sicilia, Italy
| | - Alberto Cacciola
- Department of Biomedical, Odontoiatric, Morphological and Functional Imaging Sciences, Università degli Studi di Messina, Messina, Italy
| | - Simona Portaro
- Scientific Institute for Research, Hospitalization and Health Care Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Gianpaolo Antonio Basile
- Department of Biomedical, Odontoiatric, Morphological and Functional Imaging Sciences, Università degli Studi di Messina, Messina, Italy
| | - Giuseppina Rizzo
- Department of Biomedical, Odontoiatric, Morphological and Functional Imaging Sciences, Università degli Studi di Messina, Messina, Italy
| | | | | | - Antongiulio Bruschetta
- Department of Biomedical, Odontoiatric, Morphological and Functional Imaging Sciences, Università degli Studi di Messina, Messina, Italy
| | - Carmelo Anfuso
- Scientific Institute for Research, Hospitalization and Health Care Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Felice Cascio
- Department of Otorhinolaryngology, Papardo Piemonte Reunited Hospitals, Messina, Sicilia, Italy
| | - Demetrio Milardi
- Department of Biomedical, Odontoiatric, Morphological and Functional Imaging Sciences, Università degli Studi di Messina, Messina, Italy
- Scientific Institute for Research, Hospitalization and Health Care Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Alessia Bramanti
- Scientific Institute for Research, Hospitalization and Health Care Centro Neurolesi Bonino Pulejo, Messina, Italy
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25
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Galletti F, Freni F, Gazia F, Gallo A. Vocal cord surgery and pharmacological treatment of a patient with HPV and recurrent respiratory papillomatosis. BMJ Case Rep 2019; 12:12/11/e231117. [PMID: 31732543 DOI: 10.1136/bcr-2019-231117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Recurrent respiratory papillomatosis (RRP) is caused by persistent infection of the respiratory epithelium by human papillomavirus (HPV), especially HPV 6 and 11. We present a case of surgically treated RRP. The main purpose of our protocol is to remove the lesions with a non-aggressive surgical technique and prevent recurrences with the use of cidofovir for local infiltrations in multiple sessions. We use low-power energy CO2 laser, directed towards the upper part of the vocal cord, to determine a retraction of the mucosa with consequent coverage of the epithelium of the free edge. The aim of this technique is to treat and stop the formation of synechia of the anterior commissure and the free margin of the vocal cords in the anterior commissure. After 8 years follow-up, there are no signs of recurrence of the disease. The voice had a net improvement confirming the effectiveness of the protocol.
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Affiliation(s)
- Francesco Galletti
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Freni
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Gazia
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Andrea Gallo
- UOC Otorinolaringoiatria - Polo Pontino, Università degli Studi di Roma La Sapienza Facoltà di Medicina e Odontoiatria, Roma, Italy
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26
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Cascio F, Basile GC, Felippu AWD, Felippu AWD, Militi D, Portaro S, Poma S, Cascio F. Diagnosis and Treatment of Bilateral Respiratory Epithelial Adenomatoid Hamartomas With and Without Sinonasal Polyposis. EAR, NOSE & THROAT JOURNAL 2019; 100:495S-497S. [PMID: 31690100 DOI: 10.1177/0145561319886500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Filippo Cascio
- Department of Otorhinolaryngology, 18597Papardo Hospital, Messina, Italy
| | - Giorgio Carmelo Basile
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, 18980University of Messina, Messina, Italy
| | | | | | - David Militi
- 120349IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | - Simona Portaro
- 120349IRCCS Centro Neurolesi Bonino Pulejo, Messina, Italy
| | | | - Felice Cascio
- Department of Otorhinolaryngology, 18597Papardo Hospital, Messina, Italy
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27
