1
|
Tochigi K, Sakamoto H, Omura K, Kessoku H, Takeda T, Oguro R, Kojima H, Tanaka Y. Safety of cricotracheostomy with skin and tracheal membrane flaps for severe COVID-19 patients. Auris Nasus Larynx 2024; 51:583-587. [PMID: 38552421 DOI: 10.1016/j.anl.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 02/04/2024] [Accepted: 03/13/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE Airway surgery is performed for COVID-19 patients who require long-term tracheal intubation and mechanical ventilation. Tracheostomy sometimes causes postoperative complications represented by bleeding at a relatively high rate in COVID-19 patients. As an alternative surgical procedure to tracheostomy, cricotracheostomy may reduce these complications, but few studies have examined its safety. METHODS Data were retrospectively collected for sixteen COVID-19 patients (11 underwent tracheostomy, 5 underwent modified cricotracheostomy). In addition to patients' backgrounds and blood test data, the frequency of complications and additional care required for postoperative complications were collected. Statistical analysis was conducted by the univariate analysis of Fischer analysis and Mann-Whitney U test. RESULTS Five cases experienced postoperative bleeding, four cases experienced peristomal infection, and one case experienced subcutaneous emphysema in the tracheostomy patients. These complications were not observed in the cricotracheostomy patients. The number of additional cares for postoperative complications was significantly lower in cricotracheostomy than in tracheostomy patients (p < 0.05). CONCLUSIONS Modified cricotracheostomy could be a safe procedure in airway surgery for patients with COVID-19 from the point of fewer postoperative complications and additional care. It might be necessary to select the cricotracheostomy depending on patients' background to reduce postoperative complications.
Collapse
Affiliation(s)
- Kosuke Tochigi
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Hikaru Sakamoto
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan; Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Hisashi Kessoku
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Teppei Takeda
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Ryoji Oguro
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
2
|
Maeda-Anezaki M, Omura K, Mori R, Ishida K. Case of giant juvenile angiofibroma resected by external incision with temporary double balloon occlusion of the internal carotid artery by intraoperative endovascular treatment. BMJ Case Rep 2024; 17:e256731. [PMID: 38479825 PMCID: PMC10941159 DOI: 10.1136/bcr-2023-256731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024] Open
Abstract
We report the first case of a juvenile nasal angiofibroma (JNA) fed by multiple arteries from the internal carotid artery (ICA), removed without complications by temporarily blocking the ICA with two balloons. An early adolescent with JNA underwent preoperative embolisation of feeding arteries arising from the external carotid artery (ECA) (University of Pittsburgh Medical Centre classification IV). Endoscopic resection was attempted once but discontinued due to massive bleeding (7000 mL). 17 months later, the JNA had grown to fill both nasal cavities. Repeated preoperative embolisation of the feeders from the ECA was performed, followed by surgery combined with endoscopic and external incision. Intraoperatively, two balloons were inserted into the right ICA, which were inflated at the proximal and distal sites of the feeder vessels to cut-off blood flow to the tumour. The tumour was almost completely resected with 6270 mL of blood loss and no postoperative neurological deterioration.
Collapse
Affiliation(s)
- Mayuka Maeda-Anezaki
- Otorhinolaryngology, The Jikei University School of Medicine, Minatoku, Tokyo, Japan
- Otorhinolaryngology, Self Defence Forces Central Hospital, Setagaya-ku, Tokyo, Japan
| | - Kazuhiro Omura
- Otorhinolaryngology, The Jikei University School of Medicine, Minatoku, Tokyo, Japan
| | - Ryosuke Mori
- Neurosurgery, The Jikei University School of Medicine, Minatoku, Tokyo, Japan
| | - Katsuhiro Ishida
- Plastic and Reconstructive Surgery, The Jikei University School of Medicine, Minatoku, Tokyo, Japan
| |
Collapse
|
3
|
Tsutsumi Y, Omura K, Kijima Y, Kobayashi M, Fukasawa N, Takeda T, Ebihara T, Aoki S, Otori N, Kojima H, Aoki M. The impact of multidisciplinary approaches on the outcomes of olfactory neuroblastoma treated with postoperative radiotherapy. Cancer Med 2024; 13:e6943. [PMID: 38497548 PMCID: PMC10945880 DOI: 10.1002/cam4.6943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/30/2023] [Accepted: 01/06/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND We investigated the outcomes of postoperative radiation therapy for olfactory neuroblastoma (ONB) and our cross-departmental collaboration to enhance the effectiveness of cancer treatment. METHODS We retrospectively evaluated 22 patients with ONB who underwent postoperative radiotherapy after tumor resection. En bloc resection was performed; pathology specimens were prepared in coronal sections; and irradiation fields were determined after discussion with radiation oncologists, head and neck surgeons, and pathologists. RESULTS The overall survival and local control rates were 95.5% and 100%, respectively, at a median 37-month follow-up. The 3- and 5-year disease-free survival (DFS) rates were 64.4% and 56.3%, respectively. Of the 22 patients, 9 (8 Kadish C and 1 Kadish B) had disease recurrence. Of the nine patients, five had positive margins and two had closed margins; cervical lymph node recurrence occurred in six, and distant metastasis with or without cervical lymph node recurrence occurred in three. DFS analysis of risk factors showed no statistically significant differences, but positive margins were a significant recurrence factor in multivariate analysis. CONCLUSIONS The local control rate of ONB treated with postoperative radiation therapy was 100%. This may be attributed to cross-departmental cooperation between head and neck surgeons, pathologists, and radiation oncologists, which resulted in accurate matching of CT images for treatment planning with the location of the tumor and positive margins. Longer follow-up periods are required to evaluate the effectiveness of our strategy.
Collapse
Affiliation(s)
- Yuki Tsutsumi
- Department of Radiation Oncology, Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Yoshikazu Kijima
- Department of Radiation Oncology, Jikei University School of Medicine, Tokyo, Japan
| | - Masao Kobayashi
- Department of Radiation Oncology, Jikei University School of Medicine, Tokyo, Japan
| | - Nei Fukasawa
- Department of Pathology, Jikei University School of Medicine, Tokyo, Japan
| | - Teppei Takeda
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Teru Ebihara
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Manabu Aoki
- Department of Radiation Oncology, Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
4
|
Baba A, Matsushima S, Kessoku H, Omura K, Kurokawa R, Fukasawa N, Takeshita Y, Yamauchi H, Ogino N, Kayama R, Uchihara K, Yoshimatsu L, Ojiri H. Radiological features of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: case series and systematic review. Neuroradiology 2024; 66:249-259. [PMID: 38103083 DOI: 10.1007/s00234-023-03254-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/15/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE To comprehensively summarize the clinical data and CT/MRI characteristics of thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA). METHODS Twenty-seven lesions from 25 study articles identified through a systematic review and three lesions from our institution associated with TL-LGNPPA were evaluated. RESULTS The mean age of the patients at diagnosis was 35.7 years, and the male-to-female ratio was nearly half. The chief complaint was nasal obstruction, followed by epistaxis. All patients underwent excision. None of the patients had neck nodes or distant metastases. All patients survived with no locoregional/distant recurrence during 3-93 months of follow-up. All lesions were located at the posterior edge of the nasal septum, attached to the nasopharyngeal parietal wall, and showed no laterality. The mean lesion diameter was 1.7 cm. The margins of lesions were well-defined and lobulated, followed by well-defined smooth margins. None of lesions were associated with parapharyngeal space or skull base destruction. All lesions were iso- and low-density on non-contrast CT. Adjacent skull base sclerosis was detected in 63.6% of lesions. High signal intensity on T2-weighted imaging and mostly iso-signal intensity on T1-weighted imaging compared to muscle tissue. Most lesions were heterogeneous and exhibited moderate contrast enhancement. Relatively large lesions (≥1.4 cm) tended to be more lobulated than smooth margins compared to relatively small lesions (<1.4 cm) (p = 0.016). CONCLUSION We summarized the clinical and radiological features of TL-LGNPPA to facilitate accurate diagnosis and appropriate management.
Collapse
Affiliation(s)
- Akira Baba
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Satoshi Matsushima
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hisashi Kessoku
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Ryo Kurokawa
- Department of Radiology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Nei Fukasawa
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yuhei Takeshita
- Department of Radiology, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka-shi, Tokyo, 181-8611, Japan
| | - Hideomi Yamauchi
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Nobuhiro Ogino
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Reina Kayama
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kimiyuki Uchihara
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Lynn Yoshimatsu
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| |
Collapse
|
5
|
Kuan EC, Wang EW, Adappa ND, Beswick DM, London NR, Su SY, Wang MB, Abuzeid WM, Alexiev B, Alt JA, Antognoni P, Alonso-Basanta M, Batra PS, Bhayani M, Bell D, Bernal-Sprekelsen M, Betz CS, Blay JY, Bleier BS, Bonilla-Velez J, Callejas C, Carrau RL, Casiano RR, Castelnuovo P, Chandra RK, Chatzinakis V, Chen SB, Chiu AG, Choby G, Chowdhury NI, Citardi MJ, Cohen MA, Dagan R, Dalfino G, Dallan I, Dassi CS, de Almeida J, Dei Tos AP, DelGaudio JM, Ebert CS, El-Sayed IH, Eloy JA, Evans JJ, Fang CH, Farrell NF, Ferrari M, Fischbein N, Folbe A, Fokkens WJ, Fox MG, Lund VJ, Gallia GL, Gardner PA, Geltzeiler M, Georgalas C, Getz AE, Govindaraj S, Gray ST, Grayson JW, Gross BA, Grube JG, Guo R, Ha PK, Halderman AA, Hanna EY, Harvey RJ, Hernandez SC, Holtzman AL, Hopkins C, Huang Z, Huang Z, Humphreys IM, Hwang PH, Iloreta AM, Ishii M, Ivan ME, Jafari A, Kennedy DW, Khan M, Kimple AJ, Kingdom TT, Knisely A, Kuo YJ, Lal D, Lamarre ED, Lan MY, Le H, Lechner M, Lee NY, Lee JK, Lee VH, Levine CG, Lin JC, Lin DT, Lobo BC, Locke T, Luong AU, Magliocca KR, Markovic SN, Matnjani G, McKean EL, Meço C, Mendenhall WM, Michel L, Na'ara S, Nicolai P, Nuss DW, Nyquist GG, Oakley GM, Omura K, Orlandi RR, Otori N, Papagiannopoulos P, Patel ZM, Pfister DG, Phan J, Psaltis AJ, Rabinowitz MR, Ramanathan M, Rimmer R, Rosen MR, Sanusi O, Sargi ZB, Schafhausen P, Schlosser RJ, Sedaghat AR, Senior BA, Shrivastava R, Sindwani R, Smith TL, Smith KA, Snyderman CH, Solares CA, Sreenath SB, Stamm A, Stölzel K, Sumer B, Surda P, Tajudeen BA, Thompson LDR, Thorp BD, Tong CCL, Tsang RK, Turner JH, Turri-Zanoni M, Udager AM, van Zele T, VanKoevering K, Welch KC, Wise SK, Witterick IJ, Won TB, Wong SN, Woodworth BA, Wormald PJ, Yao WC, Yeh CF, Zhou B, Palmer JN. International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors. Int Forum Allergy Rhinol 2024; 14:149-608. [PMID: 37658764 DOI: 10.1002/alr.23262] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Sinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represent a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology-based topics spanning the field. METHODS In accordance with prior International Consensus Statement on Allergy and Rhinology documents, ICSNT assigned each topic as an Evidence-Based Review with Recommendations, Evidence-Based Review, and Literature Review based on the level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses format, and completed sections underwent a thorough and iterative consensus-building process. The final document underwent rigorous synthesis and review prior to publication. RESULTS The ICSNT document consists of four major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology-based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention. CONCLUSION As an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.
