Publications by authors named "Joao Flavio Nogueira"

 The endoscopic anatomy of the middle ear (ME) and of the external acoustic meatus (EAM) has been described in cadavers, in fresh temporal bones, or in vivo using conventional video recording, but not in dry bones or using an alternative inspection and recording technique.  To study the anatomy of the ME and of the EAM in dry temporal bones using a smartphone-endoscope system.  The EAM and the ME were studied in dry temporal bones using an endoscopic transcanal approach with a telescope connected to a smartphone (M-scope mobile endoscope app and adaptador, GBEF Telefonia, São Paulo, SP, Brazil).

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Objective: To investigate the influence of the COVID-19 pandemic on operative practices of otology and neurotology providers internationally.

Study Design: Cross-sectional survey.

Methods: A 78-question survey was distributed to otologists and neurotologists between May 12, 2020 and June 8, 2020 to assess the impact of the pandemic on surgical practices.

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Endoscopic ear surgery has gained popularity in recent years, becoming standard practice in otology centers around the world as an adjunct to conventional microscopic surgery and as a sole tool for limited disease. During the last years, technical improvements and growing expertise in the handling of the endoscope allowed introducing an exclusive endoscopic approach to the middle ear, lateral skull base, middle cranial fossa, and posterior fossa/cerebellopontine angle pathologies. Endoscopic instrumentation, techniques, and knowledge have improved during the last few years, and in the future, endoscopic surgical techniques will gain even more importance in otologic surgery.

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Purpose: Otolaryngologists have had to postpone the majority of surgical procedures in the current COVID-19 pandemic. Airborne transmission, beyond the projection of droplets from upper airways, expose healthcare workers to a risk of viral infection. Aerosol generating procedures (AGP) increase the risk of viral transmission to staff within the operating room.

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Objectives: This article reviews the advantages and disadvantages of endoscopic ear surgery (EES).

Method: Pubmed, Google and the Proquest Central Database at Kırıkkale University were queried using the keywords "endoscopic ear surgery", "ear surgery" and "endoscopy" to identify the literature needed for the review.

Results: Endoscopes allow for enhanced surgical visualisation.

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Objective: Describe a reliable anatomical landmark that can be used to locate the maxillary sinus natural ostium (MSNO) during endoscopic surgery, even if the uncinate process is preserved.

Design: Descriptive anatomical.

Setting: An anatomical and radiological study was performed to evaluate the consistency of the landmark, denominated "M" line.

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Primary spontaneous cerebrospinal fluid (CSF) rhinorrhea is an unusual phenomenon that may occur anywhere along the skull base. However, CSF leaks originating from clival defects are rarely reported in the literature. The majority of reported cases were managed with microscopic techniques, using free grafts.

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Background: Orbital cavernous hemangiomas (OCH) are the most common adult orbital tumor and represent an ideal index lesion for endonasal orbital tumor surgery. In order to standardize outcomes reporting, an anatomic-based staging system was developed.

Methods: An international, multidisciplinary panel of 23 experts in orbital tumor surgery was formed.

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Extracorporeal video microscopes, or "exoscopes," provide high-definition views of the operative field and are alternatives to the operating microscope or loupes for large-corridor surgical approaches. In this proof-of-concept study, we aim to determine the feasibility of 3-dimensional exoscopes as alternatives to operating microscopes in otology and neurotology, espeically in conjunction with endoscopes. Eleven consecutive cases were performed using 3-dimensional exoscopes in place of, or as adjuncts to, the operating microscope.

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Objective: The aim of this paper would be to describe the first case series of exclusive transcanal endoscopic approach to treat lesions with limited extension at the suprageniculate fossa. This endoscopic approach allowed a complete removal of suprageniculate disesases with low complication rates using a minimally invasive surgical route.

Methods: This is a retrospective chart analysis and a surgery video recording review of these patients were performed in August 2015.

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Objective: To investigate the efficacy and safety of endoscopic middle ear paraganglioma (glomus tympanicum) resection.

Study Design: Case series with chart review.

Setting: Multi-institutional tertiary university medical centers.

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The endoscope has transformed the way we observe, understand, and treat chronic ear disease. Improved view, exclusive transcanal techniques, assessment of ventilation routes and mastoid tissue preservation have led to decreased morbidity and functional enhancement of minimally invasive reconstruction of the middle ear. The philosophical identity of endoscopic ear surgery is evolving; new research, long-term results, and widespread acknowledgement of its postulates will undoubtedly define its role in otology.

