The Modified Open Rhinoplasty

1993 ◽  
Vol 1 (3) ◽  
pp. 131-136
Author(s):  
Laurence T Glickman ◽  
Gene W Lee
Keyword(s):  
Surgical Approach ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
The Past ◽  
External Incision ◽  
Wide Exposure

LT Glickman, GW Lee. The modified open rhinoplasty. Can J Plast Surg 1993;1(3):131-136. Despite considerable attention in the past 10 to 20 years, the open rhinoplasty remains a controversial procedure. Advocates of this technique argue that the exposure and thus the surgical manoeuvres it makes are unequalled. Detractors argue that the transcolumellar scar left by the procedure is unacceptable and is most often unnecessary. This report describes a modification of the open rhinoplasty which has most of the advantages of the open approach, but is performed without the external incision. The procedure, its advantages and drawbacks, and comparisons among the modified open, open and closed rhinoplasty are described. It is concluded that the modified open rhinoplasty is an excellent surgical approach that can be used on most patients and that it provides wide exposure without an external incision.

Surgical Approach to Frontal Sinus Osteoma: A Systematic Review

2019 ◽  
Vol 33 (5) ◽  
pp. 462-469 ◽  
Author(s):  
Duncan C. Watley ◽  
Eric R. Mong ◽  
Nikunj A. Rana ◽  
Elisa A. Illing ◽  
Mohamad R. Chaaban
Keyword(s):  
Systematic Review ◽  
Surgical Approach ◽  
Frontal Sinus ◽  
Clinical Presentation ◽  
Sagittal Plane ◽  
Residual Disease ◽  
Complete Removal ◽  
Open Approach ◽  
The Past

Background Osteoma of the paranasal sinuses are benign bony masses most commonly found in the frontal sinus. In the past, due to the anatomical complexity of the frontal sinus, these often required an open approach, but with the invention of angled tools and endoscopes, many rhinologists are now attempting endoscopic or combined resections. No large systematic reviews currently exist that describe the surgical management of frontal sinus osteoma. Objective To perform a systematic review detailing the surgical resection of frontal sinus osteoma. Review Methods: A systematic literature review was performed using PubMed, Embase, and Ovid databases. Data extracted included demographics, clinical presentation, radiologic, histologic findings, surgical approach, and recurrence. Results A total of 32 studies, with 477 surgically resected tumors, were included in the analysis. Sex data were available for 179 patients (M:F, 93:86), with a mean age of 43.2 years. All resected tumors presented symptomatically: facial pain/headache (80.2%), recurrent sinusitis (30.5%), mucocele (4.3%), cosmetic deformity other than proptosis (12.8%), and proptosis (5.5%). Transnasal endoscopic surgery alone was the most common surgical approach utilized (44.9%), followed by open osteoplastic flaps (36.9%) and endoscopic assisted (18.2%). Osteoma with anterior (79%) and posterior (73%) attachments were treated statistically more often with endoscopic approach compared with floor (42%) and extrasinus (50%) attachment ( P < .0005). There was no statistical difference in approach to masses that crossed the sagittal plane extending from the lamina papyracea (63% endoscopic, 29% endoscopic assisted, 8% open, P = .21). Mean follow-up was 29.7 months, with recurrence or persistent residual disease occurring in 12 patients. Conclusion Despite the increasing use of endoscopic alone procedures for expanding indications, patients may still require an open or endoscopic assisted approach for complete removal.

scholarly journals Nasal sill augmentation: an overlooked concept in rhinoplasty—a technical note and review of the literatures

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Gholamhossein Adham ◽  
Seied Omid Keyhan ◽  
Hamid Reza Fallahi ◽  
Heliya Ziaei ◽  
Mohan Thomas
Keyword(s):  
Technical Note ◽  
Open Rhinoplasty ◽  
Open Approach ◽  
Base Approach ◽  
Patient Dissatisfaction ◽  
Novel Technique ◽  
Alar Base ◽  
Defect Area ◽  
Augmentation Procedure ◽  
Made In

Abstract Background Nasal sill is one of the components of the alar ring, affecting the esthetic outcomes of rhinoplasty; accordingly, we developed a novel technique to adjust defects in this area and compared it with the available techniques. Methods Our technique was based on creating a tunnel access to the nasal sill area through an incision made in the lower third of the columella using the open approach or through a nostril base incision in patients, who underwent alar base reduction, followed by insertion of a cartilaginous graft into the marked defect area. Results A total number of 54 patients with a defect in the nasal sill area were included in this study. Thirty-one patients underwent open rhinoplasty with the sill approach from the lower third of the columella, while 23 patients underwent rhinoplasty with a nostril base approach for nasal sill augmentation procedure. There were no reports of patient dissatisfaction, infection, bleeding, sensory dysfunction, or remaining asymmetry of the sill area. Conclusion Based on the findings of the present study, this technique can be successfully used in reconstructing the nasal sill area with minimal complications and morbidity.