Collapse
Affiliation(s)
- Edward C Kuan
- Departments of Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Orange, California, USA
| | - Eric W Wang
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Nithin D Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Daniel M Beswick
- Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Nyall R London
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Sinonasal and Skull Base Tumor Program, Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shirley Y Su
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Marilene B Wang
- Department of Otolaryngology-Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA
| | - Waleed M Abuzeid
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Borislav Alexiev
- Department of Pathology, Northwestern University Feinberg School of Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Jeremiah A Alt
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Paolo Antognoni
- Division of Radiation Oncology, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Michelle Alonso-Basanta
- Department of Radiation Oncology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Pete S Batra
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Mihir Bhayani
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Diana Bell
- Department of Pathology, City of Hope Comprehensive Cancer Center, Duarte, California, USA
| | - Manuel Bernal-Sprekelsen
- Otorhinolaryngology Department, Surgery and Medical-Surgical Specialties Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Christian S Betz
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard, UNICANCER, Université Claude Bernard Lyon I, Lyon, France
| | - Benjamin S Bleier
- Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA
| | - Juliana Bonilla-Velez
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Claudio Callejas
- Department of Otolaryngology, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Ricardo L Carrau
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Roy R Casiano
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Rakesh K Chandra
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Simon B Chen
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Alexander G Chiu
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Garret Choby
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Naweed I Chowdhury
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Martin J Citardi
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Marc A Cohen
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Roi Dagan
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Gianluca Dalfino
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Iacopo Dallan
- Department of Otolaryngology-Head and Neck Surgery, Pisa University Hospital, Pisa, Italy
| | | | - John de Almeida
- Department of Otolaryngology-Head and Neck Surgery, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Angelo P Dei Tos
- Section of Pathology, Department of Medicine, University of Padua, Padua, Italy
| | - John M DelGaudio
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Charles S Ebert
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ivan H El-Sayed
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Jean Anderson Eloy
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - James J Evans
- Department of Neurological Surgery and Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Christina H Fang
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York, USA
| | - Nyssa F Farrell
- Department of Otolaryngology-Head and Neck Surgery, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Marco Ferrari
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Nancy Fischbein
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Adam Folbe
- Department of Otolaryngology-Head and Neck Surgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Meha G Fox
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | | | - Gary L Gallia
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul A Gardner
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Mathew Geltzeiler
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Christos Georgalas
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Nicosia Medical School, Nicosia, Cyprus
| | - Anne E Getz
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
| | - Satish Govindaraj
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Stacey T Gray
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Jessica W Grayson
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Bradley A Gross
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Jordon G Grube
- Department of Otolaryngology-Head and Neck Surgery, Albany Medical Center, Albany, New York, USA
| | - Ruifeng Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Patrick K Ha
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Ashleigh A Halderman
- Department of Otolaryngology-Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ehab Y Hanna
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Richard J Harvey
- Rhinology and Skull Base Research Group, Applied Medical Research Centre, University of South Wales, Sydney, New South Wales, Australia
| | - Stephen C Hernandez
- Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center, New Orleans, Louisiana, USA
| | - Adam L Holtzman
- Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Claire Hopkins
- Department of Otolaryngology-Head and Neck Surgery, Guys and St Thomas' Hospital, London, UK
| | - Zhigang Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Zhenxiao Huang
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
| | - Ian M Humphreys
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - Peter H Hwang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - Alfred M Iloreta
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Masaru Ishii
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Michael E Ivan
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Aria Jafari
- Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, USA
| | - David W Kennedy
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mohemmed Khan
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Adam J Kimple
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Todd T Kingdom
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA
| | - Anna Knisely
- Department of Otolaryngology, Head and Neck Surgery, Swedish Medical Center, Seattle, Washington, USA
| | - Ying-Ju Kuo
- Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Devyani Lal
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric D Lamarre
- Head and Neck Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ming-Ying Lan
- Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hien Le
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Matt Lechner
- UCL Division of Surgery and Interventional Science and UCL Cancer Institute, University College London, London, UK
| | - Nancy Y Lee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jivianne K Lee
- Department of Head and Neck Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA
| | - Victor H Lee
- Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Corinna G Levine
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jin-Ching Lin
- Department of Radiation Oncology, Changhua Christian Hospital, Changhua, Taiwan
| | - Derrick T Lin
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Brian C Lobo
- Department of Otolaryngology-Head and Neck Surgery, University of Florida, Gainesville, Florida, USA
| | - Tran Locke
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Amber U Luong
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kelly R Magliocca
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Svetomir N Markovic
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gesa Matnjani
- Department of Radiation Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Erin L McKean
- Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA
| | - Cem Meço
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University Medical School, Ankara, Turkey
- Department of Otorhinolaryngology Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria
| | - William M Mendenhall
- Department of Radiation Oncology, University of Florida College of Medicine, Jacksonville, Florida, USA
| | - Loren Michel
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Shorook Na'ara
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA
| | - Piero Nicolai
- Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neurosciences, University of Padua, Padua, Italy
| | - Daniel W Nuss
- Department of Otolaryngology-Head and Neck Surgery, LSU Health Sciences Center, New Orleans, Louisiana, USA
| | - Gurston G Nyquist
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Gretchen M Oakley
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Richard R Orlandi
- Department of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Peter Papagiannopoulos
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | - Zara M Patel
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA
| | - David G Pfister
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alkis J Psaltis
- Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - Mindy R Rabinowitz
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Murugappan Ramanathan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ryan Rimmer
- Department of Otolaryngology-Head and Neck Surgery, Yale University, New Haven, Connecticut, USA
| | - Marc R Rosen
- Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Olabisi Sanusi
- Department of Neurosurgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Zoukaa B Sargi
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Philippe Schafhausen
- Department of Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Rodney J Schlosser
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Ahmad R Sedaghat
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Brent A Senior
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Raj Shrivastava
- Department of Neurosurgery and Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Raj Sindwani
- Head and Neck Institute, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Timothy L Smith
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA
| | - Kristine A Smith
- Department of Otolaryngology-Head and Neck Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Carl H Snyderman
- Departments of Otolaryngology-Head and Neck Surgery and Neurological Surgery, University of California, Irvine, Orange, California, USA
| | - C Arturo Solares
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Satyan B Sreenath
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA
| | - Aldo Stamm
- São Paulo ENT Center (COF), Edmundo Vasconcelos Complex, São Paulo, Brazil
| | - Katharina Stölzel
- Department of Otorhinolaryngology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Baran Sumer
- Department of Otolaryngology-Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Pavol Surda
- Department of Otolaryngology-Head and Neck Surgery, Guys and St Thomas' Hospital, London, UK
| | - Bobby A Tajudeen
- Department of Otorhinolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Brian D Thorp
- Department of Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Charles C L Tong
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Raymond K Tsang
- Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Justin H Turner
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, ASST Sette Laghi Hospital, Varese, Italy
| | - Aaron M Udager
- Department of Pathology, Michigan Center for Translational Pathology, Rogel Cancer Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Thibaut van Zele
- Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium
| | - Kyle VanKoevering
- Department of Otolaryngology-Head and Neck Surgery, The Ohio State University, Columbus, Ohio, USA
| | - Kevin C Welch
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sarah K Wise
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ian J Witterick
- Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Tae-Bin Won
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Stephanie N Wong
- Division of Otorhinolaryngology, Department of Surgery, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Bradford A Woodworth
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Peter-John Wormald
- Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth Hospital, Adelaide, South Australia, Australia
| | - William C Yao
- Department of Otorhinolaryngology-Head & Neck Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Chien-Fu Yeh
- Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bing Zhou
- Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology-Head and Neck Surgery, Ministry of Education, Beijing, China
| | - James N Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
6
|
Omura K, Nomura K, Aoki S, Takeda T, Ebihara T, Kimple AJ, Thorp BD, Zeatoun AL, Otori N, Senior BA. Simple and safe resection of the crista galli. Head Neck 2024; 46:439-446. [PMID: 38041523 DOI: 10.1002/hed.27590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 12/03/2023] Open
Abstract
A critical procedure in the transcribriform approach is the resection of the crista galli. However, the standard technique for crista galli resection has several disadvantages. We reviewed the cases of patients with olfactory neuroblastomas who underwent an endoscopic endonasal transcribriform approach using a newly developed technique for crista galli resection. We performed a cadaveric study to measure the superior accessibility limits using the proposed method. We included 38 patients with olfactory neuroblastomas in this study. The tumor invaded the posterior crista galli in four patients. The anterior end of the crista galli was not invaded by the tumor. Our cadaveric study showed that the dura was approachable to the point that was 7.4 ± 1.3 mm superior and 23.2 ± 7.2 mm lateral to the foramen cecum following crista galli removal. By resecting the crista galli in advance, manipulation of the superior dura became feasible.
Collapse
Affiliation(s)
- Kazuhiro Omura
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
- Division of Rhinology, Allergy, and Skull Base Surgery, Department of Otolaryngology - Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology - Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Teppei Takeda
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Teru Ebihara
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Adam J Kimple
- Division of Rhinology, Allergy, and Skull Base Surgery, Department of Otolaryngology - Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brian D Thorp
- Division of Rhinology, Allergy, and Skull Base Surgery, Department of Otolaryngology - Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Abdullah L Zeatoun
- Division of Rhinology, Allergy, and Skull Base Surgery, Department of Otolaryngology - Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Nobuyoshi Otori
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Brent A Senior
- Division of Rhinology, Allergy, and Skull Base Surgery, Department of Otolaryngology - Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
7
|
Tochigi K, Ebihara T, Omura K, Aoki S, Takeda T, Otori N, Tanaka Y. Nasal Packing Materials and Placement Duration on Wound Healing in Nasal Mucosa: An Animal Study. Laryngoscope 2024; 134:562-568. [PMID: 37409795 DOI: 10.1002/lary.30865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 06/12/2023] [Accepted: 06/16/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE The histological findings of wound healing depending on different nasal packing materials and replacement periods were lacking. METHODS Mucosal defects were created in the nasal septum of rabbits and covered with Spongel®, Algoderm®, or Nasopore®, which were cleaned on Day 14. To investigate the effect of replacement durations, Spongel® was removed on Days 3 and 7. All nasal septal specimens were collected on Day 28. Samples without packing material were prepared as controls. Depending on residual packing materials in the regenerated tissue, specimens were classified into the remnant and non-remnant groups, and morphology was compared using epithelium grade score and subepithelial thickness. RESULTS The epithelium grade score in the Spongel-14d group was lower than that in the other groups (p < 0.05). Subepithelial thickness was higher in the Algoderm-14d and Spongel-14d groups (p < 0.05). Epithelium grade scores were higher and subepithelial thicknesses were lower in the Spongel-3d and -7d groups than in the Spongel-14d group. Epithelium grade score was lower and subepithelial thickness was higher in the remnant group (n = 10) than in the non-remnant group (n = 15; p < 0.05). CONCLUSIONS Differences in packing materials and placement durations affected wound healing of nasal mucosa. The selection of appropriate packing materials and replacement duration was considered essential for ideal wound healing. LEVEL OF EVIDENCE NA Laryngoscope, 134:562-568, 2024.
Collapse
Affiliation(s)
- Kosuke Tochigi
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Teru Ebihara
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Teppei Takeda
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
8
|
Kidoguchi M, Imoto Y, Noguchi E, Nakamura T, Morii W, Adachi N, Ii R, Koyama K, Aoki S, Miyashita K, Hosokawa Y, Omura K, Tanaka Y, Tanaka K, Hida Y, Ninomiya T, Kato Y, Sakashita M, Takabayashi T, Fujieda S. Middle meatus microbiome in patients with eosinophilic chronic rhinosinusitis in a Japanese population. J Allergy Clin Immunol 2023; 152:1669-1676.e3. [PMID: 37768238 DOI: 10.1016/j.jaci.2023.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 09/29/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a common chronic inflammatory disease and is subdivided into eosinophilic and noneosinophilic forms. There are few reports investigating the nasal microbiome and its pathological functions in patients with CRS. OBJECTIVE We sought to analyze factors contributing to variations of the nasal microbiome in CRS, and on the basis of these factors, to elucidate whether the bacterial metabolites were related to the pathogenesis. METHODS Nasal swabs were collected, and the V3 to V4 variable region of the 16S ribosomal RNA gene was amplified and sequenced. Factors contributing to variations of the nasal microbiome in patients with CRS were compared. The most influential factor was whether CRS was eosinophilic, and we compared α- and β-diversity, bacterial species, and predictive bacterial functions between the 2 patient groups. In addition, the metabolites of the key bacteria were extracted, and we evaluated the predicted bacterial functions in airway epithelial cells. RESULTS In total, 110 patients with CRS and 33 control subjects were enrolled. On the basis of the factors of variation, it was found that patients with eosinophilic CRS (n = 65) had different microbiomes with weighted UniFrac β-diversity and lower α-diversity compared with those with noneosinophilic CRS (n = 45). A higher abundance of Fusobacterium nucleatum and an increased LPS pathway were observed in patients with noneosinophilic CRS compared with those with eosinophilic CRS. In airway epithelial cells, LPS derived from F nucleatum suppressed the expression levels of ALOX15 induced by TH2 cytokines. CONCLUSIONS The differences in the nasal microbiome may play a key role in the pathophysiology of CRS.