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Surgical approaches to vestibular schwannomas (VS) are widely known and extensively recorded. For the first time, an exclusive endoscopic approach to the internal acoustic canal (IAC) was described and used to safely remove a cochlear schwannoma involving IAC in March 2012. The aim of this article was to summarize indications and technique to treat intracanalicular VS by transcanal/transpromontorial endoscopic approach.

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Tantamount to the management of temporal bone neoplasms is the ability to visualize the pathology and its relationship with the numerous critical structures housed therein. Transcanal endoscopic ear surgery provides the surgeon with an unparalleled view of the entire middle ear. This article presents the latest information on the usefulness of transcanal endoscopic ear surgery in the management of middle ear and temporal bone neoplasms.

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Tympanic facial nerve segment surgery has been traditionally performed using microscopic approaches, but currently, exclusive endoscopic approaches have been performed for traumatic, neoplastic, or inflammatory diseases, specially located at the geniculate ganglion, greater petrosal nerve, and second tract of the facial nerve, until the second genu. The tympanic segment of the facial nerve can be reached and visualized using an exclusive transcanal endoscopic approach, even in poorly accessible regions such as the second genu and geniculate ganglion, avoiding mastoidectomy, bony demolition, and meningeal or cerebral lobe tractions, with low complication rates using a minimally invasive surgical route.

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Background: Endoscopic orbital surgery represents the next frontier in endonasal surgery. The current literature is largely composed of small, heterogeneous, case series with little consensus regarding optimal techniques. The purpose of this study was to combine the experience of multiple international centers to create a composite of the global experience on the endoscopic management of a single type of tumor, the orbital cavernous hemangioma (OCH).

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Objectives: To report patient outcomes after transcanal endoscopic cochlear implantation for sensorineural hearing loss.

Patients: Males and female subjects more than 7 years old with sensorineural hearing loss (confirmed with audiologic studies) were selected. CT imaging was used to rule out any anatomic anomalies of the temporal bone.

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This article covers state-of-the-art instruments and devices specially designated for endoscopic ear surgery. New technologies stimulate the creation of special endoscopic equipment and microinstruments specially designed to satisfy the exclusive requirements of endoscopic ear surgery, which contribute to the progress of the procedure. The article presents the advantages and disadvantages of working with ear endoscopes and details the advances in equipment used in ear endoscopies.

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Currently, the main application of endoscopic surgery relies on the middle ear cholesteatoma surgical treatment. However, in the natural evolution of the technique there are the steps toward of lateral skull base surgery and treatment of pathologic conditions of pertous bone. The endoscopic approaches to lateral skull base are (1) a transcanal exclusively endoscopic approach or (2) combined approaches (microscopic endoscope-assisted), including transotic, infralabyrinthine, and suprameatal translabyrinthine.

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This article presents the endoscopic anatomy of the retrotympanum and its relationship to other important anatomic landmarks in the middle ear to provide understanding of its importance and relevance during surgeries. A well-detailed tour of the retrotympanum, its associated structures, variability of anatomic structures, and surgical relevance is presented.

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The endoscope allows for better inspection for cholesteatoma in cases with chronic otitis media, better access to selective epitympanic poor ventilation and secondary selective chronic otitis media, better visualization of anterior poor ventilation of the mesotympanum (reestablishing adequate ventilation to the mesotympanum), better visualization and reconstruction of anterior tympanic membrane perforations, allows use of Sheehy's lateral graft tympanoplasty through a transcanal approach, and increases the odds of preoperative detection of ossicular chain disruption associated with perforations.

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The authors present a manual of transcanal ear dissection, a completely clinically focused discussion of the goals, steps, and outcomes of endoscopic dissection of the middle ear. From operating station setup through instrumentation and tasks, the reader is presented with detailed technique steps interspersed with observe notes that provide anatomic and technique pearls, such as "by removing the skin of the canal and the epithelial layer of the tympanic membrane (TM), you have largely eliminated the bleeding elements of the external ear and TM".

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A detailed and comprehensive discussion of transcanal endoscopic management of cholesteatoma is presented. After a presentation of the anatomy of the area, the rationale, advantages and limitations, technique, and long-term results of each technique are presented. A case presentation follows each technique.

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