scholarly journals Treatment of juvenile angiofibromas: 18-year experience of a single tertiary centre in Spain

2012 ◽  
Vol 50 (1) ◽  
pp. 95-103
Author(s):  
Fernando Lopez ◽  
Vanessa Suarez ◽  
Maria Costales ◽  
Carlos Suarez ◽  
Jose L. Llorente
Keyword(s):  
Surgical Approach ◽  
Early Stage ◽  
Tumour Size ◽  
Vascular Supply ◽  
Open Approach ◽  
Tertiary Centre ◽  
Preauricular Approach ◽  
Conventional Open Approach ◽  
Open Surgical Approach

Background: The management of juvenile angiofibroma (JA) has changed during the last decades but it still continues to be a challenge. The objective of this study was to review the used treatment and our outcomes. Methods: From 1992 to 2010, 48 cases of JA were treated at our department. Charts were reviewed for standard demographic, tumour size and location, vascular supply and results of embolization, surgical approach, operative results, adjuvant therapies, recurrence and postoperative follow-up. Results: Most tumours were Andrews-Fisch stages III and IV and surgery was used as the main treatment in all cases. We used an open surgical approach in 37 (77%) patients and 11 (23%) were treated endoscopically. The most common open approach used in this series was the subtemporal-preauricular approach. Until 1995, all tumours were operated on by a conventional open approach. Afterwards, early-stage tumours were operated on through an endoscopic approach. Ten patients were treated through surgery followed by radiosurgery. Two (4%) patients had recurrent disease. Conclusions: These tumours should be treated at centres with expertise in skull base surgery to achieve complete surgical resections with low morbidity. Radiosurgery after surgery seems to be a valuable option in the long-term control of some extended JAs.

scholarly journals Management and Treatment of Gynecomastia with Liposuction

1970 ◽  
Vol 1 (4) ◽  
Author(s):  
Tessa Puspita Sari ◽  
Gentur Sudjatmiko
Keyword(s):  
Breast Tissue ◽  
Physical Activities ◽  
Breast Mass ◽  
Open Approach ◽  
Adult Males ◽  
Periareolar Incision ◽  
The Past ◽  
Early Return ◽  
Minimal Scar ◽  
Open Excision

Background: Gynecomastia is a common problem of the male breast, with a reported overall incidence of 32 to 36 percent. The surgical management of gynecomastia has undergone significant changes over the past few decades, from a predominantly open approach to one involving liposuction only or liposuction combined with direct excision through a periareolar or remote incision. Patients and Method: We present five cases with bilateral gynecomastia. One patient is a teenager and others are adult males. Liposuction only was performed in patients without palpable glandular breast mass. Direct excision was made to help remove the excessive glandular breast mass. The compressive garment is worn for 4 to 6 weeks after procedure to prevent the complications of the surgical procedure.Result: Three of the patients are corrected with liposuction only. There are two patients who underwent combination of open excision and liposuction. The liposuction procedure only left minimal scar from canulas incision. Other patient has minimal periareolar incision to remove excess breast tissue. None of the patients showed complication after surgery.Summary: All of the patients presented were satisfied by the correction of gynecomastia using liposuction. None of the patients shows any complication after liposuction procedure. The result after surgery is a natural-looking chest without extensive scar. The patients appreciate the early return to work and normal physical activities.

scholarly journals Maxillary Sinus Pneumocele Presenting as Aesthetic Deformity: A Case Report With Literature Review

2019 ◽  
Vol 99 (6) ◽  
pp. 397-401
Author(s):  
Hyun Sang Cho ◽  
Seok Jung Hong ◽  
Hyun Kyu Chae ◽  
Kyung Soo Kim
Keyword(s):  
Case Report ◽  
Maxillary Sinus ◽  
Surgical Approach ◽  
Clinical Symptoms ◽  
Interesting Case ◽  
Operation Technique ◽  
Comprehensive Review ◽  
The Past ◽  
Standard Operation ◽  
Eye Symptoms

We report an interesting case of maxillary sinus pneumocele that presented with aesthetic deformity and completely treated with Caldwell-Luc approach and thoroughly review all of the past literature focusing on clinical symptoms and surgical approach. Based on our comprehensive review of maxillary sinus pneumocele, we found 2 important characteristics. First, maxillary sinus pneumocele may be asymptomatic but cause various symptoms owing to the displacement of neighboring structures, such as facial symptoms, eye symptoms, and nasal obstruction. Second, there is no standard operation technique for maxillary sinus pneumocele, but surgical approach should be individualized depending on patient’s symptoms and needs. Therefore, more case studies are needed to confirm this.