Collapse
Affiliation(s)
- Masanori Kidoguchi
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui; Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Yoshimasa Imoto
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Emiko Noguchi
- Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki.
| | - Takako Nakamura
- Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Wataru Morii
- Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Naoto Adachi
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui; Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Rieko Ii
- Department of Medical Genetics, Institute of Medicine, University of Tsukuba, Ibaraki
| | - Keisuke Koyama
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Satoshi Aoki
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Keisuke Miyashita
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Yu Hosokawa
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Kazuhiro Omura
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Yasuhiro Tanaka
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Kaori Tanaka
- Division of Anaerobe Research, Life Science Research Center, Gifu University, Gifu
| | - Yukio Hida
- Division of Clinical Laboratory, University of Fukui Hospital, Fukui
| | - Takahiro Ninomiya
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Yukinori Kato
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Masafumi Sakashita
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Tetsuji Takabayashi
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| | - Shigeharu Fujieda
- Division of Otorhinolaryngology and Head & Neck Surgery, Department of Sensory and Locomotor Medicine, Faculty of Medical Science, University of Fukui, Fukui
| |
Collapse
|
9
|
Miyashita K, Tochigi K, Omura K, Aoki S, Tanaka Y. Preventive effects of skin protectants on the development of medical device-related pressure wounds in endoscopic sinonasal surgery. Auris Nasus Larynx 2023; 50:880-886. [PMID: 36906471 DOI: 10.1016/j.anl.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/15/2023] [Accepted: 02/24/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES Medical device-related pressure ulcer (MDRPU) is a skin or subcutaneous tissue injury caused by medical devices. Skin protectants have been used to prevent MDRPU in other fields. In endoscopic sinonasal surgery (ESNS), rigid endoscopes and forceps can cause MDRPU; however, detailed investigations have not been conducted. This study aimed to investigate the frequency of MDRPU in ESNS and the preventive effects of skin protectants METHODS: Thirty-nine patients who received ESNS and consented to study participation were randomly assigned to the "protective agent" (n = 18) or "control" (n = 21) group. MDRPU presence around the nostril was evaluated for up to 7 days post-surgically based on physical findings and subjective symptoms. The occurrence ratio and severity of MDRPU were statistically compared between the groups to evaluate the efficacy of skin protective agents. RESULTS Stage 1 MDRPU, according to the National Pressure Ulcer Advisory Panel classification, was seen in 20.5% (8/39) of the patients, and no patient had more high-grade ulceration. On postoperative days 2 and 3, skin erythema was predominantly observed on the nasal floor, with a comparatively lower incidence in the protective agent group. Significant pain reduction was observed in the nostril's floor on postoperative days 2 and 3 in the protective agent group. CONCLUSIONS MDRPU occurred with a relatively high frequency around the nostrils after ESNS. Protective agent use in the external nostrils was effective especially in reducing post-operative pain on the nasal floor, where tissue damage can easily occur due to device-related friction.
Collapse
Affiliation(s)
- Keisuke Miyashita
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kousuke Tochigi
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan; Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan.
| | - Satoshi Aoki
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
10
|
Maeda M, Omura K, Kan I, Sano T, Nomura K, Takeda T, Ishibashi T, Otori N. Application of Digital Subtraction Angiography in Predicting the Outcomes of Intraoperative Hemorrhage of Juvenile Nasopharyngeal Angiofibroma. World Neurosurg 2023; 178:e339-e344. [PMID: 37480988 DOI: 10.1016/j.wneu.2023.07.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023]
Abstract
OBJECTIVE Juvenile nasopharyngeal angiofibroma (JNA) is a very rare hemorrhagic vascular tumor that predominantly affects adolescent boys. The tumor is relatively large when detected, and the risk of intraoperative bleeding is high. We aimed to examine factors associated with intraoperative blood loss in JNA surgery. METHODS Thirteen patients with JNA who underwent surgery at the Jikei University Hospital between 2009 and 2020 were retrospectively reviewed, and factors associated with blood loss were examined by single regression analysis. RESULTS The mean age was 20.8 ± 7.7 years. Preoperative angiographic images were evaluated in 9 of the 13 cases. The 6 patients with the largest bleeding volumes, all had residual nutrient vessels from the internal carotid artery (ICA), with an average number of 2.5 vessels. The mean blood loss of patients with residual nutrient vessels from the ICA was 3037 ± 2568 mL. Single regression analysis of bleeding volume against the number of remaining nutrient vessels from the ICA and the total peak contrast density of nutrient vessels (Cmax) standardized by region of interest showed that the coefficient was positive (P < 0.05 for both), confirming a significant correlation between the 2, respectively. CONCLUSIONS The amount of bleeding significantly correlated with the number of remaining nutrient vessels from the ICA after preoperative embolization and with the total Cmax/region of interest. The ability to predict the amount of preoperative blood loss using this study will facilitate proposals for external incisions in patients with JNA.
Collapse
Affiliation(s)
- Mayuka Maeda
- Department of Otolaryngology and Head and Neck Surgery, Self-Defense Forces Central Hospital, Setagaya-ku, Tokyo, Japan; Department of Otolaryngology, The Jikei University Hospital, Minato-ku, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otolaryngology, The Jikei University Hospital, Minato-ku, Tokyo, Japan.
| | - Issei Kan
- Department of Neurosurgery, The Jikei University Hospital, Minato-ku, Tokyo, Japan
| | - Toru Sano
- Department of Neurosurgery, The Jikei University Hospital, Minato-ku, Tokyo, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku University, Sendai, Miyagi, Japan
| | - Teppei Takeda
- Department of Otolaryngology, The Jikei University Hospital, Minato-ku, Tokyo, Japan
| | - Toshihiro Ishibashi
- Department of Neurosurgery, The Jikei University Hospital, Minato-ku, Tokyo, Japan
| | - Nobuyoshi Otori
- Department of Otolaryngology, The Jikei University Hospital, Minato-ku, Tokyo, Japan
| |
Collapse
|
11
|
Tochigi K, Miyashita K, Aoki S, Sakamoto H, Omura K, Tanaka Y. Characteristics of Nasal Foreign Bodies and Equipment on Complications During Removal Procedures. Laryngoscope 2023; 133:2553-2557. [PMID: 36688270 DOI: 10.1002/lary.30581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The treatment of nasal foreign bodies involves safe and reliable removal. Few reports have investigated the relationship between equipment and the incidence of complications. METHODS This retrospective study included 300 patients with nasal foreign bodies (average: 3.28 years, interquartile range: 2-4 years). Patients' background, characteristics of nasal foreign body, equipment to remove the nasal foreign body, and complications were obtained from medical records. Statistical analysis was performed using Pearson's chi-square test for associated factors and the incidence of epistaxis among the complications. RESULTS Nasal foreign bodies were found and removed in 256 patients. Forceps, hooks, suction, modified paper clips, and cotton swabs were mainly used to remove the nasal foreign bodies. Epistaxis due to the removal procedure was observed in 26 patients. The occurrence of epistaxis differed depending on the equipment (p = 0.077) and was less frequent in suction and paper clips than in forceps (p < 0.05 and p = 0.077). Epistaxis was not observed when a cotton swab was used. Aspiration and septal perforation were not observed. A statistical relationship was not detected between the hardness of foreign bodies and the occurrence of epistaxis (p = 0.251). The incidence of epistaxis was higher in cases nasal foreign bodies remained for 1 day and over than in cases foreign bodies were removed within 1 day (p < 0.05). CONCLUSIONS This study revealed that suction, modified paper clips, and cotton swabs could be beneficial options for minimizing complications in the removal of nasal foreign bodies. LEVEL OF EVIDENCE 4 Laryngoscope, 133:2553-2557, 2023.
Collapse
Affiliation(s)
- Kosuke Tochigi
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Keisuke Miyashita
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Hikaru Sakamoto
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
- Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology/Head and Neck Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
12
|
Mohammad I, Omura K, Stack T, Zeatoun A, Norris M, Kim S, Lamb M, Kimple A, Senior B. Cranial nerve zero: What the rhinologist needs to know. Int Forum Allergy Rhinol 2023; 13:1991-1993. [PMID: 37057684 DOI: 10.1002/alr.23166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/15/2023]
Affiliation(s)
- Ibtisam Mohammad
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Otolaryngology, Gazi University, Ankara, Turkey
| | - Kazuhiro Omura
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
- Department of Otolaryngology, Jikei University, Tokyo, Japan
| | - Taylor Stack
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Abdullah Zeatoun
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Meghan Norris
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Sulgi Kim
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Meredith Lamb
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Adam Kimple
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Brent Senior
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, USA
| |
Collapse
|
13
|
Oguro R, Omura K, Uchio N, Imagawa N, Kitamura T, Takemoto H, Otori N. Effects of Increased Nasal Volume due to Topical Adrenaline on the Voice. J Voice 2023:S0892-1997(23)00255-2. [PMID: 37718140 DOI: 10.1016/j.jvoice.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/14/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVES Resonance properties of the nasal and sinus cavities are involved in the individuality of speech. However, detailed information on how alterations in the nasal cavity morphology affect voice quality is lacking. The aim of the present study was to investigate the effects of structural changes in the nasal cavity on voice production by spraying a topical adrenaline solution with a vasoconstrictive effect into the nasal cavity, causing nasal mucosal contraction. STUDY DESIGN Prospective. METHODS Overall, 51 adult volunteers were recruited from the Otorhinolaryngology Outpatient Department of the Jikei University Hospital from June to September 2022. Among them, 20 completed acoustic rhinometry and voice recordings before and after adrenaline spraying. The nasal consonant [N] uttered with the mouth completely closed was recorded for 5 seconds. The remaining 31 volunteers completed all auditory experiments. This was conducted to determine whether the changes in voice before and after adrenaline spraying could be discriminated against by the participants. RESULTS The nasal volume had increased 5 and 10 minutes after spraying compared to that before spraying, reaching a significance at 10 minutes (P = 0.06). It had increased at 2 and 5 cm from the external nostrils compared to that within 3 cm of the external nostrils (P = 0.04). Among the 31 volunteers in the auditory experiments, 30 had a discrimination rate >90%, with a mean of 96.3% (standard error, 3.2). The spectral envelope of the 16 frequency bands varied significantly at 500-Hz increments (P = 0.0006). In particular, changes in the high-frequency bands were larger between 4500 and 6000 Hz. CONCLUSIONS Nasal enlargement with 0.02% topical adrenaline affects the spectral envelope, particularly in the high-frequency bands between 4500 and 6000 Hz, and perceptibly alters the voice.
Collapse
Affiliation(s)
- Ryoji Oguro
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan; Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Hiroshima, Japan.
| | - Norihiko Uchio
- Sorairo Otolaryngology Clinic, Yokohama, Kanagawa, Japan
| | - Norie Imagawa
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | | | | | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
14
|
Yui R, Takahashi M, Noda K, Yoshida K, Sakurai R, Ohira S, Omura K, Otori N, Wada K, Kojima H. Preoperative prediction of sinonasal papilloma by artificial intelligence using nasal video endoscopy: a retrospective study. Sci Rep 2023; 13:12439. [PMID: 37532726 PMCID: PMC10397257 DOI: 10.1038/s41598-023-38913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023] Open
Abstract
Sinonasal inverted papilloma (IP) is at risk of recurrence and malignancy, and early diagnosis using nasal endoscopy is essential. We thus developed a diagnostic system using artificial intelligence (AI) to identify nasal sinus papilloma. Endoscopic surgery videos of 53 patients undergoing endoscopic sinus surgery were edited to train and evaluate deep neural network models and then a diagnostic system was developed. The correct diagnosis rate based on visual examination by otolaryngologists was also evaluated using the same videos and compared with that of the AI diagnostic system patients. Main outcomes evaluated included the percentage of correct diagnoses compared to AI diagnosis and the correct diagnosis rate for otolaryngologists based on years of practice experience. The diagnostic system had an area under the curve of 0.874, accuracy of 0.843, false positive rate of 0.124, and false negative rate of 0.191. The average correct diagnosis rate among otolaryngologists was 69.4%, indicating that the AI was highly accurate. Evidently, although the number of cases was small, a highly accurate diagnostic system was created. Future studies with larger samples to improve the accuracy of the system and expand the range of diseases that can be detected for more clinical applications are warranted.
