Publications by authors named "Andreas Leunig"

Purpose: The current standard endoscopic technique is a high resolution visualisation up to Full HD and even 4 K. A recent development are 3D endoscopes providing a 3-dimensional picture, which supposedly gives additional information of depth, anatomical details and orientation in the surgical field. Since the 3D-endoscopic technique is new, little scientific evidence is known whether the new technique provides advantages for the surgeon compared to the 2D-endoscopic standard technique in FESS.

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Objectives: An increasing proportion of patients who are candidates for endoscopic sinus surgery can be treated as an outpatient. A preoperative risk assessment is needed to evaluate eligibility for day surgery. This study analyses the effectiveness of a risk assessment scoring system which examines medical, procedure-related, and socioeconomic factors.

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Background: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease associated with a substantial personal and socioeconomic burden. Monitoring of patient-reported outcomes by mobile technology offers the possibility to better understand real-life burden of CRS.

Methods: This study reports on the cross-sectional evaluation of data of 626 users of mySinusitisCoach (mSC), a mobile application for CRS patients.

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Background: The endonasal access to the frontal recess and sinus may be complicated by a variety of anatomical variations. Previous classifications of these variants were characterized by proper names or position information without anatomical reference. The IFAC is intended to simplify the classification of anatomical variations of the frontoethmoidal complex.

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Purpose: Most cases of non-traumatic nasal cerebrospinal fluid (CSF) leaks occur spontaneously without any obvious reason. Severe and life-threatening complications are possible consequences. Endoscopic repair is considered the gold standard; however, diagnosis and therapy of these CSF leaks stay challenging.

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Introduction: The basic difference between the various common medical laser systems is the wavelength of the emitted light, leading to altered light-tissue interactions due to the optical parameters of the tissue. This study examines laser induced tissue effects in an in vitro tissue model using 1,470 nm diode laser compared to our standard practice for endonasal applications (940 nm diode laser) under standardised and reproducible conditions. Additionally, in vivo induced tissue effects following non-contact application with focus on mucosal healing were investigated in a controlled intra-individual design in patients treated for hypertrophy of nasal turbinate.

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Article Synopsis
  • The development of endoscopic sinus surgery has sparked renewed interest in the anatomy of the internal nose and paranasal sinuses due to its surgical significance.
  • The European Position Paper aims to redefine the anatomical terms commonly used by endoscopic surgeons and compares them to the official Terminologica Anatomica, highlighting clinical relevance.
  • The paper provides a summarized overview of the anatomical structures relevant to routine endoscopic surgery, acknowledges variations in anatomy, and includes illustrations to support understanding.
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In otorhinolaryngology, dermatology and reconstructive surgery biomaterials as implants and a variety of lasers are used. Laser light applied near to an implant could have the risk to damage these materials. Therefore, their resistance exposed to laser light is of interest.

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Objectives. Hemangiopericytoma is a rare tumor entity deriving from pericytes. Less than 5% of hemangiopericytoma occur in the nasal cavity and are characterised by a rather benign nature with low tendency of metastasis.

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Primary paragangliomas of the paranasal sinuses are very rare conditions with only few cases described in the literature. Paragangliomas are locally aggressive, often recur and can metastasize. Usually, open surgery is used to resect such tumors from the sinonasal tract.

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Background: This study evaluated the capability of optical coherence tomography (OCT) to differentiate premalignant and early malignant lesions of the upper aerodigestive tract (UADT).

Methods: An OCT screening was performed in 52 healthy volunteers. Epithelial thicknesses on 38 OCT images and histopathological slides were correlated.

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Introduction: The need for reduction of post-tonsillectomy hemorrhage has led to promotion of tonsillotomy techniques for tonsil tissue reduction in obstructive tonsillar hypertrophy. This trial compares ablative tissue effects using 1,470 nm diode laser and carbon dioxide laser for tonsillotomy in an intraindividual design.

Methods: 21 children aged 3-13 years (mean age 6.

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Recalcitrant forms of recurrent nasal polyposis are problematic for patients as for rhinosurgeons. In aspirin-sensitive patients, aspirin desensitization is supposed to prevent recurrence by targeting the metabolism of arachidonic acid. Aspirin-sensitive patients (n = 65) following aspirin desensitization after functional endoscopic sinus surgery (FESS) for recurrent nasal polyposis under daily intake of 500-mg aspirin were compared to a post-FESS group (n = 81) of aspirin-sensitive individuals using exclusively topical mometasone.

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Paranasal fungus ball can cause chronic rhinosinusitis. Removal via functional endoscopic sinus surgery is usually performed; however objective data on the overall benefit and patient satisfaction are very scarce. The study focuses on the clinical outcome and the quality of life following endoscopic surgery due to fungus ball sinusitis.

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Objective: The widespread use of image guided surgery in the frontolateral skull base region has been limited by the need for a reliable and non-invasive registration procedure that provides sub-millimetric accuracy. We developed and validated preclinically a non-invasive, easy-to-use registration device based on a dental splint with a laterally mounted fiducial carrier.

Methods: Repeated accuracy measurements were performed on six titanium target fiducials which were screwed into the lateral skull base region of a cadaver head and could be unequivocally identified both on the CT image and in reality.

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Introduction: Various laser systems have been used for volume reduction of hyperplastic nasal turbinates. For endonasal application, fiber controlled diode lasers are preferred over conventional laser systems for reasons of cost and practicability. This study compares coagulative tissue effects using λ = 1,470 nm and λ = 940 nm lasers in treatment of hyperplastic inferior nasal turbinates in an intraindividual manner.

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While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation.

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Background: Fluorescence endoscopy is used for the early detection and delineation of laryngeal cancer and its precursor lesions. No systematic review of these promising imaging techniques has yet been performed.

Methods: A systematic review of the published literature and meta-analysis of data extracted from 16 included studies were performed.

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The complete surgical removal of disease is a desirable outcome particularly in oncology. Unfortunately much disease is microscopic and difficult to detect causing a liability to recurrence and worsened overall prognosis with attendant costs in terms of morbidity and mortality. It is hoped that by advances in optical diagnostic technology we could better define our surgical margin and so increase the rate of truly negative margins on the one hand and on the other hand to take out only the necessary amount of tissue and leave more unaffected non-diseased areas so preserving function of vital structures.

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The ossifying fibroma is a fibro-osseous lesion that rarely occurs in the paranasal sinuses. Due to its tendency to behave locally aggressively, complete resection is generally recommended. A subdivision into the aggressive juvenile ossifying fibroma (JOF) and the less aggressive cemento-ossifying fibroma of the adult (COF) is clinically reasonable.

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Osteomas are among the most common benign tumors of the paranasal sinuses. Symptomatic osteomas are most often found in the frontal recess and the frontal sinus. While the extranasal approach is still a part of the treatment concept for removing osteomas at this localization, over the last years the endoscopically controlled endonasal approach has greatly gained in importance due to the improved surgical equipment.

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