The impact of COVID-19 pandemic on acute otitis media among the pediatric population.

Background: The incidence of respiratory diseases has dropped during the school closures at the COVID-19 pandemic including acute otitis media (AOM) among the pediatric population.

Methods: This study included 2090 patients under 12 years old, that were diagnosed with AOM between March 2019 and February 2021 at the otolaryngology and pediatrics emergency room at a public tertiary hospital in Sao Paulo, Brazil.

Results: There was a significant drop in number of AOM cases diagnosed during the quarantine.

Closure of Skull Base Defects after Endonasal Endoscopic Resection of Planum Sphenoidale and Tuberculum Sellae Meningiomas.

Background: The expanded endoscopic endonasal transplanum transtuberculum approach allows tumor removal by minimally invasive procedures. A large dural and bone defect is created during the surgical procedure, increasing the risk of postoperative cerebrospinal fluid (CSF) leakage.

Objective: The aim of this study is to describe a surgical technique and complications observed in patients undergoing endonasal resection of planum sphenoidale and/or tuberculum sellae meningiomas.

Quality-of-life evaluation for patients submitted to nasal endoscopic surgery for resection of pituitary tumours.

Purpose: This study aimed to evaluate the pre- and post-operative quality-of-life of patients submitted to the resection of pituitary adenoma via endoscopic transsphenoidal.

Methods: This was a prospective study on patients submitted to endoscopic transsphenoidal pituitary surgery with the harvest of a nasoseptal flap who responded to the questionnaires FV-36 and SNOT-22 in the pre-operative and in months 1, 3 and 6 following the surgical procedure.

Results: A total of 42 patients submitted to pituitary adenoma resection surgery via endoscopic transsphenoidal with a nasoseptal flap were recruited.

Design of a temporoparietal fascial flap after a spontaneous nasal fistula unresolved by conventional approaches.

We report the surgical management of a spontaneous and recurrent nasal fistula using a temporoparietal fascial flap for definitive treatment after several failed attempts to close the fistula by conventional approaches. Two formalin-fixed cadaveric human heads were also dissected to study the anatomy and surgical technique involved in the design of the temporoparietal fascial flap.

Relationship Between the Bilateral Removal of the Middle Nasal Turbinate and the Olfactory Function in Endoscopic Skull Base Surgery.

Objective: To determine the impact of endonasal endoscopic access to the skull base on the olfaction sense, involving the harvest of a nasoseptal flap, with the removal of the middle nasal turbinate.

Methods: A study was performed on a prospective cohort of 50 patients who underwent transnasal endoscopic surgery of the anterior skull base, with the harvest of a nasoseptal and reverse flap. The patients were divided into 2 groups: partial unilateral removal of the middle nasal turbinate and bilateral removal.

Evaluation of olfactory function in patients undergoing endoscopic skull base surgery with nasoseptal flap.

Introduction: Endoscopic transnasal access to the skull base, both for treatment and reconstruction, can cause olfactory morbidity. Knowing the main consequences of this intervention is essential to have objective criteria for decision-making regarding the appropriate surgical technique.

Objectives: The aim of this study is to determine the impact on olfactory function of the endonasal endoscopic access to the skull base with the creation of the nasoseptal flap.

Development of an Experimental Model for Studying the Nasosinusal and Skull Base Arterial and Venous Systems Using Iodinated Contrast and Latex in Cadavers.

Background: Cadaver dissection remains one of the most reliable and safest ways to study anatomy, whereas computed tomography angiography (CTA) is an essential technology for enabling students to become familiar with human anatomy and surgical planning. Thus, the convergence of both radiologic and anatomic information is important for surgical success, especially in regions of complex anatomy such as the nasosinusal and skull base regions. Here we propose an experimental model in formalinized cadaver heads consisting of intravascular injection of colored latex and iodinated contrast mixture, followed by CTA scans of the nasosinusal and skull base arterial and venous systems before dissection.

Long Term Follow-up after Endoscopic Endonasal Approach for the Treatment of Cushing's Disease.

 Surgery has been the standard treatment for Cushing's disease. Currently, the endoscopic endonasal approach (EEA) is the most widely used technique. However, among some endocrinologists and neurosurgeons used to the microscope assisted technique, there are still questions about the effectiveness and safety of transitioning to the EEA.

Technique for Latex Injection and Reuse of Human Heads Preserved in Formaldehyde.

 Understanding the anatomy of the skull base is paramount for every skull base surgeon, particularly in light of the expanded endoscopic endonasal approaches, and of the refined surgical technique used in both medial and lateral approaches. A comprehensive knowledge of anatomy is the cornerstone for a safe surgery, maximizing resection and minimizing complications. The best study method is the careful dissection of fresh human cadaveric heads in a well-equipped anatomy laboratory.

Evaluation of the sensitivity of the Psychosocial Scale of Facial Appearance in peripheral facial paralysis.

Purpose: To investigate the sensitivity and internal consistency of the Psychosocial Scale of Facial Appearance (PSFA) based on the comparison between its results and those from other facial functional assessment instruments: House-Brackmann scale (HBS) and Facial Grading System - and the psychosocial implications measured by the Hospital Anxiety and Depression Scale (HADS).

Methods: The study was approved by the Research Ethics Committee of the aforementioned Institution under protocols no. 196.

Endoscopic endonasal double flap technique for reconstruction of large anterior skull base defects: technical note.

Introduction: One of the main concerns in endoscopic endonasal approaches to the skull base has been the high incidence and morbidity associated with cerebrospinal fluid leaks. The introduction and routine use of vascularized flaps allowed a marked decrease in this complication followed by a great expansion in the indications and techniques used in endoscopic endonasal approaches, extending to defects from huge tumours and previously inaccessible areas of the skull base.

