The Use of Nasal Endoscopes in the Diagnosis of Nasal and Paranasal Sinus Masses

The histopathologic diagnosis of nasal and paranasal sinus masses may be problematic. Traditionally, a biopsy through an external ethmoidectomy or Caldwell-Luc procedure has been required. The advent of nasal endoscopy provides an alternative method of obtaining tissue. The diagnostic evaluations of 57 cases of nasal or paranasal sinus masses, seen from 1985 through 1991, were reviewed. The use of nasal endoscopy in the diagnosis of nasal and paranasal sinus masses was associated with decreased morbidity as compared to more traditional approaches. Potential surgical approaches were not violated prior to definitive treatment. Representative cases will be presented illustrating changes in management by using nasal endoscopes.

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A Comparative Study of Endoscopic Finding and Radiological Appearance in Paranasal Sinus Disease

Journal of Medical Research and Innovation ◽

10.15419/jmri.128 ◽

2018 ◽

Vol 2 (S1) ◽

pp. e000128

Author(s):

Anjani Agarwal ◽

Alpesh Fefar ◽

Manish Mehta

Keyword(s):

Ct Scan ◽

Paranasal Sinus ◽

Uncinate Process ◽

Nasal Endoscopy ◽

High Association ◽

Sinus Disease ◽

Radiological Appearance ◽

Highly Sensitive ◽

Operative Findings ◽

Paranasal Sinus Disease

Aims and Objectives: The study is carried out with an objective to compare the diagnostic nasal endoscopic findings and radiological appearance in patients with paranasal sinus disease. Methods: 50 cases of chronic sinusitis not responding to routine medical line of treatment were selected and operated after being thoroughly investigated by means of nasal endoscopy and CT scan. Results: Out of 50 cases, 35 underwent bilateral surgery and 15 underwent unilateral surgery, so a total of 85 procedures were carried out. Findings of both the CT scan as well as diagnostic nasal endoscopy were compared to each other and ultimately correlated with operative findings. Conclusion: In our study, a high association is found between both the modalities of investigation i.e CT scan and diagnostic nasal endoscopy with one scoring over the other in different parameters. Diagnostic nasal endoscopy is found to be highly sensitive investigatory modality for parameters like frontal recess, spheno-ethmoid recess and hiatus semilunaris, where as CT scan is found to be highly sensitive for parameters like maxillary sinus, uncinate process and posterior ethmoids. So, a case of sinus disease should be diagnosed as early as possible using both these modalities as together they complement each other. Early diagnosis and effective management cures the pathology and prevents disastrous complications.

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A review study of nasal endoscopy protocol during the COVID-19 pandemic

Iraqi National Journal of Medicine ◽

10.37319/iqnjm.2.csi.5 ◽

2020 ◽

Vol 2 (CSI) ◽

pp. 38-41

Author(s):

Rafid Jabbar

Keyword(s):

High Risk ◽

Health Services ◽

Paranasal Sinus ◽

Medical Staff ◽

Nasal Endoscopy ◽

Paranasal Sinus Diseases ◽

The World ◽

Major Procedure ◽

Risk Of Exposure ◽

Review Study

During ENT practice, we have to examine the nose and perform several nasal procedures in our clinics. Otolaryngologists are at a high risk of exposure to the COVID-19 virus. Nasal endoscopy is a major procedure for the diagnosis of the nasal and paranasal sinus diseases and introducing proper health services for our patients. In addition, the world is living the era of the COVID-19 pandemic, for which we have to protect ourselves, educate our medical staff, and work together against the spread of this severely contagious disease within our communities. The main purpose of this study is to review the protocol of nasal endoscopy in the ENT clinic and enhance the safest way to deal with patients during this pandemic.(1)

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The Investigation and Management of Adenomyosis in Women Who Wish to Improve or Preserve Fertility

BioMed Research International ◽

10.1155/2018/6832685 ◽

2018 ◽

Vol 2018 ◽

pp. 1-12 ◽

Cited By ~ 3

Author(s):

Jin-Jiao Li ◽

Jacqueline P. W. Chung ◽

Sha Wang ◽

Tin-Chiu Li ◽

Hua Duan

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Treatment Options ◽

Management Strategies ◽

Definitive Treatment ◽

Surgical Approaches ◽

Child Bearing ◽

Fertility Sparing

The management of adenomyosis remains a great challenge to practicing gynaecologists. Until recently, hysterectomy has been the only definitive treatment in women who have completed child bearing. A number of nonsurgical and minimally invasive, fertility-sparing surgical treatment options have recently been developed. This review focuses on three aspects of management, namely, (1) newly introduced nonsurgical treatments; (2) management strategies of reproductive failures associated with adenomyosis; and (3) surgical approaches to the management of cystic adenomyoma.