Readmissions After Lobectomy in an Era of Increasing Minimally Invasive Surgery: A Statewide Analysis

2019 ◽  
Vol 14 (5) ◽  
pp. 453-462
Author(s):  
Brandon S. Hendriksen ◽  
Michael F. Reed ◽  
Matthew D. Taylor ◽  
Christopher S. Hollenbeak
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Health Care Cost ◽  
Thoracoscopic Surgery ◽  
Patient Characteristics ◽  
Open Approach ◽  
Minimally Invasive Surgical ◽  
Chi Squared ◽  
The Impact ◽  
Video Assisted Thoracoscopic Surgery

Objective Utilization of minimally invasive surgical modalities for lobectomy is increasing. Lobectomy can be associated with notable rates of readmission. As use of these modalities increases, evaluation of the impact on readmission is warranted. Methods Data from the Pennsylvania Health Care Cost Containment Council were used to identify lobectomy operations performed in Pennsylvania from 2011 through 2014. Operations were stratified by approach: open, video-assisted thoracoscopic surgery (VATS) or robotic. Differences in patient characteristics were assessed with analysis of variance and chi-squared tests. Logistic regression modeled risk of 30-day readmission and linear regression modeled length of stay (LOS) after controlling for confounders. Results We evaluated 4,939 lobectomy operations (2,501 open, 1,944 VATS, 494 robotic) with 583 readmissions (11.8%). Robotic cases increased 333% over 4 years. VATS and open cases increased 38% and 22%, respectively. Surgical approach was not associated with hospital readmission (VATS odds ratio (OR) = 0.95; P = 0.632; and robotic OR = 1.02; P = 0.916). Longer LOS was associated with a greater likelihood of readmission (OR = 1.58; P = 0.002). LOS was 1 day less for VATS ( P < 0.001) and 1.5 days less for robotic lobectomy ( P < 0.001) when compared to an open approach. The most common reasons for readmission were respiratory complications and nonrespiratory infection. Conclusions Surgical approach does not directly affect readmission. However, minimally invasive lobectomy appears to be associated with shorter LOS and results in more patients discharged home. Decreased LOS and discharge home are associated with fewer readmissions.

Surgical approach for enlarged peroneal tubercles

1989 ◽  
Vol 79 (9) ◽  
pp. 451-454 ◽  
Author(s):  
JS Berenter ◽  
FD Goldman
Keyword(s):  
Surgical Treatment ◽  
Surgical Approach ◽  
Lateral Aspect ◽  
Inferior Surface ◽  
Anatomic Landmark ◽  
Simple Excision ◽  
The Past

The peroneal tubercle is an anatomic landmark consistently found on the lateral aspect of the calcaneus. Its enlargement can be either congenital or acquired. In the past, surgical treatment of enlarged tubercles has consisted of simple excision of the tubercle. The authors have presented a technique to preserve the gliding facet that is often found on the inferior surface of the tubercle.

Selecting the surgical approach in complex reoperative partial nephrectomies: Does robotics have a role?

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 658-658
Author(s):  
Sandeep Gurram ◽  
Siobhan Telfer ◽  
Winston Li ◽  
Heather Chalfin ◽  
W. Marston Linehan ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Robotic Surgery ◽  
Surgical Approach ◽  
Open Surgery ◽  
Perioperative Outcomes ◽  
Open Approach ◽  
Renal Surgery ◽  
Estimated Blood Loss ◽  
Operative Complications ◽  
Post Operative Complications

658 Background: Minimally invasive surgery (MIS) has shown equal oncologic efficacy as the open approach for treating small renal masses but results in improved perioperative parameters. Surgical principles also dictate that the open technique should be considered when facing difficult surgeries though this is experience and not evidenced based. The goal of our study is to explore differences in outcomes amongst open or robotic approaches in complex reoperative partial nephrectomies. Methods: 194 patients who had prior renal surgery from 2008 to 2019 were identified, the majority of which presented with multiple tumors due to known or suspected hereditary kidney cancer syndrome. Patients were stratified into the following cohorts based on surgical history: open after open surgery, open after MIS, robotic after open surgery, and robotic after MIS. Perioperative outcomes were compared amongst cohorts. Results: Significant differences were noted in estimated blood loss (EBL), number of tumors resected, and postoperative complications as assessed by Clavien score. Univariate regression analysis of EBL showed that the number of tumors resected (p <.0001, coefficient: 111 ml), number of prior renal procedures (p=.012, coefficient: 419 ml), hilar clamping (p = .015, coefficient: 840 ml), and intended surgical approach (p = .001; coefficient: 905 ml) were significant. On multivariate analysis, number of tumors resected (p<.0001, coefficient: 97 ml) was the only significant factor. Univariate analysis on post-operative complications showed that number of prior surgeries (p = 0.03, OR: 1.5) and final intended approach (p < .0001, OR: 4.6) were significant. On multivariate analysis, the final intended surgical approach (p = .001, OR: 4.3) was shown to be significant. Conclusions: These data show that the surgical approach of prior procedures is not a significant factor that affects perioperative outcomes, but the use of robotic surgery was associated with decreased post-operative complications in reoperative renal surgery . While open surgery will likely continue to be the standard of care for complex reoperative procedures, these data suggest that robotic surgery is safe and well tolerated in select cases.

