In Vivo Laser Tissue Welding in the Rabbit Maxillary Sinus

2008 ◽  
Vol 22 (6) ◽  
pp. 625-628 ◽  
Author(s):  
Benjamin S. Bleier ◽  
James N. Palmer ◽  
Michael A. Gratton ◽  
Noam A. Cohen
Keyword(s):  
Intracranial Pressure ◽  
Maxillary Sinus ◽  
Skull Base ◽  
Thermal Injury ◽  
Surrounding Tissue ◽  
Csf Leak ◽  
Tissue Welding ◽  
Laser Tissue Welding ◽  
And Control

Background One of the challenges in the current expansion of endoscopic sinonasal surgery is the ability to adequately reconstruct the skull base. Laser tissue welding (LTW) uses laser energy coupled to a biological solder to produce tissue bonds with burst thresholds exceeding human intracranial pressure. This technology could be used to reduce the rate of postoperative cerebrospinal fluid (CSF) leak. We performed this study to determine whether LTW can create durable tissue bonds in sinonasal mucosa that support normal wound healing and produce minimal collateral thermal injury. Methods Bilateral maxillary sinus mucosal incisions were made in 20 New Zealand white rabbits and one side was repaired using LTW. Burst pressure thresholds were measured on postoperative days 0, 5, and 15 and were compared with control using a two- way ANOVA and a post hoc Tukey test. Welds were examined histologically for thermal injury, inflammation, and fibroplasia and graded on a 4-point scale by three blinded observers. Results The burst pressures of the LTW group were significantly higher than control on postoperative day 0 (120.85 mm Hg, N = 4, SD = 47.84 versus 7.85 mm Hg, N = 4, SD = 0.78), and day 5 (132.56 mm Hg, N = 8, SD = 24.02 versus 41.7 mm Hg, N = 8, SD = 7.2; p < 0.05). By postoperative day 15 there was no significant difference between LTW (169.64 mm Hg, N = 8, SD = 18.49) and control (160.84 mm Hg, N = 8, SD = 14.16) burst thresholds. There was no evidence of thermal injury to the surrounding tissue in any group as well as no difference between experimental group and control with respect to inflammation or fibroplasia. Conclusion This is the first in vivo study showing that LTW is capable of producing tissue bonds exceeding human intracranial pressure with negligible thermal injury in sinonasal tissue. Welding can be performed endoscopically using a fiberoptic cable and may be useful in CSF leak and skull base repair.

Pneumocephalus and CSF leak secondary to skull base fracture by pyrotechnical object: case report

2021 ◽  
Vol 3 (3) ◽  
Author(s):  
Marcos Vilca ◽  
◽  
Carlos Palacios ◽  
Sofía Rosas ◽  
Ermitaño Bautista ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Skull Base ◽  
Rare Complication ◽  
Cerebrospinal Fluid Leak ◽  
Standing Position ◽  
Csf Leak ◽  
Skull Base Fracture ◽  
Timely Diagnosis ◽  
The Right

Introduction: Pneumocephalus is mainly associated with traumatic injuries, being a rare complication but with high mortality rates; it behaves like a space-occupying lesion and increases intracranial pressure. The symptoms are not specific, but in the event of trauma it is necessary to suspect this entity to carry out a timely diagnosis and treatment, since being the product of the skull base fracture it can cause communication with the outside, and the appearance of cerebrospinal fluid (CSF) leak. Clinical Case: a 38-year-old male patient who suffers trauma from a pyrotechnic explosion near his right ear, when handling a pyrotechnic object (whistle) during the New Year, presenting severe pain, slight bleeding in the right ear, feeling faint and holocranial headache that increased in a standing position; likewise, he presents high-flow aqueous secretion (CSF) from the right ear. Brain and skull base tomography (CT) showed air in the intracranial cavity, fracture of the skull base, and the ossicles of the right middle ear. Conservative management was performed using rest and lumbar drainage, presenting a satisfactory evolution. Conclusion: Pneumocephalus is a frequent and expected complication of trauma with a skull base fracture. Its early and timely diagnosis using skull base CT is essential to define therapeutic measures. Accidents due to the misuse of pyrotechnics continue to be a relevant problem in our country. Knowing and disseminating its consequences can help raise awareness in the population. Keywords: Pneumocephalus, Skull Base, Intracranial Pressure, Cerebrospinal Fluid Leak. (Source: MeSH NLM)