Collapse
Affiliation(s)
- Ryosuke Yui
- Department of Otorhinolaryngology, Jikei University School of Medicine, Nishi-Shimbashi, Minato-ku, Tokyo, Japan
- Department of Otolaryngology, Head and Neck Surgery, Toho University Faculty of Medicine, Tokyo, Japan
| | - Masahiro Takahashi
- Department of Otorhinolaryngology, Jikei University School of Medicine, Nishi-Shimbashi, Minato-ku, Tokyo, Japan.
| | - Katsuhiko Noda
- SIOS Technology Inc., Minami-Azabu, Minato-ku, Tokyo, Japan
| | - Kaname Yoshida
- SIOS Technology Inc., Minami-Azabu, Minato-ku, Tokyo, Japan
| | - Rinko Sakurai
- Department of Otorhinolaryngology, Jikei University School of Medicine, Nishi-Shimbashi, Minato-ku, Tokyo, Japan
| | - Shinya Ohira
- Department of Otolaryngology, Head and Neck Surgery, Toho University Faculty of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, Jikei University School of Medicine, Nishi-Shimbashi, Minato-ku, Tokyo, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Nishi-Shimbashi, Minato-ku, Tokyo, Japan
| | - Kota Wada
- Department of Otolaryngology, Head and Neck Surgery, Toho University Faculty of Medicine, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otorhinolaryngology, Jikei University School of Medicine, Nishi-Shimbashi, Minato-ku, Tokyo, Japan
| |
Collapse
|
15
|
Ishii Y, Omura K. [Expanded Endoscopic Endonasal Surgery for Skull Base Tumors]. No Shinkei Geka 2023; 51:663-671. [PMID: 37491063 DOI: 10.11477/mf.1436204799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
With the development of endoscopic and surgical instruments, expanded endoscopic endonasal surgery for skull base tumors has been widely performed. Compared with conventional microscopic transsphenoidal surgery, endoscopic surgery provides a wider view and clearer images, owing to the introduction of a high-resolution camera. However, for safe and reliable surgery, it is necessary to create an appropriate surgical field and avoid complications. This article discusses the basic knowledge needed for expanded endoscopic endonasal surgery, focusing on surgical anatomy and techniques and how to close the skull base completely.
Collapse
Affiliation(s)
- Yudo Ishii
- Department of Neurosurgery, the Jikei University
| | | |
Collapse
|
16
|
Nagaoka M, Omura K, Nomura K, Takeda T, Otori N, Kojima H. Endoscopic-assisted total maxillectomy with precise surgical margins. Head Neck 2023; 45:521-528. [PMID: 36336818 DOI: 10.1002/hed.27237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/12/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022] Open
Abstract
In traditional open maxillectomy, identifying the posterior margin is difficult because of its deep location and bleeding from the pterygoid venous plexus. Here, we present our endoscope-assisted total en bloc maxillectomy technique and discuss its merits and demerits compared to previously reported methods. We developed an endoscope-assisted total en bloc maxillectomy procedure. We reviewed a series of total maxillectomies performed with and without endoscopic assistance to verify the advantages of endoscopic assistance over conventional total maxillectomy. We analyzed (1) the precision using the distance of the remaining pterygoid process, (2) the operation time, and (3) blood loss. The length of the remnant pterygoid process was significantly shorter in the endoscopic assistance group. The operation time and blood loss were not significantly different between the two groups. Endoscopic assistance makes total maxillectomy more precise without requiring additional time and is a reasonable option for total maxillectomies.
Collapse
Affiliation(s)
- Masato Nagaoka
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai-shi, Miyagi, Japan
| | - Teppei Takeda
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuyoshi Otori
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
17
|
Hosokawa Y, Miyawaki T, Omura K, Akutsu T, Kimura R, Ikezono T, Otori N. Surgical Treatment for Empty Nose Syndrome Using Autologous Dermal Fat: Evaluation of Symptomatic Improvement. Ear Nose Throat J 2022:1455613221130885. [PMID: 36174975 DOI: 10.1177/01455613221130885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Empty nose syndrome (ENS) is caused by nasal turbinate surgery. The standard treatment for ENS is an inferior meatus augmentation procedure (IMAP) in which autologous tissue such as auricular cartilage, rib cartilage, or artificial material is transplanted into the nasal cavity. However, some challenges like a very small auricular cartilage are associated with these autologous tissue types. Moreover, since using rib cartilage is a highly invasive technique, the scar on the chest from where the harvesting is done is easily visible, and the artificial material is susceptible to infection. We used autologous dermal fat (ADF) in IMAPs in our study for the following reasons: the quantity of ADF could be increased or reduced as needed, ADF is considered a safer option than rib cartilage because it is harvested from superficial tissue, it is superior in terms of cosmetic appearance to harvested rib cartilage, and it has a lower risk of infection than any artificial material.Objective: The purpose of our study was to investigate the efficacy and safety of IMAPs using ADF.Methods: We included nine patients with ENS who underwent an IMAP using ADF. The patients' backgrounds and responses to the Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) were recorded. Changes in each item of the ENS6Q before and after surgery (up to 3 months) were analyzed.Results: The postoperative ENS6Q total score and parameters were significantly better than their preoperative counterparts. Nasal dryness improved slightly less than other symptoms. There were no complications.Conclusions: The IMAP using ADF was effective in improving ENS symptoms; however, some physiological functions were difficult to improve, and dryness persisted. Autologous dermal fat is larger than auricular cartilage, less invasive than rib cartilage, and has a lower risk of infection than artificial material.
Collapse
Affiliation(s)
- Yu Hosokawa
- Department of Otorhinolaryngology, Saitama Medical University, Saitama, Japan
- Department of Otorhinolaryngology, the Jikei University School of Medicine, Tokyo, Japan
- Septorhinoplasty Clinic, Jikei University Hospital, Tokyo, Japan
| | - Takeshi Miyawaki
- Septorhinoplasty Clinic, Jikei University Hospital, Tokyo, Japan
- Department of Plastic Surgery, the Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, the Jikei University School of Medicine, Tokyo, Japan
| | - Taisuke Akutsu
- Department of Otorhinolaryngology, the Jikei University School of Medicine, Tokyo, Japan
| | - Ryohei Kimura
- Department of Otorhinolaryngology, the Jikei University School of Medicine, Tokyo, Japan
| | - Tetsuo Ikezono
- Department of Otorhinolaryngology, Saitama Medical University, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, the Jikei University School of Medicine, Tokyo, Japan
- Septorhinoplasty Clinic, Jikei University Hospital, Tokyo, Japan
| |
Collapse
|
18
|
Yamamichi T, Ichinose J, Tamagawa S, Omura K, Hashimoto K, Matsuura Y, Nakao M, Okumura S, Mun M. EP02.01-014 Prognostic Classification of Early-Stage Lung Cancer Using Preoperative Prealbumin and D-dimer Levels. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
19
|
Baba A, Kurokawa R, Fukuda T, Fujioka H, Kurokawa M, Fukasawa N, Sonobe S, Omura K, Matsushima S, Ota Y, Yamauchi H, Shimizu K, Kurata N, Srinivasan A, Ojiri H. Radiological features of human papillomavirus-related multiphenotypic sinonasal carcinoma: systematic review and case series. Neuroradiology 2022; 64:2049-2058. [PMID: 35833947 DOI: 10.1007/s00234-022-03009-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/02/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To comprehensively summarize the radiological characteristics of human papillomavirus (HPV)-related multiphenotypic sinonasal carcinomas (HMSCs). METHODS We reviewed the findings for patients with HMSCs who underwent computed tomography (CT) and/or magnetic resonance imaging (MRI) and included nine cases from nine publications that were identified through a systematic review and three cases from our institution. Two board-certified radiologists reviewed and evaluated the radiological images. RESULTS The locations in almost all cases included the nasal cavity (11/12, 91.7%). The involved paranasal sinuses included the ethmoid sinus (6/12, 50.0%) and maxillary sinus (3/12, 25.0%). The mean long diameter of the tumors was 46.3 mm. The margins in 91.7% (11/12) of the cases were well-defined and smooth. Heterogeneous enhancement on contrast-enhanced CT, heterogeneous high signal intensities on T2-weighted images and heterogeneous enhancement on gadolinium-enhanced T1-weighted images were noted in 2/2, 5/5, and 8/8 cases, respectively. Mean apparent diffusion coefficient values in two cases of our institution were 1.17 and 1.09 × 10-3 mm2/s. Compressive changes in the surrounding structures were common (75%, 9/12). Few cases showed intraorbital or intracranial extension. None of the cases showed a perineural spread, neck lymph node metastasis, or remote lesions. CONCLUSIONS We summarized the CT and MRI findings of HMSCs. Knowledge of such characteristics is expected to facilitate prompt diagnosis and appropriate management.
Collapse
Affiliation(s)
- Akira Baba
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA. .,Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Ryo Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Takeshi Fukuda
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroaki Fujioka
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Mariko Kurokawa
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Nei Fukasawa
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Shoko Sonobe
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Satoshi Matsushima
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Yoshiaki Ota
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Hideomi Yamauchi
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Kanichiro Shimizu
- Department of Radiology, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-shi, Chiba, 277-8567, Japan
| | - Naoki Kurata
- Department of Radiology, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-shi, Chiba, 277-8567, Japan
| | - Ashok Srinivasan
- Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Hiroya Ojiri
- Department of Radiology, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan
| |
Collapse
|
20
|
Takekoshi D, Inukai S, Hatano S, Fujimoto S, Kadota T, Takeda T, Omura K, Mori E, Araya J, Kuwano K. Aspiration of Cerebrospinal Fluid Rhinorrhea as a Cause of Non-resolving Pneumonia. Intern Med 2022; 61:1877-1880. [PMID: 34776493 PMCID: PMC9259804 DOI: 10.2169/internalmedicine.8596-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We herein report two cases of cerebrospinal fluid (CSF) rhinorrhea associated with lung infiltrates. One patient presented with symptomatic non-resolving pneumonia, while the other was asymptomatic. In both cases, the lung infiltrates completely resolved when CSF leakage had subsided. Pulmonary involvement in CSF rhinorrhea is under-recognized, and despite being the definitive treatment, surgery for CSF rhinorrhea is typically postponed due to the presence of lung infiltrates. However, meningitis is a serious complication due to a delay in surgical management. Physicians should be made aware that CSF rhinorrhea is a potential cause of intractable lung infiltrates.
Collapse
Affiliation(s)
- Daisuke Takekoshi
- Division of Respiratory Medicine, Department of Internal Medicine, the Jikei University School of Medicine, Japan
| | - Shun Inukai
- Division of Respiratory Medicine, Department of Internal Medicine, the Jikei University School of Medicine, Japan
| | - Satoki Hatano
- Division of Respiratory Medicine, Department of Internal Medicine, the Jikei University School of Medicine, Japan
| | - Shota Fujimoto
- Division of Respiratory Medicine, Department of Internal Medicine, the Jikei University School of Medicine, Japan
| | - Tsukasa Kadota
- Division of Respiratory Medicine, Department of Internal Medicine, the Jikei University School of Medicine, Japan
| | - Teppei Takeda
- Department of Otorhinolaryngology, the Jikei University School of Medicine, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, the Jikei University School of Medicine, Japan
| | - Eri Mori
- Department of Otorhinolaryngology, the Jikei University School of Medicine, Japan
| | - Jun Araya
- Division of Respiratory Medicine, Department of Internal Medicine, the Jikei University School of Medicine, Japan
| | - Kazuyoshi Kuwano
- Division of Respiratory Medicine, Department of Internal Medicine, the Jikei University School of Medicine, Japan
| |
Collapse
|
21
|
Takeda T, Omura K, Mori E, Mori R, Ishii Y, Otori N. Endoscopic modified transseptal bi-nostril approach for pituitary tumors. Efficacy of complex preservation of every turbinate and olfaction: A STROBE analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2022; 139:337-342. [PMID: 35597759 DOI: 10.1016/j.anorl.2022.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 01/31/2022] [Accepted: 02/01/2022] [Indexed: 12/17/2022]
Abstract
AIMS Endoscopic modified transseptal bi-nostril approach minimizes turbinate and olfactory mucosal invasion and ensures preservation of the turbinates and bilateral olfaction. The main objective of this study was to investigate the pre- and postoperative variations in olfactory function in patients using this approach, and the secondary objective was to investigate the complications associated with the surgical procedure. MATERIAL AND METHODS This study is a single-center prospective cohort study using STROBE analysis. To completely protect the bilateral turbinates and olfactory epithelium, this procedure provided access to the sphenoid sinus by a transseptal approach via the left nasal cavity and by the olfactory cleft approach via the right nasal cavity without any turbinate resection. A T&T olfactometer was used to assess the mean recognition threshold of the left, right, and bilateral nasal passages before and after surgery, and complications associated with the surgical approach were investigated. OBJECTIVES We included 27 patients who underwent endoscopic modified transseptal pituitary surgery with an olfactory and turbinate preservation approach at our hospital between April 2018 and December 2019. RESULTS The mean postoperative recognition threshold of the right, left, and bilateral nasal cavities did not worsen (P<0.001 for all) relative to the preoperative values, and there was no difference in values between the right and left nasal cavities (P=0.85). The nasal turbinates were preserved in all patients during the study period, and no recurrence was observed. CONCLUSION Our modified EETSA could be implemented as an approach for turbinate and olfaction preservation.
