The present multicentered study of endoscopic stapes surgery demonstrates similar audiometric and postoperative outcomes previously published in the literature, with a median postoperative air-bone gap of 9.0 dB HL. Future prospective endoscopic stapes surgery studies, addressing the need for scutum removal, postoperative taste changes, and pain scores, are merited.
Resumo
Objetivos Os objetivos deste estudo foram caracterizar melhor o papel da liberação endoscópica do túnel cubital na neurite hansênica e determinar se há melhora da dor, sensibilidade e força com esta técnica minimamente invasiva.
Métodos Um total de 44 procedimentos endoscópicos para descompressão do nervo ulnar no cotovelo foram realizados em pacientes previamente diagnosticados com neurite por hanseníase. Os critérios de inclusão foram indicação cirúrgica para liberação do nervo ulnar e insucesso do tratamento clínico por 4 semanas em pacientes com síndrome do túnel cubital que sofreram deterioração progressiva da função motora ou sensitiva do nervo ulnar apesar do tratamento de 1 mg/kg/dia de prednisona e fisioterapia. A liberação endoscópica foi realizada com CTS Relief Kit (Linvatec. Largo, FL, EUA) e um artroscópio padrão de 4 mm e 30°.
Resultados O estudo incluiu 39 pacientes, sendo 29 (74,4%) homens e 10 (25,6%) mulheres. A idade dos pacientes variou de 12 a 64 anos (33 ± 14,97). Cinco pacientes foram submetidos à liberação bilateral. A liberação provocou melhora estatisticamente significativa de dor (p = 0,002), sensibilidade (p <0,001) e força (p <0,001). Os melhores resultados foram obtidos quando a liberação ulnar foi realizada em menos de 6 meses após a indicação da cirurgia. Nenhum procedimento foi convertido de endoscópico para aberto. Não foram relatadas complicações maiores (infecção, lesão vascular e lesão nervosa). Um paciente apresentou subluxação do nervo ulnar.
Conclusão A liberação endoscópica do nervo ulnar no cotovelo na neurite hansênica traz benefícios verdadeiros e seguros para o paciente, como melhora da dor, sensibilidade e força.
Objectives: Cochlear implant is traditionally performed using a mastoidectomy, posterior tympanotomy and cochleostomy using a surgical microscope. Because of the anatomical and physiological understanding of the mastoid cells and their role in maintaining ventilation and pressure equalization in the middle ear, and the possible risk of facial nerve injury, some techniques without mastoidectomy and without posterior tympanotomy have been introduced as an alternative approach, showing excellent results. The aim of the study was to describe totally endoscopic technique without mastoidectomy in 6 patients with bilateral profound hearing loss who underwent cochlear implantation from January 2012 to February 2013, showing its viability and the advantages and disadvantages. Methods: All cases were selected based on computed tomography, magnetic resonance, audiological tests and psychological evaluation. Surgical steps, intra- and postoperative complications were analyzed. Each procedure duration was recorded. Surgical procedure was described step by step focusing on the anatomy of the round window (RW) niche. Results: The mean duration of the procedure was 62 minutes. No facial nerve injury was observed. All cases showed a normal RW conformation and endoscopic cochleostomy was conducted. No difficult insertion of the IC electrode was observed. The longest follow-up is 2 years. No postoperative complications were observed in this series. Conclusions: Totally endoscopic cochlear implantation is safe and allows a direct approach to the RW and cochlea. A larger series is paramount to evaluate its total benefits and may represent a breakthrough in the ongoing process of developing scientific knowledge.
Objective
Describe a reliable anatomical landmark that can be used to locate the maxillary sinus natural ostium (MSNO) during endoscopic surgery, even if the uncinate process is preserved.
Design
Descriptive anatomical.
Setting
An anatomical and radiological study was performed to evaluate the consistency of the landmark, denominated "M" line.
Subjects and Methods
Dissections were performed in 57 cadaver heads (114 sides). In addition, 73 computerised tomography (CT) scans (146 sides) of patients with chronic inflammatory sinonasal disease were analysed using a three‐dimensional (3D) reconstruction computer program.
Results
The "M" line crossed the MSNO in 112 dissected sides (98.2%) and 140 sides at CT 3D reconstruction (95.9%).
Conclusion
The "M" line is a reliable anatomical landmark for predicting MSNO location. As such, it could improve and facilitate endoscopic sinus surgery, using traditional, minimally invasive or uncinate preserving techniques.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.