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Primary Malignant Orbital Tumors

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0040-1722635 ◽

2021 ◽

Vol 82 (01) ◽

pp. 081-090

Author(s):

Jacquelyn Laplant ◽

Kimberly Cockerham

Keyword(s):

Multimodal Therapy ◽

Surgical Techniques ◽

Surgical Approaches ◽

Imaging Features ◽

Orbital Surgery ◽

Diagnosis And Management ◽

Microsurgical Techniques ◽

Invasive Techniques ◽

Traditional Approaches ◽

Orbital Imaging

Abstract Objective Primary orbital malignancy is rare. Awareness of the characteristic clinical and imaging features is imperative for timely identification and management. Surgery remains an important diagnostic and treatment modality for primary orbital malignancy, but determining the optimal surgical approach can be challenging. The purpose of this article is to explore recent advances in the diagnosis, management, and surgical approaches for primary orbital malignancies. Design In this review, the clinical presentation, imaging features, and medical and surgical management of primary orbital malignancies with representative cases will be discussed. Setting Outpatient and inpatient hospital settings. Participants Patients with diagnosed primary orbital malignancies. Main Outcome Measures Descriptive outcomes. Results Advancements in orbital imaging, microsurgical techniques, and multimodal therapy have improved the diagnosis and management of primary orbital malignancies. Special considerations for biopsy or resection are made based on the tumor's location, characteristics, nearby orbital structures, and goals of surgery. Minimally invasive techniques are supplanting traditional approaches to orbital surgery with less morbidity. Conclusions Advances in imaging technologies and surgical techniques have facilitated the diagnosis and management of primary orbital malignancies. Evolution toward less invasive orbital surgery with focus on preservation and restoration of function is underway.

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Early Versus Late Computed Tomography and Nasal Endoscopy in the Diagnosis of Nasopharyngeal and Paranasal Sinus Malignancy

American Journal of Rhinology and Allergy ◽

10.1177/1945892419838106 ◽

2019 ◽

Vol 33 (4) ◽

pp. 388-394 ◽

Cited By ~ 1

Author(s):

Michael J. Marino ◽

Mei-Chin Hsieh ◽

Eric L. Wu ◽

Charles A. Riley ◽

Xiao-Cheng Wu ◽

...

Keyword(s):

Computed Tomography ◽

Overall Survival ◽

Relative Risk ◽

Paranasal Sinus ◽

Cancer Diagnosis ◽

Clinical Utility ◽

Early Cancer ◽

Disease Stage ◽

Nasal Endoscopy ◽

Early Cancer Diagnosis

Background Chronic rhinosinusitis (CRS) and allergic rhinitis (AR) may be associated with an increased risk of subsequent diagnosis of nasopharyngeal carcinoma (NPC) or paranasal sinus cancer (PSC) in elderly Americans. The clinical utility of this association remains uncertain. Objective To compare early computed tomography (CT) or nasal endoscopy (NE) with late diagnostic studies for the diagnosis of NPC or PSC in elderly Americans with CRS or AR. Methods The Surveillance, Epidemiology, and End Results (SEER)-Medicare database was queried from 2003 to 2011 and included 150 088 Medicare beneficiaries. Patients with a diagnosis of CRS or AR were examined for either NE or CT performed within 6 months of the exposure diagnosis. The risk of a cancer diagnosis was determined between the early and the late diagnostic groups. Results The relative risk of early cancer diagnosis with NE was 1.98 (95% confidence interval [CI], 1.60–2.43). The number needed to detect (NND) a case of cancer with NE was 503 (95% CI, 387–718). The relative risk of an early cancer diagnosis using CT was 3.40 (95% CI, 2.85–4.06) and NND was 221 (95% CI, 194–255). The stage of NPC or PSC for the late diagnostic group was not different from those with early NE ( P = .458) or CT ( P = .497). Overall survival was not different between diagnostic groups for NE ( P = .789) or CT ( P = .425). Conclusions Early NE or CT is associated with a higher likelihood of cancer diagnosis in elderly individuals with a diagnosis of CRS or AR. The clinical utility of this association is limited due to the low prevalence of these malignancies and lack of difference in disease stage and overall survival between diagnostic groups.