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Perez de San Roman-Mena L, Monroy-Sosa A, Chakravarthi SS, Gonen L, Epping A, Khalili S, Smithee W, Kassam M, Celix JM, Kura B, Jennings J, Rovin RA, Fukui MB, Kassam AB. An Anatomically-Based Endoscopic Endonasal Model to Navigate the Anterior Ventral Skull Base. World Neurosurg 2019; 134:e422-e431. [PMID: 31655241 DOI: 10.1016/j.wneu.2019.10.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Endoscopic endonasal approaches to access the sellar and parasellar regions are challenging in the face of anatomical variations or pathologic conditions. We propose an anatomically-based model including the orbitosellar line (OSL), critical oblique foramen line (COFL), and paramedial anterior line (PAL) facilitating safe, superficial-to-deep dissection triangulating upon the medial opticocarotid recess. METHODS Five cadaveric heads were dissected to systematically expose the OSL, COFL, and PAL, illustrated with image guidance. Application of the coordinate system and a 6-step dissection sequence is described. RESULTS The coordinate system consists of 1) the OSL, connecting a) the anterior orbital point, junction of the anterior buttress of the middle turbinate with the agger nasi region, located 34.3 ± 0.9 mm above the intersection of the vertical plane of the lacrimal crest, and the orthogonal plane of the maxillo-ethmoidal suture; b) the posterior orbital point, junction of the optic canal with the lamina papyracea, located 4 ± 0.7 mm below the posterior ethmoidal artery; and c) the medial opticocarotid recess; 2) COFL (15 ± 2.8 mm), connecting the palatovaginal canal, vidian canal, and foramen rotundum; and 3) PAL (39 ± 0.06 mm), connecting the vidian canal with the posterior ethmoidal artery. CONCLUSIONS OSL, COFL, and PAL form an anatomically-based model for the systematic exposure when accessing the parasellar and sellar regions. Preliminary anatomical data suggest that this model may be of value when normal anatomy is distorted by pathology or anatomic variations.
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Affiliation(s)
| | - Alejandro Monroy-Sosa
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - Srikant S Chakravarthi
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - Lior Gonen
- Shaare Zedek Medical Center, Jerusalem, Israel
| | - Austin Epping
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - Sammy Khalili
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - William Smithee
- School of Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | | | - Juanita M Celix
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - Bhavani Kura
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - Jonathan Jennings
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - Richard A Rovin
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - Melanie B Fukui
- Aurora Neuroscience Innovation Institute, Aurora St. Luke's Medical Center, Milwaukee, Wisconsin, USA
| | - Amin B Kassam
- Neeka Health Enterprises, Milwaukee, Wisconsin, USA.
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28
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Galletti B, Costanzo D, Gazia F, Galletti F. High-grade chondrosarcoma of the larynx: treatment and management. BMJ Case Rep 2019; 12:12/9/e230918. [PMID: 31527210 DOI: 10.1136/bcr-2019-230918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We present a case of an 88-year-old man with high-grade chondrosarcoma of the larynx. The patient presents with a history worsening dysphonia and dyspnoea treated with antibiotic and corticosteroid therapy as it was a bronchopneumonia. Thanks to fibrolaryngoscopy, radiological imaging and final biopsy with immunohistochemistry, we have done differential diagnosis with the others sarcomas of the larynx. The histological diagnosis and the correct grading are essential for treatment and management of the pathology. The best treatment is primary surgical resection with negative margins. Chemoradiotherapy may provide some benefit if there are margin positive resections or with palliative intent. In our case, we performed only surgery treatment and a close follow-up at 1-3-6 months and after every 6 months. After 18 months from surgery, there are no signs of recurrence of disease.
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Affiliation(s)
- Bruno Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Daria Costanzo
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Gazia
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
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29
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Ciodaro F, Gazia F, Galletti B, Galletti F. Hyperbaric oxygen therapy in a case of cervical abscess extending to anterior mediastinum, with isolation of Prevotella corporis. BMJ Case Rep 2019; 12:12/7/e229873. [PMID: 31296620 DOI: 10.1136/bcr-2019-229873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We present a case of an odontogenic abscess, first spreading at the lateral cervical level and then in mediastinum. We isolated an anaerobic bacterium, Prevotella corporis, rarely documented in literature. The mortality rates of cervical abscesses secondary to odontogenic infections and complicated by mediastinitis vary from 10% to 40%. Treatment of descending mediastinitis involves multidisciplinary teams such as otorhinolaryngology, thoracic surgeons, infectious disease physicians, anesthetists and intensivists. Due to the combined treatment with surgical drainage within 48 hours of hospitalisation, antibiotics and subsequent hyperbaric oxygen therapy, we have achieved complete recovery of the patient.