Collapse
Affiliation(s)
- T Takeda
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - K Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan.
| | - E Mori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - R Mori
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Y Ishii
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | - N Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan
| |
Collapse
|
22
|
Takeda T, Yanagi N, Fukasawa N, Mori E, Maeda M, Sakaguchi R, Tei M, Omura K, Otori N. Respiratory epithelial adenomatoid hamartoma with nasal polyps affects dupilumab efficacy. Rhinology 2022; 60:148-151. [PMID: 35174813 DOI: 10.4193/rhin21.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- T Takeda
- Department of Otorhinolaryngology, Jikei University School of Medicine, Japan
| | - N Yanagi
- Department of Otorhinolaryngology, Jikei University School of Medicine, Japan
| | - N Fukasawa
- Department of Pathology, Jikei University School of Medicine, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Japan
| | - M Maeda
- Department of Otorhinolaryngology, Jikei University School of Medicine, Japan
| | - R Sakaguchi
- Department of Pathology, Jikei University School of Medicine, Japan
| | - M Tei
- Department of Otorhinolaryngology, Jikei University School of Medicine, Japan
| | - K Omura
- Department of Otorhinolaryngology, Jikei University School of Medicine, Japan
| | - N Otori
- Department of Otorhinolaryngology, Jikei University School of Medicine, Japan
| |
Collapse
|
23
|
Omura K, Nomura K, Mori R, Ishii Y, Aoki S, Takeda T, Tochigi K, Tanaka Y, Otori N, Kojima H. Optimal Multiple-Layered Anterior Skull Base Reconstruction Using a 360° Suturing Technique. Oper Neurosurg (Hagerstown) 2022; 22:e1-e6. [PMID: 34982903 DOI: 10.1227/ons.0000000000000013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/24/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Advances in technique and instrumentation have improved outcomes after resection of anterior skull base tumors. However, cerebrospinal fluid (CSF) leak occurs in 4%-20% of patients. To reduce the risk of CSF leak, we have developed a novel reconstruction technique that consists of a 4-layered graft with patchwork suturing and hard material. OBJECTIVE To evaluate the effectiveness of this reconstruction technique when used for resection of anterior skull base tumors. METHODS This case series included 59 patients with anterior skull base tumors in whom the 4-layered closure technique was used. The main outcome measures were complications, including CSF leak, meningitis, postoperative bleeding, and infection. RESULTS There were no CSF leak cases or serious complications after closure of the anterior skull base using the 4-layered technique. CONCLUSION Closure of the anterior skull base in 4 layers prevented CSF leak and was not associated with any serious complications. However, further studies in larger numbers of patients are needed to confirm our outcomes using this closure method.
Collapse
Affiliation(s)
- Kazuhiro Omura
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan.,Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai, Japan
| | - Ryosuke Mori
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Yudo Ishii
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Aoki
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Teppei Takeda
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kosuke Tochigi
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Yasuhiro Tanaka
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Nobuyoshi Otori
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
24
|
Tochigi K, Ebihara T, Omura K, Torng H, Aoki S, Takeda T, Otori N, Kojima H, Tanaka Y. Mucosal Epithelial Preservation of Free Nasal Grafts Depending on the Recipient Site. Laryngoscope 2021; 132:2301-2306. [DOI: 10.1002/lary.29983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/27/2021] [Accepted: 12/01/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Kosuke Tochigi
- Department of Otorhinolaryngology Dokkyo Medical University Saitama Medical Center Saitama Japan
| | - Teru Ebihara
- Department of Otorhinolaryngology–Head and Neck Surgery The Jikei University School of Medicine Tokyo Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology Dokkyo Medical University Saitama Medical Center Saitama Japan
- Department of Otorhinolaryngology–Head and Neck Surgery The Jikei University School of Medicine Tokyo Japan
| | - Haw Torng
- Department of Otorhinolaryngology–Head and Neck Surgery The Jikei University School of Medicine Tokyo Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology Dokkyo Medical University Saitama Medical Center Saitama Japan
| | - Teppei Takeda
- Department of Otorhinolaryngology–Head and Neck Surgery The Jikei University School of Medicine Tokyo Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology–Head and Neck Surgery The Jikei University School of Medicine Tokyo Japan
| | - Hiromi Kojima
- Department of Otorhinolaryngology–Head and Neck Surgery The Jikei University School of Medicine Tokyo Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology Dokkyo Medical University Saitama Medical Center Saitama Japan
| |
Collapse
|
25
|
Aoki S, Omura K, Miyashita K, Otori N, Haruna S, Tanaka Y. A Covered Lateral and Posterior Wall Flap of the Maxillary Sinus Prevents Reocclusion of the Postoperative Maxillary Cyst. Indian J Otolaryngol Head Neck Surg 2021; 73:504-509. [PMID: 34692462 DOI: 10.1007/s12070-021-02658-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/17/2021] [Indexed: 12/01/2022] Open
Abstract
Although the number of postoperative maxillary cyst (POMC) cases has declined recently, a few reports of refractory cases have also been reported. The indications for endoscopic sinus surgery (ESS) for POMC removal are broadening and attempts to prevent postoperative recurrence at the cyst opening site have been widely investigated. Here, we have advocated our original pedunculated mucoperiosteal flap (CLAP flap; covered lateral and posterior wall flap of the maxillary sinus), where the bony area exposed intraoperatively is covered, to prevent postoperative recurrence. We have also presented the method for creating the CLAP flap. We classified the POMC as being medial, lateral, or anterior superior type and performed ESS. We introduced the CLAP flap after 2015 for the lateral type and some of the medial types of POMCs. We examined the cyst opening rate using computed tomography, age, sex, cyst position, and a follow-up period in four patients (five sides) who did not undergo flap surgery, but who were managed in our hospital in 2015, and in eight patients (nine sides) who underwent the CLAP flap technique in our hospital. In the group with the CLAP flap, the cyst opening rate was significantly higher (P < 0.05). The CLAP flap was effective for preventing postoperative bony regrowth. It may be one of the options for covering the exposed bone surface as widely as possible. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-021-02658-x.
Collapse
Affiliation(s)
- Satoshi Aoki
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.,Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Keisuke Miyashita
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinichi Haruna
- Department of Otorhinolaryngology-Head and Neck Surgery, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
26
|
Omura K, Han B, Nishijima H, Aoki S, Ebihara T, Kondo K, Otori N, Kojima H, Yamasoba T, Kikuta S. Heterogeneous distribution of mature olfactory sensory neurons in human olfactory epithelium. Int Forum Allergy Rhinol 2021; 12:266-277. [PMID: 34538025 DOI: 10.1002/alr.22885] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/28/2021] [Accepted: 07/29/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND The olfactory cleft (OC) comprising the olfactory epithelium (OE) is the most important anatomical location for olfactory function. Endoscopic sinus surgery (ESS) is used to treat diseases related to the OC and improve olfactory dysfunction. However, iatrogenic OE injury occasionally occurs. Comprehensive knowledge of the olfactory region is required to avoid damage to the OE during endoscopic procedures. METHODS Immunohistochemistry was performed on olfactory mucosa obtained from the unaffected side of olfactory neuroblastoma surgical specimens. The OE was defined as the epithelium containing mature olfactory sensory neurons (OSNs). The distribution and cell kinetics of the OE were examined. RESULTS The OE was selectively localized to the anterior two-thirds of the superior turbinate (ST) and in the nasal septum (NS) just opposite to the ST; the OE was not detected within the mucosa of the superior meatus. The density of mature OSNs was high at the ethmoid tegmen but gradually decreased with distance from the ethmoid tegmen. The extent of cell death and proliferation was relatively even across the OE. Analysis of airflow profiles revealed that resection of inferior ST does not decrease airflow to the OC. CONCLUSION The results indicate that the distribution and degree of differentiation of mature OSNs are heterogenous throughout the OE. Epithelial resection of the anterior or superior ST has the potential to damage olfactory function. Resection of the inferior or posterior ST or widening of the superior meatus is a safer alternative that does not damage mature OSNs or alter airflow to the OC.
Collapse
Affiliation(s)
- Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Bing Han
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hironobu Nishijima
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Teru Ebihara
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Kenji Kondo
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Tatsuya Yamasoba
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shu Kikuta
- Department of Otorhinolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
27
|
Omura K, Nomura K, Takeda T, Yanagi N, Kuroyanagi H, Yanagihara T, Tanaka Y, Kojima H, Otori N. How I Do It: Inferior Turbinectomy: Modified Techniques for Submucosal Resection. Allergy Rhinol (Providence) 2021; 12:21526567211034736. [PMID: 34408915 PMCID: PMC8365174 DOI: 10.1177/21526567211034736] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Although inferior turbinectomy with submucosal resection effectively reduces the
volume of the inferior turbinate, there is room for improvement in surgical
procedures. Techniques have been developed to reduce crusting and bleeding while
efficiently achieving volume reduction. State-of-the-art procedures pertaining
to the local injection site, incision line, exposure of the periosteum,
submucosal outfracture of the turbinate bone, trimming of redundant mucosa, and
incision line suturing are described. Pre and postoperative Nasal Obstruction
Symptom Evaluation (NOSE) scores and postoperative inferior turbinate bleeding
and crusting were evaluated. For the 18 consecutive patients analyzed, the pre
and postoperative NOSE scores were 67.8 ± 14.8 and 16.1 ± 13.0, respectively
(P = .0002). Postoperatively, bleeding was absent, and only
minor suture thread crusting was observed in 13 patients. In conclusion, our
novel technique improves the effectiveness of surgery as well as the
postoperative quality of the inferior turbinate.
Collapse
Affiliation(s)
- Kazuhiro Omura
- Department of Otolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan.,Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai-shi, Miyagi, Japan
| | - Teppei Takeda
- Department of Otolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Norihiro Yanagi
- Department of Otolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Hiroki Kuroyanagi
- Department of Otolaryngology, Asahi General Hospital, Asahi-shi, Chiba, Japan
| | - Taichi Yanagihara
- Department of Otolaryngology, Asahi General Hospital, Asahi-shi, Chiba, Japan
| | - Yasuhiro Tanaka
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Hiromi Kojima
- Department of Otolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Nobuyoshi Otori
- Department of Otolaryngology, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| |
Collapse
|
28
|
Nakashima D, Mori E, Takeda T, Hosokawa Y, Takaishi S, Omura K, Kojima H, Otori N. Preemptive analgesia for endoscopic sinus surgery: a retrospective study. Rhinology 2021; 59:398-401. [PMID: 34185822 DOI: 10.4193/rhin20.624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a common disease, and endoscopic sinus surgery (ESS) is widely performed. However, there is no consensus regarding postoperative pain control after ESS, and postoperative opioid abuse is a problem in many countries. Acetaminophen is reportedly effective for postoperative pain control. Preemptive analgesia has received more attention lately, wherein pain is prevented before it occurs. In this study, we assessed the use of acetaminophen for preemptive analgesia during the perioperative period in ESS. METHODOLOGY This is a retrospective study of 175 patients who underwent ESS, septoplasty, and bilateral inferior turbinate mucosal resection at our hospital from April 2016 to February 2018. In total, 82 patients received 1,000 mg of acetaminophen during surgery and 4 hours after the first dose, while 93 patients did not receive it routinely. We compared these two groups. The primary outcome was the need to use additional analgesics prescribed by the ward physician and the secondary outcomes included postoperative pain, postoperative bleeding, reoperation, blood pressure, and body temperature. RESULTS The use of additional oral and intravenous analgesics was significantly reduced in the patients who received acetaminophen perioperatively. CONCLUSION Preemptive analgesia during the perioperative period of ESS could lead to satisfactory postoperative pain control.
