"M" line: New anatomical landmark for the maxillary sinus natural ostium.

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.

Increased Accuracy, Confidence, and Efficiency in Anterior Ethmoidal Artery Identification with Segmented Image Guidance.

Objective: To determine whether using image guidance technology with 3-dimensional image segmentation increases the endoscopic surgeon's accuracy, efficiency, and confidence in identifying the anterior ethmoidal artery.

Methods: This is a cross-sectional study of attending physicians and residents at an academic medical center. Because identification of the anterior ethmoidal artery during image-guided surgery can be challenging, we studied the effect of anterior ethmoidal artery image segmentation (ie, partitioning and coloring) on surgeon test performance.

Virtual Mapping of the Frontal Recess: Guiding Safe and Efficient Frontal Sinus Surgery.

Unlabelled: Objective To define relationships between the frontal sinus opening, ostia of other frontal recess cells, and endoscopic landmarks and to develop a clinically useful framework to guide frontal sinus surgery. Study Design Retrospective review. Setting Tertiary care academic referral center.

The Emerging Role of 3-Dimensional Printing in Rhinology.

Nasal septal perforations, particularly those that are large and irregular in shape, often present as challenging surgical dilemmas. New technology has allowed us to develop techniques using computed tomography imaging and 3-dimensional (3D) printers to design custom polymeric silicone septal buttons. These buttons offer patients an option that avoids a surgical intervention when standard buttons do not fit well or are not tolerated.

Three-dimensional printing of large nasal septal perforations for optimal prosthetic closure.

Background: Since 1972, patients with large nasal perforations, who were symptomatic, and who were not candidates for surgery, had the option of custom prosthetic closure at Mayo Clinic. Although septal prostheses have helped many patients, 27% of pre-1982 patients chose not to keep the prosthesis in place. Two-dimensional computed tomography (CT) sizing resulted in more of the patients choosing to retain the prosthesis.

The effect of vibrissae on subjective and objective measures of nasal obstruction.

Background: Nasal congestion and/or obstruction represents a prevalent and extensively studied problem. No published research exists that describes the impact of nasal hair (vibrissae) on nasal obstruction.

Objective: To assess the impact of nasal vibrissae on subjective and objective measurements of nasal obstruction.

Volumetric computed tomography analysis of the olfactory cleft in patients with chronic rhinosinusitis.

Background: Commonly used computed tomography (CT) staging systems for chronic rhinosinusitis (CRS) focus on the sinuses and do not quantify disease in the olfactory cleft. The goal of the current study was to determine whether precise measurements of olfactory cleft opacification better correlate with olfaction in patients with CRS.

Methods: Olfaction was assessed using the 40-item Smell Identification Test (SIT-40) before and after sinus surgery in adult patients.

Identifying the presence of clinically significant hepatic involvement in hereditary haemorrhagic telangiectasia using a simple clinical scoring index.

Background & Aims: Though hepatic involvement is common in patients with hereditary haemorrhagic telangiectasia (HHT), symptomatic liver disease is rare but potentially fatal without liver transplantation. Factors associated with clinically significant liver disease in patients with HHT are unknown.

Methods: In this prospective cohort study, we included consecutive patients from 2001 to 2011 with definite HHT, who underwent systematic protocol screening including contrast-enhanced hepatic CT and/or abdominal ultrasound.

Computed tomography scans as an objective measure of disease severity in chronic rhinosinusitis.

Objectives: A truly objective method of measuring disease severity in chronic rhinosinusitis (CRS) has only recently existed. We evaluated computed tomography (CT) scans of CRS patients using this novel objective 3D computerized system and compared results with a novel 2D computerized analysis of a single coronal slice through the osteomeatal complex (OMC) and subjective methods including Lund-Mackay and Zinreich's modified Lund-Mackay.

Study Design: Prospective multicenter study.

Three-dimensional volumetric computed tomographic scoring as an objective outcome measure for chronic rhinosinusitis: clinical correlations and comparison to Lund-Mackay scoring.

Background: We aimed to test the hypothesis that three-dimensional (3D) volume-based scoring of computed tomography (CT) images of the paranasal sinuses was superior to Lund-Mackay CT scoring of disease severity in chronic rhinosinusitis (CRS). We determined correlation between changes in CT scores (using each scoring system) with changes in other measures of disease severity (symptoms, endoscopic scoring, and quality of life) in patients with CRS treated with triamcinolone.

Methods: The study group comprised 48 adult subjects with CRS.

Mapping the frontal sinus ostia using virtual endoscopy.

Objectives/hypothesis: To determine the relative location of the frontal sinus opening to other frontal cells using virtual endoscopy; and to assess whether the relative location of the frontal sinus ostium can be predicted.