Objective: Describe the technique of performing endoscopic double flap multi-layered reconstruction of the anterior skull base without craniotomy.

An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery.

 The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the internal carotid artery (ICA).  To evaluate the anatomic variations of the SS and its relationship to the ICA using computed tomography (CT).

Long term follow-up of growth hormone-secreting pituitary adenomas submitted to endoscopic endonasal surgery.

Objective: The aim of this study was to evaluate the results of the endoscopic transsphenoidal technique for growth hormone (GH)-secreting adenomas.

Methods: A retrospective analysis based on medical records of 23 acromegalic patients submitted to endoscopic transsphenoidal surgery. Biochemical control was defined as basal GH < 1ng/ml, nadir GH < 0.

Anatomical nuances of the internal carotid artery in relation to the quadrangular space.

OBJECTIVE The aim of this study was to evaluate the anatomical variations of the internal carotid artery (ICA) in relation to the quadrangular space (QS) and to propose a classification system based on the results. METHODS A total of 44 human cadaveric specimens were dissected endonasally under direct endoscopic visualization. During the dissection, the anatomical variations of the ICA and their relationship with the QS were noted.

Role of the type I tumor necrosis factor receptor in inflammation-associated olfactory dysfunction.

Background: To understand mechanisms of human olfactory dysfunction in chronic rhinosinusitis, an inducible olfactory inflammation (IOI) model has been utilized to chronically express inflammatory cytokines locally, resulting in neuronal loss, diminished odorant responses, and repressed olfactory regeneration. Knockout of the minor tumor necrosis factor α receptor 2 (TNFR2) was previously shown to partially rescue these olfactory changes. The purpose of current study was to investigate the role of the major TNF receptor, TNFR1, in chronic olfactory inflammation.

Postoperative otorhinolaryngologic complications in transnasal endoscopic surgery to access the skull base.

Introduction: The large increase in the number of transnasal endoscopic skull base surgeries is a consequence of greater knowledge of the anatomic region, the development of specific materials and instruments, and especially the use of the nasoseptal flap as a barrier between the sinus tract (contaminated cavity) and the subarachnoid space (sterile area), reducing the high risk of contamination.

Objective: To assess the otorhinolaryngologic complications in patients undergoing endoscopic surgery of the skull base, in which a nasoseptal flap was used.

Methods: This was a retrospective study that included patients who underwent endoscopic skull base surgery with creation of a nasoseptal flap, assessing for the presence of the following post-surgical complications: cerebrospinal fluid leak, meningitis, mucocele formation, nasal synechia, septal perforation (prior to posterior septectomy), internal nasal valve failure, epistaxis, and olfactory alterations.

Endoscopic endonasal study of the cavernous sinus and quadrangular space: Anatomic relationships.

Background: The quadrangular space permits an anterior entry into Meckel's cave while obviating the need for cerebral or cranial nerve retraction. This avenue is intimately associated with the cavernous sinus; thus, from this ventral perspective, it is feasible to visualize the anteromedial, anterolateral, and Parkinson triangles.

Methods: Twenty middle cranial fossae were dissected endonasally under direct endoscopic visualization.

Endoscopic endonasal anatomical study of the cavernous sinus segment of the ophthalmic nerve.

Objectives/hypothesis: This cadaveric study analyzes the endoscopic endonasal anatomy of the ophthalmic division of the trigeminal nerve (V1 ), from the middle fossa to its orbital entry via the superior orbital fissure. Anatomical relationships with the surrounding cranial nerves and blood vessels are described, with emphasis on their clinical correlation during surgery in this region. Our objective was to describe the anatomical relationships of the ophthalmic division of the trigeminal nerve.

Differences in the diameter of facial nerve and facial canal in bell's palsy--a 3-dimensional temporal bone study.

Unlabelled: Bell's palsy is hypothesized to result from virally mediated neural edema. Ischemia occurs as the nerve swells in its bony canal, blocking neural blood supply. Because viral infection is relatively common and Bell's palsy relatively uncommon, it is reasonable to hypothesize that there are anatomic differences in facial canal (FC) that predispose the development of paralysis.

A rare association of tension pneumocephalus and a large frontoethmoidal osteoma: imaging features and surgical treatment.

Osteomas are the most common benign paranasal sinus tumors and are often found in the frontal and ethmoidal sinus. Intracranial complications such as pneumocephalus have occasionally been reported in association with osteomas. We describe a 33-year-old man with a large frontoethmoidal osteoma complicated by tension pneumocephalus and neurological disturbances, and we discuss the clinical and imaging resolutions after surgical management.

Endoscopic endonasal transsphenoidal approach for pituitary adenomas: technical aspects and report of casuistic.

Objective: Analyse technical aspects, effectiveness and morbidity of the endoscopic endonasal transphenoidal approach for pituitary adenomas.

Method: From January 2005 to September 2008, 30 consecutive patients underwent endoscopic endonasal resection of pituitary adenomas with a follow up from 3 to 36 months. Their medical charts were retrospectively analysed.

Varicella zoster virus in Bell's palsy: a prospective study.

Unlabelled: Although Bell's palsy is the major cause of acute peripheral facial palsy, its pathogenesis remains unknown. Reactivation of the varicella zoster virus has been implicated as one of the main causes of Bell's palsy, however, studies which investigate the varicella zoster virus reactivation in Bell's palsy patients are mostly Japanese and, therefore, personal and geographic characteristics are quite different from our population.

Aims: To determine varicella zoster virus frequency in saliva samples from patients with Bell's palsy, using PCR.

A method for measuring the length of the cochlea through magnetic resonance imaging.

Unlabelled: We know that hearing impairment affects a large part of the population. In cases of profound and bilateral hearing loss, children may have problems in speech development, as well as communication and socialization. Cochlear implants have been used as a treatment option in these cases.