Collapse
Affiliation(s)
- D Nakashima
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - E Mori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - T Takeda
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Y Hosokawa
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - S Takaishi
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - K Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - H Kojima
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - N Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
29
|
Omura K, Nomura K, Mori R, Ishii Y, Tanaka Y, Otori N, Kojima H. Advanced Endoscopic Endonasal Approach to the Pterygopalatine Fossa and Orbit: The Endoscopic Tri-port Approach. J Neurol Surg B Skull Base 2021; 82:437-442. [PMID: 35573923 PMCID: PMC9100435 DOI: 10.1055/s-0040-1713106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 04/26/2020] [Indexed: 10/24/2022] Open
Abstract
Objective The pterygopalatine fossa (PPF) is a narrow space situated posterior to the maxillary sinus. While external approaches have been used to treat tumors of the PPF, recent endoscopic approaches have become favored as an alternative; we developed an endoscopic tri-port approach, which provides wide surgical corridor with minimal invasion, for PPF. This report aims to introduce and verify the new approach. Design Case series. Setting A tertiary referral hospital. Participants We reviewed 11 patients with PPF or orbital tumors who were treated with the endoscopic tri-port approach. Main Outcome Measures Accessing tri-port approach's effects and limitations. Results When the tumor was located in the PPF or orbit without intracranial invasion, en bloc resection was achieved in six patients. With the exception of one patient, the nasal septum was preserved if not used for skull base reconstruction. If not invaded by a tumor or necessary for reconstruction, the inferior and middle turbinates were preserved. Conclusion The endoscopic tri-port approach provides an excellent surgical view and wide corridor and not requires an external approach, including a gingival incision.
Collapse
Affiliation(s)
- Kazuhiro Omura
- Department of Otolaryngology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai-shi, Miyagi, Japan
| | - Ryosuke Mori
- Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Yudo Ishii
- Department of Neurosurgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otolaryngology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otolaryngology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan
| |
Collapse
|
30
|
Ebihara T, Omura K, Otori N, Aoki S, Tochigi K, Takeda T, Kojima H. Management and surgical approach ingenuity for nasal fibro-osseous lesions at our facility: A case series of 15 patients. J Craniomaxillofac Surg 2021; 49:1119-1123. [PMID: 34215495 DOI: 10.1016/j.jcms.2021.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/05/2021] [Accepted: 06/21/2021] [Indexed: 11/27/2022] Open
Abstract
To retrospectively evaluate our treatment algorithm and surgical approaches for nasal fibro-osseous lesions at our hospital. Fifteen patients with nasal fibro-osseous lesions treated from January 1, 2010, to January 31, 2020 were included. Among them, 13 patients who underwent surgery were divided into groups A and B, based on whether they were treated before or after the treatment algorithm was established. The extent of the lesion, surgical approach, and outcomes, including bone regrowth assessed postoperatively using computed tomography at 6 months, were analyzed. In group A, six cases were treated via endoscopy and two via a combined endoscopy and external approach. In group B, three cases were treated via endoscopy, one via combined endoscopy and external approach, and one combined with craniotomy. Two group A cases and no group B cases had residual lesions postoperatively. Postoperative bone regrowth occurred in three group A patients and no group B patients. Multi-angled approaches for nasal fibro-osseous lesions based on the unified treatment algorithms used in the study may lead to a reduction in postoperative recurrence and complication rates.
Collapse
Affiliation(s)
- Teru Ebihara
- Department of Otorhinolaryngology, Asahi General Hospital, Chiba, Japan; Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kosuke Tochigi
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Teppei Takeda
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
31
|
Hosokawa Y, Miyawaki T, Akutsu T, Omura K, Tsumiyama S, Iimura J, Otori N, Kojima H. Effectiveness of modified cutting and suture technique for endonasal caudal septoplasty in correcting nasal obstruction and preventing nasal tip projection loss. J Otolaryngol Head Neck Surg 2021; 50:35. [PMID: 34130761 PMCID: PMC8205607 DOI: 10.1186/s40463-021-00516-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/11/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Caudal septoplasty is a difficult procedure. The cutting and suture technique is suitable for caudal septoplasty, but a batten graft is always necessary and bears the risk of nasal tip projection loss. We established a modified cutting and suture technique (MCAST), without using a batten graft, and investigated its effectiveness in correcting nasal obstruction and preventing nasal tip projection loss. METHODS We retrospectively reviewed the medical records of 22 patients who underwent caudal septoplasty using MCAST. Subjective assessment by Nasal Obstruction Symptom Evaluation (NOSE) score and objective assessment by computed tomography (CT) were performed before and after the surgery. For evaluating nasal tip projection, we asked patients about their awareness of external nasal deformity. Additionally, the nasal tip projection was measured by CT and compared before and after surgery. RESULTS The median preoperative NOSE score reduced significantly after MCAST (P < 0.001). On CT, the ratio of the area of the convex side to that of the concave side in the anterior portion of the nasal cavity increased significantly after MCAST (P < 0.001). All patients were unaware of external nasal deformity. There were no significant differences in the mean preoperative and postoperative nasal tip height and nasolabial angle. The mean supra tip height was significantly greater postoperatively than preoperatively (P = 0.02). CONCLUSIONS The MCAST was useful for correcting nasal obstruction with caudal septal deviation. There was no postoperative loss of nasal tip projection. The MCAST can be suitable for correcting C-shaped caudal deviations without dislocating the caudal septum from the anterior nasal septum.
Collapse
Affiliation(s)
- Yu Hosokawa
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-8, Nishishimbashi, Minato-ku, Tokyo, 105-8471, Japan. .,Septorhinoplasty Clinic, The Jikei University Hospital, Tokyo, Japan.
| | - Takeshi Miyawaki
- Septorhinoplasty Clinic, The Jikei University Hospital, Tokyo, Japan.,Department of Plastic Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Taisuke Akutsu
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-8, Nishishimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-8, Nishishimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Shinya Tsumiyama
- Septorhinoplasty Clinic, The Jikei University Hospital, Tokyo, Japan.,Department of Plastic Surgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Jiro Iimura
- Septorhinoplasty Clinic, The Jikei University Hospital, Tokyo, Japan.,Department of Otorhinolaryngology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-8, Nishishimbashi, Minato-ku, Tokyo, 105-8471, Japan.,Septorhinoplasty Clinic, The Jikei University Hospital, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-8, Nishishimbashi, Minato-ku, Tokyo, 105-8471, Japan
| |
Collapse
|
32
|
Umibe A, Kitahara T, Aoki S, Suzuki Y, Tochigi K, Miyashita K, Ihara K, Inoue Y, Anazawa U, Akiyoshi R, Nishijima Y, Omura K, Tanaka Y. Clinical Diagnosis of Central Vertigo in Patients With Dizziness in Emergency Practice. Neurologist 2021; 26:75-79. [PMID: 33942786 DOI: 10.1097/nrl.0000000000000323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Life-threatening diseases should be promptly identified to provide appropriate medical care for emergency outpatients experiencing dizziness. However, dizziness is associated with various medical conditions; thus, a definitive diagnosis is challenging. To accurately diagnose vertigo in an emergency outpatient, we conducted a survey on the need to identify vertigo patients in the current outpatient departments. MATERIALS AND METHODS The participants included 509 patients who visited the outpatient department at our hospital from February 2014 to May 2017. Overall, 12 characteristics were retrospectively extracted from the patients' medical records: age, sex, visit method, medical history (diabetes, hypertension, cardiac, or cerebrovascular disease), dizziness history, vertigo characteristics, concomitant symptoms, systolic blood pressure, nystagmus, imaging history, diagnosis, and hospitalization department. Univariate and multivariate analyses were performed to identify factors related to central vertigo. RESULTS The diagnosis of central vertigo was confirmed when intracranial lesions were detected through imaging. In multivariate analysis, the presence/absence of a history of headache and cardiovascular disease were significantly correlated with central vertigo (P=0.002 and 0.006, respectively), with odds ratios of 5.18 and 4.38, respectively. CONCLUSIONS To avoid missing central dizziness in a patient, diagnostic abilities should be improved by including careful interviews and confirmation of the presence/absence of accompanying symptoms. Furthermore, collaboration with neurology and neurosurgery departments is important for improving the diagnosis in suspected cases.
Collapse
Affiliation(s)
- Akiko Umibe
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Tadashi Kitahara
- Department of Otolaryngology, Head and Neck Surgery, Nara Medical University, Nara
| | - Satoshi Aoki
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Yumi Suzuki
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Kosuke Tochigi
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Keisuke Miyashita
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Kanako Ihara
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Yukari Inoue
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Utaro Anazawa
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Ryohei Akiyoshi
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Yoshikata Nishijima
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama
| |
Collapse
|
33
|
Matsushita Y, Kurihara S, Omura K, Kojima H. Delay of COVID-19 diagnosis due to aspiration Pneumonia. Auris Nasus Larynx 2021; 49:885-888. [PMID: 33731260 PMCID: PMC7936556 DOI: 10.1016/j.anl.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 01/31/2021] [Accepted: 03/02/2021] [Indexed: 12/15/2022]
Abstract
COVID-19 was first confirmed in December 2019 in Wuhan, China and is now spreading worldwide. Diagnosis of COVID-19 is sometimes difficult due to the absence of symptoms and its tendency to be masked by other diseases. In this paper, we report a COVID-19 case in which diagnosis was delayed due to aspiration pneumonia. A 64-year-old man visited our department for evaluation of swallowing function. However, during the examination, the patient aspirated testing food and subsequently developed a fever. Based on his medical history and computed tomography (CT) images, he was diagnosed with aspiration pneumonia and admitted to the hospital to begin treatment. However, after admission, his respiratory condition deteriorated, and the result of a COVID-19 polymerase chain reaction (PCR) test was positive. Previous reports have shown that CT images in cases of COVID-19 pneumonia were normal in the early phase, and abnormalities usually appeared approximately 6–11 days after onset. Common findings of COVID-19 are consolidation, ground-glass opacities, and a distribution of lesions predominantly in the bilateral inferior lung field periphery. It is difficult to differentiate COVID-19 pneumonia from other types of pneumonia; it should therefore be listed as a differential diagnosis during the current pandemic.
Collapse
Affiliation(s)
- Yutaka Matsushita
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Sho Kurihara
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan; Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
| | - Hiromi Kojima
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
34
|
Anazawa U, Omura K, Nishijima Y, Aoki K, Kojima H, Tanaka Y. External auditory canal reconstruction with inferior pedicled square screw flap from the preauricular area after resection of external auditory canal cancer. Laryngoscope Investig Otolaryngol 2021; 6:77-80. [PMID: 33614933 PMCID: PMC7883608 DOI: 10.1002/lio2.505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/11/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The postoperative reconstruction of ear canal cancer with a local flap such as the snail flap technique has been reported for cases with few tissue defects. The snail flap technique requires a large skin incision and is at risk of facial neuropathy. We have devised a new flap that addresses these problems. METHODS An 80-year-old woman underwent total right ear canal resection for cancer of the right ear canal, and the defect of the ear canal was reconstructed using a local flap. The local flap was used by making a rectangular incision in front of the auricle and rolling it into a cylindrical shape. We named this flap a square screw flap. RESULTS The patient was discharged 1 week after surgery without complications. CONCLUSIONS This method is considered to be useful for reconstruction of the ear canal with a small defect.