NIR-laser tissue welding in an in vivo guinea pig animal model

2008 ◽  
Author(s):  
Vidyasagar Sriramoju ◽  
Howard E. Savage ◽  
A. Katz ◽  
Rahul Chakraverty ◽  
Yuri Budansky ◽  
...  
Keyword(s):  
Animal Model ◽  
Guinea Pig ◽  
Tissue Welding ◽  
Laser Tissue Welding ◽  
Pig Animal Model ◽  
Nir Laser

Use of Radiofrequency Technology in Endonasal Skull Base and Transcranial Procedures

2021 ◽  
Author(s):  
Shahed Tish ◽  
Ghaith Habboub ◽  
Hamid Borghei-Razavi ◽  
Troy D. Woodard ◽  
Raj Sindwani ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Skull Base ◽  
Potential Benefit ◽  
Thermal Injury ◽  
Chemical Interaction ◽  
Surrounding Tissue ◽  
Tissue Destruction ◽  
Endoscopic Endonasal ◽  
Safe Technique ◽  
Transcranial Surgery

AbstractObjective Radiofrequency ablation is widely utilized in otorhinolaryngology. It is used for ablation, coagulation and resection, and hemostasis. It causes tissue destruction through a chemical interaction of ions. The potential benefit is to cause less thermal injury to surrounding tissues compared with other coagulative tools. In this article, we present novel uses of radiofrequency ablation in endoscopic endonasal, and transcranial surgery. This is the first study to describe its use in transcranial cases.Design, Setting, and Participants This is a retrospective study of patients between 2016 and 2018 who underwent either endoscopic endonasal or transcranial surgery where radiofrequency ablation was used.Main Outcome Measures We looked at indication for usage, blood loss, postoperative imaging to identify any stroke or edema, and clinical outcomes of these patients.Results The radiofrequency device was used in eight endoscopic endonasal cases and four craniotomies. Four cases were for encephalocele repair and eight were for various intracranial pathologies. In endonasal encephalocele repair, the radiofrequency ablation helped in shrinking the herniated brain while minimizing thermal injury to the surrounding tissue. In tumors resection, the combination of ablation and coagulation effect was particularly effective for highly vascularized tumors. There were no vascular or major neurologic injuries. Postoperative periencephalocele edema was noted in one case.Conclusion Initial experience with radiofrequency ablation showed that it was a safe technique to use in both endonasal skull-base and transcranial procedures. It seemed particularly useful for highly vascularized tumors but a greater experience is needed to further clarify its role in these procedures.

Expanded Endonasal Approach for Resection of Extradural Infratemporal Fossa Trigeminal Schwannoma: 2-Dimensional Operative Video

2020 ◽  
Vol 19 (4) ◽  
pp. E396-E397
Author(s):  
Karam Asmaro ◽  
Jack Rock ◽  
John Craig
Keyword(s):  
Maxillary Sinus ◽  
Skull Base ◽  
Infratemporal Fossa ◽  
Posterior Wall ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Foramen Ovale ◽  
Nasoseptal Flap ◽  
Carotid Canal ◽  
Expanded Endonasal Approach

