Anterior superior alveolar nerve injury after extended endoscopic medial maxillectomy: a preclinical study to predict neurological morbidity

Schreiber, Alberto; Mattavelli, Davide; Ferrari, Marco; Rampinelli, Vittorio; Lancini, Davide; Ravanelli, Marco; Bertazzoni, Giacomo; Rodella, Luigi Fabrizio; Buffoli, Barbara; Doglietto, Francesco; Nicolai, Piero

doi:10.1002/alr.22001

Cited by 25 publications

(14 citation statements)

References 18 publications

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“…The resection can also cause facial deformity. However, we did not experience this complication when using EMMM in the present study because we kept the pyriform aperture to preserve the neural anastomotic network around the anterior superior alveolar nerve (ASAN), to which the middle and posterior superior alveolar nerves run from laterally and the septal plexus and palatal plexus run from medially, running into the pyriform aperture 33 . We used a chisel instead of a drill to start the osteotomy at the conchal crest of the maxillary body to separate the inferior turbinate from it, thus preventing the nerve from being damaged by the heat of the drill.…”

Section: Discussionmentioning

confidence: 99%

Prelacrimal approach vs conventional surgery for inverted papilloma in the maxillary sinus

et al. 2020

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Background: The prelacrimal approach, termed endoscopic modified medial maxillectomy (EMMM), has recently been applied for treatment of inverted papilloma (IP) in the maxillary sinus. EMMM provides wider access to the maxillary sinus while preserving the inferior turbinate and nasolacrimal duct. Methods: We reviewed patients with IP in the maxillary sinus to compare the surgical results obtained by conventional surgery (ie, endoscopic maxillary sinus antrostomy or in combination with the Caldwell-Luc approach) with those obtained by EMMM. Results: All patients had a T3 on the Krouse staging system, and the average follow-up time was 46.0 months. Of the 18 patients in the conventional group, recurrence was seen in 3 patients (16.6%). No recurrence was seen in the 27 patients who showed preservation of the inferior turbinate and nasolacrimal duct, and no complications occurred in the EMMM group. Conclusions: EMMM is an effective surgical approach that reduces recurrence with fewer complications.

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Section: Discussionmentioning

confidence: 99%

Prelacrimal approach vs conventional surgery for inverted papilloma in the maxillary sinus

et al. 2020

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“…This might also reduce the chance to damage the ASAN and its anastomotic network. 21 Future studies are needed to evaluate this assumption. Sixth, the relocation of the medial wall can be obtained only with nasal packing in most of the cases.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Endonasal Prelacrimal Approach: Radiological Considerations, Morbidity, and Outcomes

et al. 2020

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This study describes a multicentric experience with the use of prelacrimal approach (PLA), focusing on preoperative radiological parameters potentially associated with surgical outcomes and postoperative morbidity.Study Design: Retrospective case-series. Methods: A retrospective review of patients undergoing PLA in three European referral centers was performed. The post-operative morbidity was analyzed in relation to two radiological parameters: width of prelacrimal recess (WPR) and internal angle of pyriform notch (APN).Results: The study included 28 patients affected by Schneiderian papilloma (20 cases), inflammatory disease (6 cases), schwannoma (1 case), and osteoma (1 case). The most reported sequela was paresthesia of ipsilateral anterior superior alveolar process (25% of the cases). An association between post-operative morbidity and APN was observed (P = .047).Conclusions: Preoperative radiological evaluation of WPR is crucial in understanding the feasibility of the approach, while APN measurement may predict postoperative morbidity, which is paramount in the patients' counseling.

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“…[18][19][20][21][22] Deep surfaces of the surgical corridor were tracked by drawing with a navigated probe the perimeter of the exposed portion of the prevertebral space (for anterior approaches) or lateral pharyngeal wall (for lateral approaches). The quantification method has been previously validated by our group for quantification of skull base approaches.…”

Section: Quantificationmentioning

confidence: 99%

“…The quantification method has been previously validated by our group for quantification of skull base approaches. [18][19][20][21][22] Deep surfaces of the surgical corridor were tracked by drawing with a navigated probe the perimeter of the exposed portion of the prevertebral space (for anterior approaches) or lateral pharyngeal wall (for lateral approaches). Superficial surfaces of the surgical corridor were tracked at the pyriform, oral, and skin apertures for transnasal, transoral, and lateral approaches, respectively.…”

Section: Quantificationmentioning

confidence: 99%

Surgical anatomy of the parapharyngeal space: Multiperspective, quantification‐based study

et al. 2018

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Background Several surgical approaches to the parapharyngeal space (PPS) have been proposed. An objective description of advantages and limitations of the surgical routes is lacking. Methods Ten cadaver heads were dissected using the transnasal (medial, lateral), sublabial, transoral (transpharyngeal, transvestibular, transmandibular), transcervical (transcervical, transparotid, transmandibular, transmastoid), and type C and D infratemporal approaches. Neurovascular and musculoskeletal structures encountered were analyzed. A navigation‐based quantification of working volume and exposure of PPS compartments was accomplished. Results Transnasal approaches exposed the upper PPS, though with limited working volume. Transoral approaches exposed the middle PPS, minimizing neurovascular structures crossed. Only transcervical and skull base approaches exposed the entire PPS, crossing several neurovascular structures. Conclusion A tentative systematization of the surgical approach(es) to PPS in relation to different targets is provided: unicompartmental resection can be performed with a single, conservative access, whereas multicompartmental dissections frequently require a wider or multiportal approach.

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Anterior superior alveolar nerve injury after extended endoscopic medial maxillectomy: a preclinical study to predict neurological morbidity

Cited by 25 publications

References 18 publications

Prelacrimal approach vs conventional surgery for inverted papilloma in the maxillary sinus

Prelacrimal approach vs conventional surgery for inverted papilloma in the maxillary sinus

Endoscopic Endonasal Prelacrimal Approach: Radiological Considerations, Morbidity, and Outcomes

Surgical anatomy of the parapharyngeal space: Multiperspective, quantification‐based study

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