Anatomical comparison of minimally invasive nasal valve procedures.

Objective: To determine the quantitative effects of Z-plasty vs spreader grafts on nasal valve surface area.

Methods: Eight fresh cadaver heads were used that provided 16 total nasal valve procedures. Surgical sides were randomized, and Z-plasty was performed on 8 valves and endonasal spreader grafts were performed on 8 valves.

Middle turbinate suture conchopexy during endoscopic sinus surgery does not impair olfaction.

Background: One of the primary goals of endoscopic sinus surgery (ESS) is to create widely patent paranasal sinus ostia, and lateralization of a middle turbinate (MT) after ESS can obstruct otherwise patent ethmoid and maxillary sinuses. Numerous methods have been used to assist in the avoidance of this complication including the use of packing in the ethmoid sinus as a "spacer," controlled creation of synechia between the MT and septum, and suture medialization of the MT to the septum. The latter is an effective technique, but because the olfactory groove lies superior in the groove between the MT and septum, concerns have been raised as to the effect of this maneuver on olfaction.

Endoscopic transnasal transethmoid ligation of the anterior ethmoid artery.

Background: The current otolaryngologic literature is lacking in basic science investigation regarding endoscopic anterior ethmoid artery (AEA) ligation as part of the armamentarium for epistaxis control. This investigation provides the anatomic rationale for endoscopic ligation of the AEA in the surgical treatment of epistaxis. In addition, it provides tools for identification of this vessel during routine endoscopic sinus surgery.

Intranasal Z-plasty for internal nasal valve collapse.

Objective: To describe the technique of intranasal Z-plasty and early results for this minimally invasive method to repair internal nasal valve collapse. Intranasal Z-plasty has been well described for nasal valve stenosis and cleft nasal deformities but poorly described for idiopathic nasal valve collapse, the most common indication for nasal valve surgery.

Design: A retrospective medical record review was performed for 12 patients undergoing intranasal Z-plasty for nasal valve collapse.

Concurrent endoscopic sinus surgery and rhinoplasty.

Background: Concerns over increased surgical risk and associated complications have been reported regarding concurrent endoscopic sinus surgery (ESS) and rhinoplasty procedures. The aim of this study was to evaluate the overall safety of these concurrent procedures in our experience.

Methods: A chart review was performed on 48 consecutive patients undergoing concurrent ESS and rhinoplasty between January 1998 and January 2005 with a mean follow-up of 12 months.

Platelet gel for endoscopic sinus surgery.

Objectives: New techniques are being utilized to improve outcomes for endoscopic sinus surgery, including newer forms of packing. Platelet gel is an innovative technique that holds many advantages, including comfort, hemostasis, and growth factors that may improve wound healing. This report discusses the theoretical advantages of this packing material and describes the initial results in a cohort of patients who underwent endoscopic sinus surgery.

The effect of endoscopic sinus surgery on symptoms of eustachian tube dysfunction.

Background: The symptom of eustachian tube dysfunction has been categorized as a "minor" symptom in chronic rhinosinusitis. The aim of this pilot study was to determine the frequency of otologic symptoms in patients with confirmed rhinosinusitis and the likelihood of its resolution in those patients undergoing endoscopic sinus surgery (ESS).

Methods: Questionnaires were obtained from 168 patients who had undergone prior ESS over a 5-year period.

Metastatic cancer to the floor of mouth: the lingual lymph nodes.

Background: The upper level of a cervical lymphadenectomy is anatomically defined at its anterior extent by the lower border of the mandible and, in surgical practice, by the lingual nerve. A neck dissection completed below this level is generally considered adequate for removal of lymph nodes at risk for metastases from oral cavity cancer. Traditional discontinuous neck dissections do not provide for removal of floor of mouth tissue along with the primary and neck specimens.