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Affiliation(s)
- Francesco Ciodaro
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Gazia
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Bruno Galletti
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology 'Gaetano Barresi', Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
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30
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Galletti B, Gazia F, Galletti C, Perani F, Ciodaro F, Freni F, Galletti F. Rhinocerebral mucormycosis with dissemination to pontine area in a diabetic patient: Treatment and management. Clin Case Rep 2019; 7:1382-1387. [PMID: 31360493 PMCID: PMC6637368 DOI: 10.1002/ccr3.2255] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/09/2019] [Accepted: 05/19/2019] [Indexed: 12/19/2022] Open
Abstract
Rhinocerebral mucormycosis is a rapidly life-threatening disease caused by a fungal infection. Every diabetic patient with sinusitis symptoms, headache, and visual changes needs radiological approach and nasal endoscopy to rule out mucormycosis. The mortality rate is 50%-85%, despite an early diagnosis and a correct treatment.
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Affiliation(s)
- Bruno Galletti
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology “Gaetano Barresi”University of MessinaMessinaItaly
| | - Francesco Gazia
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology “Gaetano Barresi”University of MessinaMessinaItaly
| | - Cosimo Galletti
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology “Gaetano Barresi”University of MessinaMessinaItaly
| | - Fulvio Perani
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology “Gaetano Barresi”University of MessinaMessinaItaly
| | - Francesco Ciodaro
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology “Gaetano Barresi”University of MessinaMessinaItaly
| | - Francesco Freni
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology “Gaetano Barresi”University of MessinaMessinaItaly
| | - Francesco Galletti
- Unit of Otorhinolaryngology, Department of Adult and Development Age Human Pathology “Gaetano Barresi”University of MessinaMessinaItaly
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31
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Galletti B, Gazia F, Galletti C, Galletti F. Endoscopic treatment of a periorbital fat herniation caused by spontaneous solution of continuity of the papyracea lamina. BMJ Case Rep 2019; 12:12/4/e229376. [PMID: 31040145 DOI: 10.1136/bcr-2019-229376] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
We present a case of a 16-year-old girl with interruption of papyracea lamina and herniation of the periorbital fat covered by a bone shell. The patient presents with a history of diplopia and visual disturbances ever since she can remember. Thanks to radiological imaging and biopsy, we have done differential diagnosis with periorbital lipoma, intraosseous lipoma and intramuscular lipoma of medial rectus. Diagnostic for images is necessary for a correct operative planning. Endoscopic sinus surgery with computer-assisted navigation is the safest and most effective method to remove the lesion that was closely related to the medial rectum muscle and to the anterior ethmoidal artery. The patient after surgery and in 1 year of follow-up reports the disappearance of symptoms.
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Affiliation(s)
- Bruno Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Gazia
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Cosimo Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology "Gaetano Barresi", Unit of Otorhinolaryngology, Universita degli Studi di Messina, Messina, Italy
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32
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Freni F, Gazia F, Stagno d’Alcontres F, Galletti B, Galletti F. Use of botulinum toxin in Frey's syndrome. Clin Case Rep 2019; 7:482-485. [PMID: 30899477 PMCID: PMC6406149 DOI: 10.1002/ccr3.2019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 12/17/2018] [Accepted: 01/06/2019] [Indexed: 11/24/2022] Open
Abstract
Frey's syndrome is the most common adverse event after parotidectomy, and usually, it appears after 6 months. In our case, symptoms appear 20 years from surgery, an uncommon condition. Intralesional botulinum toxin gives excellent results in therapy, regardless of the time elapsed between surgery and the first treatment.
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Affiliation(s)
- Francesco Freni
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, unit of OtorhinolaryngologyUniversity of MessinaMessinaItaly
| | - Francesco Gazia
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, unit of OtorhinolaryngologyUniversity of MessinaMessinaItaly
| | - Ferdinando Stagno d’Alcontres
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, unit of OtorhinolaryngologyUniversity of MessinaMessinaItaly
| | - Bruno Galletti
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, unit of OtorhinolaryngologyUniversity of MessinaMessinaItaly
| | - Francesco Galletti
- Department of Adult and Development Age Human Pathology “Gaetano Barresi”, unit of OtorhinolaryngologyUniversity of MessinaMessinaItaly
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