Collapse
Affiliation(s)
- Utaro Anazawa
- Department of OtolaryngologyDokkyo Medical University Saitama Medical CenterSaitamaJapan
| | - Kazuhiro Omura
- Department of OtorhinolaryngologyThe Jikei University School of MedicineTokyoJapan
| | - Yoshikata Nishijima
- Department of OtolaryngologyDokkyo Medical University Saitama Medical CenterSaitamaJapan
| | | | - Hiromi Kojima
- Department of OtorhinolaryngologyThe Jikei University School of MedicineTokyoJapan
| | - Yasuhiro Tanaka
- Department of OtolaryngologyDokkyo Medical University Saitama Medical CenterSaitamaJapan
| |
Collapse
|
35
|
Tochigi K, Omura K, Miyashita K, Aoki S, Otori N, Tanaka Y. Effects of Hangeshashinto on the nasal physiological function: An in vitro study. Auris Nasus Larynx 2020; 48:235-240. [PMID: 32859442 DOI: 10.1016/j.anl.2020.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 07/28/2020] [Accepted: 08/12/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Hangeshashinto is a Japanese Kampo medicine applied for the treatment of oral mucositis and gastroenteritis. Hangeshashinto exhibits broad-spectrum antibacterial activity and suppresses prostaglandin (PG)E2 production in the mucosa and has the ability to improve the inflammatory condition. In addition to these effects, because cAMP, a composition of Hangeshashinto, facilitates ciliary beat, Hangeshashinto could also improve the physiological function of the nasal mucosa, consist of ciliated epithelium, but details were unknown. METHODS This study was aimed to investigate the effects of Hangeshashinto on the nasal mucosa. Healthy nasal mucosal sections were collected from the nasal septum of ten Japanese white rabbits, placed in a collagen dish for tissue culture, and rinsed with two different concentrations of Hangeshashinto solution (1.0%, n = 10 and 2.5%, n = 10) and cAMP solution (50µM, n=10 and 100 µM, n=10) or saline (control, n = 10). Ciliary beat frequency (CBF) as a physiological function of the nasal mucosa was recorded at 1, 3 and 7 days after rinsing, and histological evaluation of epithelial damage was performed at 7 days after rinsing. RESULTS CBF in the 1.0% but not in the 2.5% Hangeshashinto group, increased at 3 and 7 days compared with that in the control group (p < 0.05). This trend was also observed in the CBF in the 100 µM cAMP group, significant difference was not observed between the CBF of the 1.0% Hangeshashinto group and the 100 µM cAMP group at 1, 3 and 7 days after rinsing (p > 0.05). Histological score only in the 2.5% Hangeshashinto group was lower than that in the control group (p < 0.05), while a significant decline was not observed in the other groups compared to that in the control group (p > 0.05). CONCLUSION Our results suggest that 1.0% Hangeshashinto solution facilitates the physiological function of the nasal mucosa by promoting ciliary functions without histological damage of cilia epithelium. When applied with the appropriate concentration, Hangeshashinto could have ability to improve the physiological functions of the nasal mucosal epithelium.
Collapse
Affiliation(s)
- Kosuke Tochigi
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-shi, Saitama, 343-8555, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-shi, Saitama, 343-8555, Japan; Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
| | - Keisuke Miyashita
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-shi, Saitama, 343-8555, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-shi, Saitama, 343-8555, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minamikoshigaya, Koshigaya-shi, Saitama, 343-8555, Japan
| |
Collapse
|
36
|
Kiko K, Omura K, Oya S. Anterior clinoidal mucocele causing the orbital apex syndrome. BMJ Case Rep 2020; 13:13/8/e236527. [PMID: 32843388 PMCID: PMC7449538 DOI: 10.1136/bcr-2020-236527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Katsunari Kiko
- Neurosurgery, Kokuho Asahi Chuo Hospital, Asahi, Chiba, Japan
| | - Kazuhiro Omura
- Otorhinolaryngology, The Jikei University School of Medicine, Minatoku, Tokyo, Japan .,Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Shigeru Oya
- Neurosurgery, Kokuho Asahi Chuo Hospital, Asahi, Chiba, Japan
| |
Collapse
|
37
|
Omura K, Hosokawa Y, Nomura K, Aoki S, Tochigi K, Miyashita K, Tanaka Y, Otori N, Kojima H. Effect of gauze placement soaked with adrenaline at suprabullar recess on hemostasis during endoscopic sinus surgery: A randomized controlled trial. Head Neck 2020; 42:2397-2404. [PMID: 32385867 DOI: 10.1002/hed.26243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/09/2020] [Accepted: 04/22/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Topical application of vasoconstrictors is necessary for endoscopic sinus surgery (ESS) for a bloodless surgical view and reduced intraoperative bleeding. We aimed to verify the effectiveness of gauze placement soaked with adrenaline at suprabullar recess, where the anterior ethmoidal artery exists, on hemostasis during ESS. METHODS A randomized, double-blinded trial was carried out for 26 patients receiving ESS. At the beginning of the surgery, gauze soaked with 2% lidocaine with or without 1:10 000 adrenaline was placed at the suprabullar recess for 8 minutes. Estimated blood loss, surgical field score, and operation time were compared between the two groups. RESULTS Estimated blood loss and surgical field score were significantly smaller in the adrenaline group than in the no adrenaline group. Operation time was not significantly different between the two groups. CONCLUSION Gauze placement soaked with adrenaline at suprabullar recess reduces estimated blood loss and clears the surgical field during ESS.
Collapse
Affiliation(s)
- Kazuhiro Omura
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan.,Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Yu Hosokawa
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan.,Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai-shi, Miyagi, Japan
| | - Satoshi Aoki
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Kosuke Tochigi
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Keisuke Miyashita
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Yasuhiro Tanaka
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya-shi, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiromi Kojima
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
38
|
Takeda T, Kajiwara R, Omura K, Otori N, Wada K. Analysis of anatomical variation of the inclination of lamellas attached to the skull base and its correlation with the anterior ethmoidal artery floating in the ethmoid sinus for use in endoscopic sinus surgery. Surg Radiol Anat 2020; 42:995-1002. [PMID: 32322908 DOI: 10.1007/s00276-020-02474-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/11/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Attention to the inclination of lamellas attached to the skull base, including the basal lamella of the middle turbinate, facilitates the intraoperative identification of each lamella without requiring the use of a navigation system. We classified the inclination between the lamella and the skull base in preoperative computed tomography (CT) images and examined the relationship between the lamellas attached to the skull base, including the basal lamella of the middle turbinate, and the position of the anterior ethmoidal artery (AEA). We aimed to develop a preoperative classification to help prevent intraoperative injury of the AEA. METHODS We retrospectively investigated the paranasal sinus sagittal section CT slices of 366 sides of 183 patients to assess the inclination of lamellas attached to the skull base and the AEA location. We also reviewed the AEA position, its correlation with the supraorbital ethmoid cell, and the lateral lamella of the cribriform plate. RESULTS We classified the lamella inclination at the skull base as the anterior direction, perpendicular direction, and posterior direction types. Lamellas containing a floating AEA inclined in the anterior direction toward the skull base were observed in 68.9% of sides, inclination in the perpendicular direction was noted in 30.5% of sides, and inclination in the posterior direction was noted in 0.5% of sides. CONCLUSION It is easier to identify the AEA intraoperatively when the lamella inclination of the skull base attachment is recognized based on preoperative CT findings. This approach could be applied to all paranasal sinus lamellas and assist in identifying the AEA and other nearby structures.
Collapse
Affiliation(s)
- Teppei Takeda
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan
- Department of Otorhinolaryngology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Ota-ku,, Tokyo, 143-8541, Japan
| | - Riko Kajiwara
- Department of Otorhinolaryngology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Ota-ku,, Tokyo, 143-8541, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan.
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Kota Wada
- Department of Otorhinolaryngology, Toho University Omori Medical Center, 6-11-1, Omori-Nishi, Ota-ku,, Tokyo, 143-8541, Japan
| |
Collapse
|
39
|
Tochigi K, Omura K, Miyashita K, Aoki S, Otori N, Tanaka Y. Pathological Features of Free Graft and Pedicled Flap in the Nasal Cavity: An Animal Study. Laryngoscope 2020; 131:E428-E433. [PMID: 32207858 DOI: 10.1002/lary.28630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 02/05/2020] [Accepted: 03/03/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS Recent developments in reconstructive techniques for mucosal defects using mucoperiosteal materials have enabled rapid recovery of physiological function after endoscopic sinus surgery. Clinical trials have described the advantages, disadvantages, and different outcomes of free graft and pedicled flap, which, respectively, sacrifice or preserve blood flow. However, histological changes, that affect the postoperative outcomes after reconstruction, remain unclear. We created an animal model for the reconstruction of mucosal defects using free grafts and pedicled flaps, and evaluated them histologically. STUDY DESIGN Animal study. METHODS We created mucosal defects in the left nasal septum of 20 rabbits and performed reconstruction with free grafts and pedicled flaps. The distribution of ciliary and goblet cells at the reconstruction site was evaluated after 7 and 28 days using hematoxylin and eosin-stained sections to calculate the Ciliary Cell Index and Goblet Cell Index. The severity of inflammation was assessed using the Cartilage Inflammatory Cell Score. RESULTS Crusting and changes in the mucosal morphology at the reconstruction site occurred only in the free graft group. In addition, the pedicled flap group had significantly greater preservation of ciliary and goblet cells and less inflammatory cell infiltration into the septal cartilage (P < .05) than the free graft group. CONCLUSIONS After reconstruction procedures for mucosal defects, histopathological differences were observed between the free graft and pedicled flap. Reconstruction with pedicled flaps had advantages including preservation of healthy mucosal epithelium and suppression of inflammation on the reconstruction site. This indicated that reconstruction with pedicled flaps might have advantages over that with free grafts. LEVEL OF EVIDENCE NA Laryngoscope, 131:E428-E433, 2021.
Collapse
Affiliation(s)
- Kosuke Tochigi
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.,Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Keisuke Miyashita
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
40
|
Omura K, Nomura K, Aoki S, Otori N, Tanaka Y. Soft tissue reconstruction with anterior pedicled inferior turbinate flap in conjunction with palatal flap for standard inferior maxillectomy with hard palate resection. Head Neck 2020; 42:1110-1114. [PMID: 32020690 DOI: 10.1002/hed.26091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/21/2019] [Accepted: 01/15/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The defect after surgical resection of sinonasal malignant tumors is normally reconstructed using free flaps obtained from donor sites. There is no report of using the palatal island flap to reconstruct defects after surgery. We aimed to describe our technique of soft tissue reconstruction through anterior pedicled inferior turbinate (APIT) flap in conjunction with palatal flap for standard inferior maxillectomy with hard palate resection and its outcomes and to discuss its advantages and disadvantages compared with free-flap reconstruction. METHODS For resection of malignant tumors arising from the anterior nasal septum, we preserved the hard palate during maxillectomy using a palatal island flap and an anterior pedicled inferior turbinate flap. RESULTS One patient developed a small oroantral fistula, which was sealed with a denture. The other patient had a good outcome. CONCLUSION Our technique of maxillectomy is useful for selected cases of sinonasal malignancy that require maxillary floor resection.
Collapse
Affiliation(s)
- Kazuhiro Omura
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan.,Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, Sendai, Miyagi, Japan
| | - Satoshi Aoki
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
41
|
Hosokawa Y, Omura K, Aoki S, Miyashita K, Akutsu M, Tsunemi Y, Kashiwagi T, Haruna S, Otori N, Tanaka Y. Predictors of Visual Acuity and Usefulness of a Treatment Algorithm in Rhinogenous Optic Neuritis. Ear Nose Throat J 2019; 100:162-166. [PMID: 31550936 DOI: 10.1177/0145561319865490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rhinogenous optic neuritis, which causes neuropathy associated with visual dysfunction, greatly reduces patient quality of life and requires suitable early treatment. This study aimed to analyze visual outcome predictors in patients with rhinogenous optic neuritis and to develop and investigate the usefulness of an algorithm to facilitate early treatment. Prospective and retrospective investigations were conducted at the Department of Otorhinolaryngology. The visual outcomes after sinus surgery of 24 of 53 patients suspected of having rhinogenous optic neuritis were analyzed. Furthermore, the usefulness of the treatment algorithm was evaluated in 27 of these 53 patients. Data from 24 patients who underwent surgery were included in a multiple regression analysis to investigate the associations between visual outcomes and concomitant symptoms and the time from symptom onset to surgery. The mean time from the initial examination to a request for otorhinolaryngological examination to assess the usefulness of the treatment algorithm was compared in 27 patients who did not undergo an initial otorhinolaryngological examination. Visual acuity improved in 23 participants who underwent surgery. Multivariate analysis identified the time from onset to surgery and headache as significant predictors of postoperative visual acuity. The mean time from the initial examination to a request for otorhinolaryngological examination was significantly shorter after the algorithm was introduced (1.13 days, 8 patients; P = .008). Early surgical treatment is essential to avoid further postoperative visual acuity decreases in patients with rhinogenous optic neuritis. Patients who experience headache may have poorer postoperative outcomes.
