CPAP complications after dacryocystorhinostomy: a narrative review.

Study Objectives: Patients with obstructive sleep apnea (OSA) often require the use of a continuous positive airway pressure (CPAP) machine. However, some patients experience issues using CPAP after receiving a dacryocystorhinostomy (DCR) for epiphora. This review aims to assess these complications and the potential interventions.

Endoscopic endonasal obliteration of the frontal recess and anterior skull base.

Background: Although endoscopic techniques have become more widespread in repair of frontal sinus (FS) defects, certain pathologies still require open approach (extensive trauma or tumors). Under certain circumstances even multiple complex open reconstructive procedures might fail to resolve persistent pneumocephalus or CSF leak and subsequently surgeons tend to escalate the invasiveness and employ even more complex and aggressive approaches. We present our experience treating persistent pneumocephalus or CSF leak after previously failed transcranial reconstruction utilizing an endoscopic endonasal approach (EEA).

Nasofrontal meningiomas: retrospective series and review of literature.

Introduction: Lesions affecting the anterior skull base and involving the paranasal sinuses (PNS), nasal cavity (NC), and orbit are infrequent and include predominantly a wide variety of sinonasal malignancies. Less than 3% of intracranial meningiomas extend extracranially and involve PNS and NC. Given their relatively low incidence, little is known about the treatment outcome of this subset of meningiomas.

Correlation between CT imaging and symptom scores in cystic fibrosis associated chronic sinusitis.

Purpose: There are limited guidelines for diagnosing and managing chronic rhinosinusitis (CRS) in the cystic fibrosis (CF) population. While CF patients are known to have significant opacification on paranasal computed tomography (CT), limited evidence suggests that CT findings are not indicative of patients' symptom burden and therefore not a reliable indicator for surgical intervention. This provides a diagnostic challenge for otolaryngologists taking care of this patient population.

Age-Related Increase of Collagen/Fibrin Deposition and High PAI-1 Production in Human Nasal Polyps.

Our previous studies showed an age-related increased prevalence of nasal polyps (NP) and reduced production of S100A8/9 in elderly patients with chronic rhinosinusitis with NP (CRSwNP). In this study, we investigated an unbiased age-related gene expression profile in CRSwNP subjects and healthy controls, and further identified the differences in their tissue remodeling. Microarrays using NP and uncinate tissues from health controls (elderly, age ≥65 vs.

Systematic review of outcomes for endoscopic sinus surgery and subsequent aspirin desensitization in aspirin-exacerbated respiratory disease.

Objective: To review and evaluate outcomes of patients with aspirin-exacerbated respiratory disease (AERD) following endoscopic sinus surgery and subsequent aspirin desensitization.

Methods: Electronic searches of OVID MEDLINE (1948 to September 10, 2019), EMBASE (1980 to September 10, 2019), and PubMed were performed on September 10, 2019. A systematic review of the literature was performed using the 2009 PRISMA guidelines.

Powered irrigation with suction evacuation for chronic rhinosinusitis in the office setting: A pilot study.

Bacterial infections in the form of adherent biofilms are frequently implicated in the pathogenesis and recalcitrance of chronic rhinosinusitis. The Hydrodebrider, a disposable powered irrigation and suction device, has been developed specifically to remove biofilm from the paranasal sinuses. We conducted a prospective study to evaluate the tolerability and efficacy of the Hydrodebrider in the office setting with the use of local anesthesia.

Endoscopic Corneal Neurotization: Technique and Initial Experience.

Purpose: The authors describe a minimally invasive surgical technique to re-establish corneal sensibility in a patient with neurotrophic keratopathy with the supraorbital nerve harvested endoscopically.

Methods: Pedicled contralateral supraorbital nerve was harvested endoscopically through small eyelid crease and scalp incisions and transferred to the affected eye.

Results: Endoscopic corneal neurotization was successfully performed with restoration of corneal sensibility and corneal epithelial integrity.

Endoscopic endonasal resection of a medullary cavernoma: a novel case.

Brainstem cavernomas can present very challenging operative problems. Endoscopic endonasal approaches to these lesions in the mesencephalon and pons have been described. In this article the authors present the first case of a medullary cavernoma resected by an endoscopic transclival approach.

Pneumatization Patterns of the Petrous Apex and Lateral Sphenoid Recess.

 The petrous apex poses a challenge for surgical intervention due to poor access. As intraoperative image guidance and surgical instrumentation improve, newer endoscopic approaches are increasingly favored. This study aims to provide normative data on the anatomy of the lateral sphenoid sinus recess and petrous apex.