scholarly journals Open surgical approach to management of rhino-orbito-cerebral mucormycosis

2021 ◽  
Vol 8 (1) ◽  
pp. 64
Author(s):  
Sunil K. C. ◽  
Praveen Kumar B. Y. ◽  
Ramesh Bhoomannavar ◽  
Rishabh Jain
Keyword(s):  
Surgical Approach ◽  
Effective Means ◽  
Tertiary Care ◽  
Wound Dehiscence ◽  
Open Approach ◽  
Cross Sectional ◽  
Temporal Fossa ◽  
Co Morbidity ◽  
Facial Swelling ◽  
Open Surgical Approach

<p class="abstract"><strong>Background: </strong>Since December 2019, when novel corona virus (COVID 19) was reported, it has spread widely to cause a pandemic. Rhino-orbito-cerebral Mucormycosis (ROCM), an opportunistic fungal infection caused by the order Mucorales and class Zygomycetes has led to an epidemic in our country.</p><p class="abstract"><strong>Methods: </strong>This prospective cross sectional study was conducted at a 1200 bed tertiary care teaching hospital in Mysore. All patients of ROCM who presented to us for treatment were selected for the study after informed consent. Only those patients who were operated via open approach were included.</p><p class="abstract"><strong>Results:</strong> Median age of the patients was 50 years (SD±10). 49 were male patients (67.1%). Diabetes mellitus was the most common underlying co-morbidity seen in 71 patients (97.3%). Facial pain (100%) and facial swelling (90.4%) were the most common presenting complaint. KOH positivity from nasal swab for Mucormycosis was positive in only 37 patients (50.7%). Traditional inaccessible areas to endoscope like the premaxilla, lateral orbit cavity, infra temporal fossa and hard palate were tackled by the open surgical approach route. Advantages of open surgical approach being the access to areas which are traditionally difficult to approach via the endoscope, aggressive debridement is possible which might be challenging endoscopically. Complications like wound dehiscence, oro-antral fistula, osteomyelitis and abscess were noted in our study.</p><p class="abstract"><strong>Conclusions: </strong>Open surgical approach offers a very viable, affordable and a very effective means for aggressive surgical debridement of infection and reduce mortality associated with ROCM.</p><p> </p>

scholarly journals Update on Laparoscopic Surgery at the Georgetown Public Hospital Corporation

2019 ◽  
pp. 36-37
Author(s):  
Joshua Bhudial ◽  
Hemraj Ramcharran ◽  
Navindranauth Rambarran ◽  
Delon Ramnarine
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Approach ◽  
Public Hospital ◽  
Diagnostic Laparoscopy ◽  
Operating Theatre ◽  
Published Data ◽  
The Past ◽  
Significant Difference ◽  
Ventral Hernias ◽  
Main Operating

Background: Laparoscopic surgery is a pioneering technique that has metamorphosed the field of surgery in the past and is now considered the recommended surgical approach for many procedures. 1 The last published data showed an average of eight cases per month. 5 The purpose of this study was to assess an increase or decrease in the number of Laparoscopic surgeries at GPHC and if there were more advanced cases as compared to the last published data. Methods: Data of the laparoscopic surgeries done at GPHC for the year 2018 was obtained from the records in the Main Operating theatre. Data collected will focus on the number and type of Laparoscopic surgeries. Results: An audit of GPHC operating register shows a total of 180 cases for 2018 representing an average of 15 cases per month. There was a significant difference in the first six months of 2018 (5 cases per month) versus the last six months of 2018 (25 cases per month). A total of 19 cases were converted. Most of the advanced cases were done in latter half of 2018 and included 27 diagnostic laparoscopy, 9 inguinal hernias, 2 AP resections, 2 Graham’s patch, 2 ventral hernias, 2 rectopexy and 1 Heller’s myotomy. Conclusion: The number of laparoscopic surgeries at GPHC has increased significantly especially in the latter half of 2018. This number has risen to three times the number in the last published data. While the majority of cases continued to be cholecystectomy and appendectomies, a greater variety of advanced cases were done in 2018 as compared to the last published data.

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