Creation of a Novel Preoperative Imaging Review Acronym to Aid in Revision Endoscopic Sinus Surgery.

Objectives: (1) Identify anatomic contributions to chronic rhinosinusitis (CRS) necessitating revision endoscopic sinus surgery (RESS). (2) Create a clinical acronym to guide imaging review prior to RESS that addresses pertinent sites of disease and potential sites of surgical morbidity.

Data Sources: Ovid MEDLINE, Embase and Medline via Embase.

Compartmentalization: An Open Technique for Frontal Sinus Repair and Preservation-Description of Technique and Early Case Series.

 Cranialization or obliteration is widely accepted intervention for traumatic or intentional breach of the frontal sinus. These techniques, however, result in the loss of frontal sinus function and have a persistent risk of cerebrospinal fluid (CSF) leak and mucocele. Compartmentalization is an open technique for repair of the frontal sinus using allograft onlay and a vascularized periosteal flap that allows for preservation of frontal sinus function.

Topical antibiotic therapy in chronic rhinosinusitis: an update.

Background: Topical antibiotic therapies have been investigated for their use in chronic rhinosinusitis (CRS). However, society guidelines and evidence-based medicine reviews have recommended against the use of topical antibiotic therapy based on randomized controlled trials (RCTs). The purpose of this article is to review recent clinical research published since the aforementioned guidelines were published.

Sinonasal malignancies: Endoscopic treatment outcomes.

Sinonasal malignancies are rare and heterogeneous cancers located adjacent to critical neurovascular structures. Proximity to the orbit, brain, cranial nerves, and carotid arteries make surgical resection technically challenging and potentially morbid. The gold standard surgical procedure for these cancers has traditionally been the open craniofacial resection.

Draf IIB with superior septectomy: finding the "middle ground".

Background: Previous studies have demonstrated a high failure rate of endoscopic sinus surgery (ESS) with Draf IIa in patients with diffuse polyposis, asthma, and aspirin-exacerbated respiratory disease. A high percentage of these patients progress to endoscopic modified Lothrop procedure (EMLP). We describe a modification of the Draf IIb with a superior septectomy (IIb+SS), which may provide similar therapeutic benefit as demonstrated by the distribution of sinus irrigations in the sinus cavity with ESS with IIb+SS vs ESS with EMLP.

Socioeconomic Factors Affecting Discharge Status of Patients with Uncomplicated Transsphenoidal Adenohypophysectomy.

 The number of transsphenoidal adenohypophysectomies (TSAs) surgeries has grown significantly since 1993. While there has been an overall decreasing trend in length of stay (LOS), socioeconomic factors may impact hospitalization. This study explores the impact of socioeconomic factors on LOS and total charges in uncomplicated patients undergoing TSA.

The impact of video nasal endoscopy on patient satisfaction.

Background: Video nasal endoscopy has significant associated expense for practices, but its use has been justified by the benefit it provides to the examiner. No study has examined the perceived benefit to the patient. In this study, the impact of video endoscopy on patient satisfaction is evaluated.

Assessing the clinical applicability of prior head imaging in patients with chronic rhinosinusitis.

Background: Patients often have received some modality of head imaging prior to being evaluated for chronic sinonasal complaints, and the clinical significance of these scans on current sinonasal symptomatology is unknown.

Methods: We performed a retrospective, cohort study of 578 patients with chronic sinonasal indications for maxillofacial computed tomography scans (CTs) in 2016. Patients were included if previous head cross-sectional imaging had been performed.

Morphometric Analysis of the Middle Clinoid Process Using Maxillofacial Computed Tomography Scans.

Background: The interest in detailed anatomy of the sella and parasellar regions has resurged recently due to the wide clinical applications of the expanded endoscopic approaches to the skull base. The middle clinoid process (MCP) is a bony structure that can affect wide endoscopic exposure of the sella and parasellar region.

Objective: To study and analyze the anatomic variations of the MCP in the general population using computed tomography scans.

Outcomes of HPV-related nasal squamous cell carcinoma.

Background: Human papilloma virus (HPV) infection has been shown to play an integral role in the development and prognosis of various head and neck cancers. Generational changes in sexual behavior may have led to an increased incidence of positivity in recent years. HPV positivity in both benign and malignant lesions of the sinonasal cavities has been shown in previous studies (estimates range from 20%-30% for malignancy).

Three-Dimensional Printed Model Used to Teach Skull Base Anatomy Through a Transsphenoidal Approach for Neurosurgery Residents.

Background: Skull base anatomy through a transsphenoidal approach is challenging for the neurosurgical resident to conquer.

Objective: To demonstrate that stereolithography, or 3-dimensional (3-D) printing, is a useful educational tool for neurosurgery residents to learn skull base anatomy.

Methods: Before any formal teaching, residents were brought into the operating room where they were asked to identify key structures seen through an endoscopic transsphenoidal approach.

Surgical management of rhinosinusitis in endoscopic-endonasal skull-base surgery.

Background: Endoscopic-endonasal skull base surgery (ESBS) provides an important approach to select pathologies. There remains a paucity of data, however, regarding morbidity in patients undergoing ESBS with comorbid acute rhinosinusitis (ARS), a fungal ball (FB), or chronic rhinosinusitis (CRS).

Methods: A retrospective database review between January 2008 and January 2013 identified 35 patients with concurrent skull-base pathology and refractory ARS, FB, CRS, and CRS with nasal polyposis (CRSP) who underwent endoscopic sinus surgery (ESS) and ESBS.

Comprehensive management of the paranasal sinuses in patients undergoing endoscopic endonasal skull base surgery.

Objective: The endonasal route often provides the most direct and safe approach to skull base pathology. In this article we review the literature with regard to management of the paranasal sinuses in the setting of skull base surgery.

Methods: We describe our institutional experience and review the literature of concurrent management of the sinusitis in patients undergoing endoscopic skull base surgery.

Endoscopic endonasal craniopharyngioma resection.

The authors present the case of a 21-year-old female with a progressive bitemporal hemianopsia. Cranial MR imaging revealed a large cystic suprasellar, retrochiasmatic lesion consistent with craniopharyngioma. The lesion was fully resected through an endoscopic endonasal transsphenoidal and transplanum approach.

Endoscopic endonasal craniopharyngioma resection.

The authors present the case of a 21-year-old female with a progressive bitemporal hemianopsia. Cranial MR imaging revealed a large cystic suprasellar, retrochiasmatic lesion consistent with craniopharyngioma. The lesion was fully resected through an endoscopic endonasal transsphenoidal and transplanum approach.

Retro-auricular video-assisted "gasless" thyroidectomy: feasibility study in human cadavers.

Background: In recent years, there has been a surge of interest in developing alternative surgical approaches to the thyroid gland with a focus on cosmesis. Approaches can be either complete endoscopic approaches using CO(2) insufflation or endoscopy-assisted approaches. We describe a novel approach for thyroidectomy via a retro-auricular incision without gas insufflation using endoscopic assistance.

Surgical approaches to the submandibular gland: a review of literature.

Objectives: Surgical excision of the submandibular gland (SMG) is commonly indicated in patients with neoplasms, and non-neoplastic conditions such as chronic sialadenitis, sialolithiasis, ranula and drooling. Traditional SMG surgery involves a direct transcervical approach. In the recent past, alternative approaches to SMG excision have been described in effort to offer minimally invasive options or better cosmetic results.