Endoscopic Corneal Neurotization: Cadaver Feasibility Study.

Purpose: The authors describe a cadaver feasibility study investigating a minimally invasive technique for corneal neurotization with the supraorbital nerve harvested endoscopically.

Methods: A cadaver study was performed to investigate the technical feasibility of corneal neurotization via endoscopic supraorbital nerve transfer to the corneoscleral limbus.

Results: Endoscopic corneal neurotization was successfully performed on each cadaveric hemiface.

Anterior inferior petrosectomy: defining the role of endonasal endoscopic techniques for petrous apex approaches.

Object: Historically, surgery to the petrous apex has been addressed via craniotomy and open microscopic anterior petrosectomy (OAP). However, with the popularization of endoscopic approaches, the petrous apex can further be approached endonasally by way of an endoscopic endonasal anterior petrosectomy (EAP). Endonasal anterior petrosectomy is a relatively new procedure and has not been compared anatomically with OAP.

Field of view comparison between two-dimensional and three-dimensional endoscopy.

Objectives/hypothesis: Relative to microscopic transnasal surgery, endoscopic surgery provides improved visualization with an increased field of view. Advances such as high-definition (HD) and three-dimensional (3D) endoscopy have been introduced and clearly improve visualization. However, do both technologies maintain an increased field of view? We hypothesize that the field of view of 3D endoscopy is restricted relative to two-dimensional (2D) HD endoscopy.

The use of narrow band imaging in patients with benign disease: hereditary hemorrhagic telangiectasia.

: Narrow band imaging (NBI) is a new type of imaging technology that enhances the visibility of blood vessels used in the detection of abnormal angiogenesis in preneoplastic and neoplastic lesions. This technique is used in the diagnosis and management of dysplastic and malignant endobronchial lesions. To our knowledge, this is the first description of the use of NBI to diagnose and manage benign lesions, hereditary hemorrhagic telangiectasia (HHT).

Polyethylene glycol (PEG) hydrogel dural sealant and collagen dural graft matrix in transsphenoidal pituitary surgery for prevention of postoperative cerebrospinal fluid leaks.

Cerebrospinal fluid (CSF) rhinorrhea is the most common complication after transsphenoidal pituitary surgery. The authors compare their previous experience using an autologous fat graft and lumbar drain placement in 107 patients with their current technique of using a dural sealant and collagen matrix in 97 patients to prevent postoperative CSF leak after pituitary tumor resection. The failure rate for CSF leak repairs between the two groups was similar.

Head and neck cancer stem cells: the side population.

Objectives/hypothesis: The cancer stem cell (CSC) theory concludes that a subpopulation of cancer cells, the cancer stem cells, can self-renew and are responsible for tumor growth. Previous studies have identified cells able to efflux Hoechst 33342 dye as the side population (SP). SP cells and CSCs share many characteristics, suggesting the SP isolated from malignant tumors contains CSCs.

Single-marker identification of head and neck squamous cell carcinoma cancer stem cells with aldehyde dehydrogenase.

Background: In accord with the cancer stem cell (CSC) theory, only a small subset of cancer cells are capable of forming tumors. We previously reported that CD44 isolates tumorigenic cells from head and neck squamous cell cancer (HNSCC). Recent studies indicate that aldehyde dehydrogenase (ALDH) activity may represent a more specific marker of CSCs.

Probiotics as adjunctive treatment for chronic rhinosinusitis: a randomized controlled trial.

Objective: To determine if oral probiotics as adjunctive treatment are more effective than placebo in improving quality of life in patients with chronic inflammatory rhinosinusitis.

Design: Prospective, randomized, double-blind, placebo-controlled trial.

Methods: A total of 77 patients with chronic inflammatory rhinosinusitis were randomly assigned to receive oral probiotic Lactobacillus rhamnosus R0011 strain (500 million active cells/tablet twice daily) (n = 39) or oral placebo treatment (n = 38) for 4 weeks.

Intranasal metered dose aerosolized surfactant reduces passive opening pressure of the eustachian tube: comparison study in two animal models.

Hypothesis: Intranasal metered dose aerosolized inhaler surfactant will reduce opening pressure of the eustachian tube in gerbils and mice.

Background: Eustachian tube opening pressure necessary to allow ventilation of the middle ear must exceed the contractile force exerted by the tension on the curved surface of the eustachian tube. When the active function of opening the eustachian tube is inefficient, functional collapse of the tube persists, resulting in negative middle ear pressure.