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Juvenile Nasopharyngeal Angiofibroma - Excision Through Lateral Rhinotomy and Sublabial Approach - A Case Report

Journal of Dhaka Medical College ◽

10.3329/jdmc.v20i1.8587 ◽

1970 ◽

Vol 20 (1) ◽

pp. 78-81

Author(s):

NK Sinha ◽

MH Rashid ◽

MM Shaheen ◽

DC Talukder ◽

MAY Fakir ◽

...

Keyword(s):

Surgical Excision ◽

Complete Removal ◽

Definitive Treatment ◽

Surgical Approaches ◽

Complete Excision ◽

Nasopharyngeal Angiofibroma ◽

Male Adolescents ◽

Large Size ◽

Complete Surgical Excision ◽

Sublabial Approach

Juvenile angiofibroma is a rare hypervascular, locally aggressive benign tumour which is exclusively found in the nose and paranasal sinuses of male adolescents. The definitive treatment for this tumour is complete surgical excision. Different surgical approaches are used for complete excision. Most recent development is excision of the tumour using endoscopes. But in certain cases with large size and different extensions, open transfacial approaches are the choice for complete removal and for less operative bleeding, which are the main challenges for surgical excision of this tumour. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8587 J Dhaka Med Coll. 2011; 20(1) :78-81

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Endoscopic-assisted posterior interhemispheric retrocallosal transfalcine approach for microsurgical resection of a pineal region falcotentorial meningioma: operative video and technical nuances

Neurosurgical FOCUS ◽

10.3171/2016.1.focusvid.15453 ◽

2016 ◽

Vol 40 (videosuppl1) ◽

pp. 1 ◽

Cited By ~ 1

Author(s):

James K. Liu ◽

Michael A. Cohen

Keyword(s):

Significant Risk ◽

Signs And Symptoms ◽

Lateral Position ◽

Surgical Anatomy ◽

Pineal Region ◽

Definitive Treatment ◽

Surgical Approaches ◽

Vein Of Galen ◽

Straight Sinus ◽

Microsurgical Resection

Falcotentorial meningiomas are rare tumors of the pineal region that arise from the dural folds where the falx and tentorium meet and are often intimately related to the vein of Galen and straight sinus. These lesions often present with signs and symptoms related to hydrocephalus and brainstem compression. Surgical resection of falcotentorial meningiomas remains the definitive treatment, with a variety of surgical approaches used to resect these lesions. The choice of approach depends on several factors, including the size and location of the tumor relative to the vein of Galen complex. Falcotentorial meningiomas can be technically challenging to remove with significant risk of morbidity because of the close proximity to and occasional invasion of the vein of Galen and straight sinus. In this operative video, the authors demonstrate an illustrative step-by-step technique for endoscopic-assisted microsurgical resection of a falcotentorial meningioma using the posterior interhemispheric retrocallosal transfalcine approach for a superiorly positioned falcotentorial meningioma. The surgical nuances are discussed, including the surgical anatomy, gravity-assisted interhemispheric approach in the lateral position, retrocallosal dissection, transfalcine exposure, tumor removal, and preservation of the vein of Galen complex. In summary, the posterior interhemispheric retrocallosal transfalcine approach is a useful surgical strategy for select superiorly positioned falcotentorial meningiomas.The video can be found here: https://youtu.be/d8mdunsRacs.