Collapse
Affiliation(s)
- Yu Hosokawa
- Department of Otorhinolaryngology, 365086Dokkyo Medical University Saitama Medical Center, Saitama, Japan.,Department of Otorhinolaryngology, 12839the Jikei University School of Medicine, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, 365086Dokkyo Medical University Saitama Medical Center, Saitama, Japan.,Department of Otorhinolaryngology, 12839the Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Aoki
- Department of Otorhinolaryngology, 365086Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Keisuke Miyashita
- Department of Otorhinolaryngology, 365086Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Makoto Akutsu
- Department of Otorhinolaryngology and Head and Neck Surgery, 365086Dokkyo Medical University, Tochigi, Japan
| | - Yasuhiro Tsunemi
- Department of Otorhinolaryngology and Head and Neck Surgery, 365086Dokkyo Medical University, Tochigi, Japan
| | - Takashi Kashiwagi
- Department of Otorhinolaryngology and Head and Neck Surgery, 365086Dokkyo Medical University, Tochigi, Japan
| | - Shinichi Haruna
- Department of Otorhinolaryngology and Head and Neck Surgery, 365086Dokkyo Medical University, Tochigi, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, 12839the Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology, 365086Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
42
|
Kajiwara R, Omura K, Takeda T, Ohira S, Matsuura K, Furuya H, Matsui H, Yaguchi Y, Tanaka Y, Wada K. Anatomical variation of the pneumatized superior turbinate and its impact on endoscopic sinus surgery in chronic rhinosinusitis. Surg Radiol Anat 2019; 42:81-86. [PMID: 31473785 DOI: 10.1007/s00276-019-02313-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 08/24/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE The posterior ethmoid sinus is adjacent to important structures, such as the orbit, optic nerve, skull base, and ostium of the sphenoid sinus. The purpose of this study was to examine the effect of pneumatization of the superior turbinate (ST) and its basal lamella, and of the position of the anterior wall of the sphenoid sinus, on opening of the posterior ethmoid and sphenoid sinuses. METHODS On axial, coronal, and sagittal computed tomography images, 394 sinuses of 197 patients who underwent endoscopic sinus surgery at Toho University Omori Medical Center in Tokyo, Japan, were classified according to the presence or absence of pneumatization of the ST and its basal lamella. The basal lamella of the ST was classified separately into the vertical and horizontal portions. We examined whether the classification of the anterior wall of the sphenoid sinus was associated with the structure of the ST. RESULTS Pneumatization was observed in the ST in 28 sinuses (7.1%), in the vertical portion of the basal lamella in 127 (32.2%), and in the horizontal portion of the basal lamella in 90 (22.8%). Pneumatization in the horizontal portion of the basal lamella was significantly more common in the anterior sphenoidal wall classified as optic-canal type. CONCLUSION Consideration should be given to the pneumatization of the ST and its basal lamella and optic-canal-type anterior sphenoidal wall, because these reduce the volume of the posterior-most ethmoid cell and may increase the risk of damaging the skull base and optic nerve.
Collapse
Affiliation(s)
- Riko Kajiwara
- Department of Otorhinolaryngology, Toho University Omori Medical Center, Tokyo, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
| | - Teppei Takeda
- Department of Otorhinolaryngology, Toho University Omori Medical Center, Tokyo, Japan
- Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan
| | - Shinya Ohira
- Department of Otorhinolaryngology, Toho University Omori Medical Center, Tokyo, Japan
| | - Kentaro Matsuura
- Department of Otorhinolaryngology, Toho University Omori Medical Center, Tokyo, Japan
| | - Hanae Furuya
- Department of Otorhinolaryngology, Toho University Omori Medical Center, Tokyo, Japan
| | - Hidehito Matsui
- Department of Otorhinolaryngology, Toho University Omori Medical Center, Tokyo, Japan
| | - Yuichiro Yaguchi
- Department of Otorhinolaryngology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kota Wada
- Department of Otorhinolaryngology, Toho University Omori Medical Center, Tokyo, Japan
| |
Collapse
|
43
|
Ishii Y, Mori R, Omura K, Otori N, Murayama Y. [Surgical Anatomy and Techniques for the Endoscopic Endonasal Skull Base Surgery]. No Shinkei Geka 2019; 47:619-627. [PMID: 31235664 DOI: 10.11477/mf.1436203996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yudo Ishii
- Department of Neurosurgery, Jikei University School of Medicine
| | | | | | | | | |
Collapse
|
44
|
Numata K, Shiga T, Omura K, Umibe A, Hiraoka E, Yamanaka S, Azuma H, Yamada Y, Kobayashi D. Comparison of acute vertigo diagnosis and treatment practices between otolaryngologists and non-otolaryngologists: A multicenter scenario-based survey. PLoS One 2019; 14:e0213196. [PMID: 30845218 PMCID: PMC6405109 DOI: 10.1371/journal.pone.0213196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/16/2019] [Indexed: 12/19/2022] Open
Abstract
Acute vertigo is a common problem in emergency departments. However, clinical strategies of acute vertigo care vary among care providers. The aim of the study was to investigate differences in diagnosis [Dix-Hallpike test, the head impulse, nystagmus, and the test of skew (HINTS) procedure, and imaging modalities] and treatment (pharmacological treatments and the Epley maneuver) by otolaryngologists and non-otolaryngologists in emergency medicine settings. We used a multicenter case-based survey for the study. Four clinical vignettes of acute vertigo (posterior canal benign paroxysmal positional vertigo, vestibular neuritis, Meniere disease, and nonspecific vertigo) were used. Total 151 physicians from all study sites participated in the study. There were 84 non-otolaryngologists (48 emergency physicians and 36 internists) and 67 otolaryngologists. The multivariate analysis indicated that otolaryngologists ordered fewer CT scans (odds ratio (OR), 0.20; 95% confidence interval (CI), 0.07-0.53) and performed fewer HINTS procedures (OR, 0.17; 95% CI, 0.06-0.46), but used the Dix-Hallpike method more often (OR, 2.36; 95% CI, 1.01-5.52) for diagnosis compared to non-otolaryngologists. For treatment, otolaryngologists were less likely to use the Epley method (OR, 0.19; 95% CI, 0.07-0.53) and metoclopramide (OR, 0.09; 95% CI, 0.01-0.97) and more likely to use sodium bicarbonate (OR, 20.50; 95% CI, 6.85-61.40) compared to non-otolaryngologists. We found significant differences in the acute vertigo care provided by non-otolaryngologists and otolaryngologists from a vignette-based research. To improve acute vertigo care, educational systems focusing on acute vertigo are needed.
Collapse
Affiliation(s)
- Kenji Numata
- Department of Emergency Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Todaijima, Urayasu city, Chiba, Japan
| | - Takashi Shiga
- Department of Emergency Medicine, International University of Health and Welfare, Mita hospital, Mita, Minato-ku Tokyo, Japan
- * E-mail:
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Nishi-shimbashi, Minato-ku, Tokyo, Japan
| | - Akiko Umibe
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Minamikoshigaya, Koshigaya city, Saitama, Japan
| | - Eiji Hiraoka
- Department of General Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Todaijima, Urayasu city, Chiba, Japan
| | - Shunsuke Yamanaka
- Department of Emergency Medicine, University of Fukui Hospital, Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Hiroyuki Azuma
- Department of Emergency Medicine, Fukui prefectural hospital, Fukui, Fukui prefecture, Japan
| | - Yasuhiro Yamada
- Department of General Internal Medicine, National Hospital Organization Tokyo Medical Center, higashigaoka, meguro-ku, Tokyo, Japan
| | - Daiki Kobayashi
- Division of General Internal Medicine, St. Luke’s International Hospital, Tokyo Japan
| |
Collapse
|
45
|
Affiliation(s)
- Yumi Suzuki
- Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Kazuhiro Omura
- Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan.,Otorhinolaryngology, The Jikei University School of Medicine, Minato, Tokyo, Japan
| | - Nobuyoshi Otori
- Otorhinolaryngology, The Jikei University School of Medicine, Minato, Tokyo, Japan
| | - Yasuhiro Tanaka
- Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| |
Collapse
|
46
|
Hirabayashi M, Takedomi H, Ando Y, Omura K. Neck carbuncle associated with methicillin-susceptible Staphylococcus aureus bacteraemia. BMJ Case Rep 2018; 2018:bcr-2018-226935. [PMID: 30366898 PMCID: PMC6203058 DOI: 10.1136/bcr-2018-226935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
| | - Hirotaka Takedomi
- Department of Otorhinolaryngology, Asahi General Hospital, Chiba, Japan
| | - Yuji Ando
- Department of Otorhinolaryngology, Asahi General Hospital, Chiba, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.,Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
47
|
Hirabayashi M, Omura K, Otori N, Tanaka Y. Recurrent meningitis caused by idiopathic cerebrospinal fluid rhinorrhoea from the sphenoid sinus. BMJ Case Rep 2018; 2018:bcr-2017-222296. [PMID: 29895541 PMCID: PMC6011432 DOI: 10.1136/bcr-2017-222296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan.,Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otorhinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| |
Collapse
|
48
|
Omura K, Nomura K, Aoki S, Katori Y, Tanaka Y, Otori N. Lacrimal sac exposure and a superior lateral anterior pedicle flap to improve outcomes of Draf type II and III procedures. Int Forum Allergy Rhinol 2018; 8:955-958. [PMID: 29601153 DOI: 10.1002/alr.22122] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 02/21/2018] [Accepted: 03/06/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Although the efficacy of Draf type II and III procedures for frontal sinus diseases is well recognized, a certain amount of postoperative stenosis of the frontal neo-ostium occurs. Exposed bone induces inflammation and leads to osteoneogenesis. To prevent stenosis, we developed a surgical technique designed to minimize bone exposure while maximizing the frontal neo-ostium area created with Draf type II and III procedures. We fully exposed the lacrimal sac and used a superior lateral anterior pedicle flap to cover the exposed bone during the Draf procedure. We aimed to describe our technique. METHODS We reviewed 19 patients who underwent a Draf type II or III procedure with our technique. Endoscopic views from the follow-ups and complications were evaluated. RESULTS Overall, the neo-ostium remained patent in all patients. No complications, such as synechiae or orbital injury, were seen in any of the patients. CONCLUSION Draf type II and III procedures with lacrimal sac exposure and a superior lateral anterior pedicle flap are convenient and seem to be effective. However, further studies with larger numbers of patients are needed to verify our technique.
Collapse
Affiliation(s)
- Kazuhiro Omura
- Department of Otolaryngology, Jikei University School of Medicine, Tokyo, Japan
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Aoki
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Yukio Katori
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiro Tanaka
- Department of Otolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Nobuyoshi Otori
- Department of Otolaryngology, Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
49
|
Hachisu T, Omura K, Otori N, Tanaka Y. Male with watery rhinorrhoea and disturbed consciousness after trauma. BMJ Case Rep 2017; 2017:bcr-2017-222288. [PMID: 29122904 PMCID: PMC5695296 DOI: 10.1136/bcr-2017-222288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Takuya Hachisu
- Department of Otorhinolaryngology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan.,Department of Otohinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Nobuyoshi Otori
- Department of Otohinolaryngology, The Jikei University School of Medicine, Tokyo, Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology, Dokkyo Medical University Koshigaya Hospital, Saitama, Japan
| |
Collapse
|
50
|
Umibe A, Omura K, Hachisu T, Anazawa U, Tanaka Y. Life-threatening injury caused by complete impalement of a toothbrush: Case report. Dent Traumatol 2017; 33:317-320. [DOI: 10.1111/edt.12346] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/17/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Akiko Umibe
- Department of Otorhinolaryngology; Dokkyo Medical University Koshigaya Hospital; Saitama Japan
| | - Kazuhiro Omura
- Department of Otorhinolaryngology; Dokkyo Medical University Koshigaya Hospital; Saitama Japan
| | - Takuya Hachisu
- Department of Otorhinolaryngology; Dokkyo Medical University Koshigaya Hospital; Saitama Japan
| | - Utaro Anazawa
- Department of Otorhinolaryngology; Dokkyo Medical University Koshigaya Hospital; Saitama Japan
| | - Yasuhiro Tanaka
- Department of Otorhinolaryngology; Dokkyo Medical University Koshigaya Hospital; Saitama Japan
| |
Collapse
|