Study Design: Retrospective analysis of high-resolution computed tomography scans from 50 adult patients without frontal sinus disease or previous sinus surgery.

Methods: Using virtual endoscopy software, 100 frontal recesses were mapped for the presence and relative position of the frontal sinus ostium to the following cells: agger nasi (ANC); frontal bullar; frontal types 1, 2, and 3; supraorbital ethmoid; suprabullar; and intersinus septal cells.

Introduction to 3D imaging technologies for the facial plastic surgeon.

3D tools for surgery allow 3D analysis of images in a way that is meaningful to surgeons for increased insight and understanding of a patient's anatomy. 3D analysis provides a way to see more than one plane at the same time in the same image. This article provides an introduction to 3D tools in the field of facial plastic surgery in 2011, beginning with a look at where surgeons would like to be and what the "dream" device would look like.

Three-dimensional CT reconstruction and virtual endoscopic study of the ostial orientations of the frontal recess.

Background: Safe and efficient endoscopic frontal sinus surgery requires a thorough knowledge of the location of the frontal sinus outflow tract. This study was designed to describe the prevalence of the different frontal recess cells and 3D analysis by virtual endoscopy of their ostial orientation in relation to the frontal ostium.

Methods: Fifty high-resolution CT scans (100 sides) of disease-free paranasal sinuses were reviewed using triplanar and virtual 3D analysis.

Surgical modifications of the upper airway for obstructive sleep apnea in adults: a systematic review and meta-analysis.

A substantial portion of patients with obstructive sleep apnea (OSA) seek alternatives to positive airway pressure (PAP), the usual first-line treatment for the disorder. One option is upper airway surgery. As an adjunct to the American Academy of Sleep Medicine (AASM) Standards of Practice paper, we conducted a systematic review and meta-analysis of literature reporting outcomes following various upper airway surgeries for the treatment of OSA in adults, including maxillomandibular advancement (MMA), pharyngeal surgeries such as uvulopharyngopalatoplasty (UPPP), laser assisted uvulopalatoplasty (LAUP), and radiofrequency ablation (RFA), as well as multi-level and multi-phased procedures.

Gene transcription changes in asthmatic chronic rhinosinusitis with nasal polyps and comparison to those in atopic dermatitis.

Background: Asthmatic chronic rhinosinusitis with nasal polyps (aCRSwNP) is a common disruptive eosinophilic disease without effective medical treatment. Therefore, we sought to identify gene expression changes, particularly those occurring early, in aCRSwNP. To highlight expression changes associated with eosinophilic epithelial inflammation, we further compared the changes in aCRSwNP with those in a second eosinophilic epithelial disease, atopic dermatitis (AD), which is also closely related to asthma.

Dose and image quality evaluation of a dedicated cone-beam CT system for high-contrast neurologic applications.

Objective: The purpose of our study was to evaluate the dose and image quality performance of a dedicated cone-beam CT (CBCT) scanner in comparison with an MDCT scanner.

Materials And Methods: The conventional dose metric, CT dose index (CTDI), is no longer applicable to CBCT scanners. We propose to use two dose metrics, the volume average dose and the mid plane average dose, to quantify the dose performance in a circular cone-beam scan.

Uvulopalatopharyngoplasty in the management of obstructive sleep apnea: the mayo clinic experience.

Objective: To assess the role of uvulopalatopharyngoplasty (UPPP) in the treatment of obstructive sleep apnea (OSA) using polysomnography (PSG) data within 6 months before and after surgery.

Patients And Methods: We analyzed PSG and body mass index (BMI) data from patients with OSA who were 18 years or older and who underwent UPPP between January 1, 1988, and August 31, 2006.

Results: Sixty-three patients (51 men [81.

Rhabdomyolysis after transnasal repair of anterior basal encephalocele.

Background: Postoperative Rhabdomyolysis (RM) is rare after neurosurgical procedures. Furthermore, it has not been observed after transnasal approaches. The authors report a case of idiopathic RM occurring after transnasal resection of a sincipital encephalocele.

Effects of continuous positive airway pressure on stridor in multiple system atrophy-sleep laryngoscopy.

The presence of stridor in patients with multiple system atrophy (MSA) is associated with poor prognosis, mainly due to a high risk of complete airway obstruction at night. Continuous positive airway pressure (CPAP) therapy has been proposed as a treatment of MSA-associated stridor, but, until now, there has been no visual documentation of the effect of CPAP on laryngeal patency during nonpharmacologically induced spontaneous sleep of a patient with MSA. We present a video-laryngoscopic documentation of a 57-year-old woman with MSA who was evaluated for nocturnal stridor.