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Pediatric Benign Paranasal Sinus Osteoneogenic Tumors: A Case Series and Systematic Review of Outcomes, Techniques, and a Multiportal Approach

American Journal of Rhinology and Allergy ◽

10.1177/1945892418793475 ◽

2018 ◽

Vol 32 (6) ◽

pp. 465-472 ◽

Cited By ~ 4

Author(s):

Karam W. Badran ◽

Jeffrey D. Suh ◽

Nikan Namiri ◽

Bozena Wrobel ◽

Elisabeth H. Ference

Keyword(s):

Systematic Review ◽

Paranasal Sinus ◽

Case Series ◽

Postoperative Recurrence ◽

Tumor Burden ◽

Sinus Surgery ◽

Surgical Approaches ◽

Tumor Type ◽

Open Approach ◽

Female Ratio

Background Pediatric benign paranasal sinus osteoneogenic tumors have previously been difficult to treat due to the surgical constraints of the developing skull. Progression may lead to intracranial complications or orbital and optic nerve compression. Objective To assess the presentation and management of benign paranasal sinus osteoneogenic tumors. Methods Systematic review of the symptoms and surgical treatment of these lesions, and a case series of 2 adolescents with osteomas impinging on the orbit treated with a multiportal approach. Results Forty-eight cases of osteomas, osteoblastoma, or osteoid osteomas were reviewed from 43 articles. The average age was 14 years, 67% of tumors were osteomas, and 48% were greater than 3 cm in longest dimension. Compared to osteoblastomas, osteomas had a greater male to female ratio (4.3:1; P = .02), presented at older age ( P = .03) with a smaller tumor burden ( P = .003), and had prior trauma or surgery ( P < .001). The ethmoid, frontal, maxillary, and sphenoid sinuses were affected in decreasing order of frequency. A purely endoscopic sinus surgery approach was taken in 31% of cases, open approach in 62% of cases, and combined approach in 7% of cases. Osteoblastoma patients had a 32% rate of recurrence, compared to only 3% among osteoma patients. On univariate logistics regression of patient demographics, tumor characteristics, and surgical approaches predictive of surgical outcomes, only tumor type was predictive of postoperative recurrence (odds ratio: 0.07; 95% confidence interval, 0.007–0.77; P = .029). Conclusion There was no association between surgical approach and postoperative complications or rate of recurrence. However, a transnasal and transorbital multiportal approach avoids facial incisions.

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Anteroinferior Cerebellar Artery Aneurysms: Surgical Approaches and Outcomes—A Review of 34 Cases

Neurosurgery ◽

10.1227/01.neu.0000141083.00866.82 ◽

2004 ◽

Vol 55 (5) ◽

pp. 1025-1035 ◽

Cited By ~ 53

Author(s):

L Fernando Gonzalez ◽

Michael J. Alexander ◽

Cameron G. McDougall ◽

Robert F. Spetzler

Keyword(s):

Cardiac Arrest ◽

Neurological Complications ◽

Cranial Base ◽

Initial Assessment ◽

Definitive Treatment ◽

Surgical Approaches ◽

Unruptured Aneurysms ◽

Giant Aneurysms ◽

Presenting Symptoms ◽

Cerebellar Artery

Abstract OBJECTIVE: Anteroinferior cerebellar artery (AICA) aneurysms are rare lesions whose treatment requires expertise in vascular, endovascular, and cranial base surgery. This article presents the largest series treated at one center. METHODS: We retrospectively analyzed presenting symptoms, aneurysm characteristics, surgical approaches, postoperative outcomes, and the application of endovascular techniques. RESULTS: We found 32 patients with 34 AICA aneurysms (11 men and 21 women; age range, 6–77 yr; mean age, 51 yr). Twenty-one aneurysms had ruptured; 13 were unruptured. Seven of the unruptured aneurysms presented with brainstem compression, and six were found incidentally. Surgical approaches included the retrosigmoid, far-lateral transcochlear, translabyrinthine, and orbitozygomatic. Eighteen patients (56%) had neurological complications. Thirty aneurysms were at proximal locations, and four were distal. Intraoperative hypothermic cardiac arrest was used to clip eight giant aneurysms. Follow-up was available in 56% of the patients for a mean of 41 months. The mean Glasgow Outcome Scale scores at discharge were not significantly different from the patients' status at their initial assessment. CONCLUSION: We recommend the standard retrosigmoid approach for treating small to medium aneurysms involving the lower two-thirds of the clivus or distal AICA aneurysms. Cranial base approaches are recommended for large or giant aneurysms or for those proximal to the emergence of the AICA from the basilar trunk. Hypothermic cardiac arrest facilitates dissection of giant aneurysms. Endovascular treatment is a useful adjunct for treating residual aneurysms but did not provide definitive treatment in any of our patients.

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