Cone-beam computed tomography is gaining popularity worldwide due to an increasingly diffuse and affordable in-office availability. It is becoming more commonplace for rhinoplasty surgeons to utilize this imaging as tool for preoperative assessment, however there is inconsistency among radiologists commenting on specific structures of the nose or nasal cavity as there is currently no standardized reporting protocol. The goal of this paper is to present clear guidelines for radiologists to report relevant nasal anatomy in the context of preoperative rhinoplasty evaluation.
We have proposed the RhinoCEROS Guidelines, which stands for:
• Rhinoplasty Cephalometric Evaluation for Radiologic pre-Operative Systematization.
This guideline highlights the primary aspects of nasal anatomy on computed tomography(CT) that affect rhinoplasty outcomes and will provide radiologists with a straight forward template for reporting this increasingly popular use for CT scan.
Introduction Tumors of the lateral skull base often require collaboration between neurosurgeons and neurotologists for the surgical approach. The three main transosseous surgical approaches are retrosigmoid (RS), translabyrinthine (TL), and middle fossa (MF). The literature reflects a relative paucity regarding the various closure techniques for these approaches and the postoperative complications. We have performed a systematic review comparing closure techniques from each approach.
Methods A systematic review was performed using Ovid MEDLINE (1990–2016) on closure technique and postoperative complications for patients undergoing lateral skull base surgery via the TL, RS, or MF approach. Studies were included if they contained at least 10 patients, described their closure technique, and provided data on postoperative complications.
Results A total of 1,403 studies were reviewed. Of these, 53 studies met inclusion criteria yielding a total of 10,466 subjects in this analysis. The average rate of cerebrospinal fluid leak was 5.3% in the TL approach, 9% in the RS approach, and 6.2% in the MF approach. There was no significant effect of various closure techniques on postoperative wound complications in the MF approach. Multiple factors were identified which affected postoperative wound complication in the RS and TL approaches.
Conclusion There are a plethora of closure techniques for lateral skull base surgery. Several techniques were identified in this review that may affect the postoperative wound complication rates in lateral skull base surgery.
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