Abstract The infratemporal fossa (ITF) is bounded superiorly by the skull base, specifically the greater wing of the sphenoid, which contains foramen ovale. It is bordered posteriorly by the temporal bone, including the petrous portion of the carotid canal, anteriorly by the posterior wall of the maxillary sinus, laterally by the mandible, and medially by the pterygoid body and lateral pterygoid plate.1-3 In this video, we report a case of a rare, exclusively extradural, schwannoma originating from the third division of the trigeminal nerve with a widened foramen ovale at the skull base. The tumor filled the ITF and extended laterally just through the sigmoid notch of the mandible. The patient complained of left cheek and lower jaw numbness and intermittent left jaw spasms. The tumor was deemed appropriate for endoscopic resection. To access the ITF, left-sided endoscopic sinus surgery, a modified endoscopic Denker's approach,4 and posterior nasal septectomy were first performed. A nasoseptal flap was also harvested in case an intraoperative cerebrospinal fluid (CSF) leak required repair. Dissection was carried out through the posterior wall of the maxillary sinus and pterygopalatine fossa to reach the ITF. Tumor resection was achieved through a 2-surgeon, 4-handed approach in which appropriate traction and countertraction were carefully applied to tease the tumor away from the skull base and dehiscent carotid canal. No CSF leak or carotid injury occurred, and the posterior maxillary sinus wall defect was repaired with the nasoseptal flap. The patient did well postoperatively. The patient consented to the procedure in a standard fashion.

Prophylaxis and Treatment of CSF Leak in Endonasal Skull Base Surgery

2014 ◽  
Vol 75 (S 02) ◽  
Author(s):  
B. Pashaev ◽  
D. Bochcarev ◽  
V. Krasnazhen ◽  
V. Danilov ◽  
A. Alekseev ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Csf Leak

Effect of in Vivo Oxidized Cellulose on in Vitro Growth of Human Respiratory Mucosa and Sub-mucosa During Endoscopic Skull Base Approaches

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Ezequiel Goldschmidt ◽  
Jorge Rasmussen ◽  
Joseph Chabot ◽  
Monica Loressi ◽  
Marcelo Ielpi ◽  
...  
Keyword(s):  
Skull Base ◽  
Oxidized Cellulose ◽  
In Vitro Growth ◽  
Respiratory Mucosa

Experimental Study of the Impact of Alisma plantago-aquatica Secretions on Pathogenic Bacteria

2014 ◽  
Vol 1 (3) ◽  
pp. 3-7
Author(s):  
O. Zhukorskyy ◽  
O. Hulay
Keyword(s):  
Pathogenic Bacteria ◽  
Initial Density ◽  
Biologically Active ◽  
Erysipelothrix Rhusiopathiae ◽  
Natural Focus ◽  
Test Species ◽  
Popula Tions ◽  
And Control ◽  
The Impact

Aim. To estimate the impact of in vivo secretions of water plantain (Alisma plantago-aquatica) on the popula- tions of pathogenic bacteria Erysipelothrix rhusiopathiae. Methods. The plants were isolated from their natural conditions, the roots were washed from the substrate residues and cultivated in laboratory conditions for 10 days to heal the damage. Then the water was changed; seven days later the selected samples were sterilized using fi lters with 0.2 μm pore diameter. The dilution of water plantain root diffusates in the experimental samples was 1:10–1:10,000. The initial density of E. rhusiopathiae bacteria populations was the same for both experimental and control samples. The estimation of the results was conducted 48 hours later. Results. When the dilution of root diffusates was 1:10, the density of erysipelothrixes in the experimental samples was 11.26 times higher than that of the control, on average, the dilution of 1:100 − 6.16 times higher, 1:1000 – 3.22 times higher, 1:10,000 – 1.81 times higher, respectively. Conclusions. The plants of A. plantago-aquatica species are capable of affecting the populations of E. rhusiopathiae pathogenic bacteria via the secretion of biologically active substances into the environment. The consequences of this interaction are positive for the abovementioned bacteria, which is demon- strated by the increase in the density of their populations in the experiment compared to the control. The intensity of the stimulating effect on the populations of E. rhusiopathiae in the root diffusates of A. plantago-aquatica is re- ciprocally dependent on the degree of their dilution. The investigated impact of water plantain on erysipelothrixes should be related to the topical type of biocenotic connections, the formation of which between the test species in the ecosystems might promote maintaining the potential of natural focus of rabies. Keywords: Alisma plantago-aquatica, in vivo secretions, Erysipelothrix rhusiopathiae, population density, topical type of connections.

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