Computer-assisted surgery and computer-assisted telesurgery in otorhinolaryngology.

Surgical preparation is enhanced by the availability of computer-generated three-dimensional models that allow surgeons to explore the surgical field in various projections prior to an actual operation. In fact, with adequate computed tomography images, an entire operation can be simulated beforehand so that surgeons can plan the safest and most effective approach and be prepared to avoid or overcome obstacles during the actual procedure. Also, computer technology allows surgeons to conduct remote consultations and to even perform telesurgery--that is, to operate on a patient from a great distance.

Tele-3-dimensional computer-assisted functional endoscopic sinus surgery: new dimension in the surgery of the nose and paranasal sinuses.

One of the main objectives of our 3-dimensional (3D) computer-assisted functional endoscopic sinus surgery was to design a computer-assisted 3D approach to the presurgical planning, intraoperative guidance, and postoperative analysis of the anatomic regions of the nose and paranasal sinuses. Such an extremely powerful approach should allow better insight into the operating field, thereby significantly increasing the safety of the procedure. The last step to implementing the technology in the operating room was to connect the computer workstations and video equipment to remote locations by using a high-speed, wide-bandwidth computer network.

Realtime transfer of live video images in parallel with three-dimensional modelling of the surgical field in computer-assisted telesurgery.

We have carried out three-dimensional, computer-assisted, functional endoscopic sinus telesurgery. Surgeons at different locations up to 300 km apart could not only see and transfer video images but also transfer three-dimensional computer models and manipulate them in realtime during surgery. Two different approaches were used.

Dynamic 3D computer-assisted reconstruction of a metallic retrobulbar foreign body for diagnostic and surgical purposes. [Case report of orbital injury with ethmoid bone involvement].

The main goal of our dynamic 3D computer-assisted reconstruction of a metallic retrobulbar foreign body following orbital injury with ethmoid bone involvement was to use 3D-information obtained from standard computed tomography (CT) data to explore and evaluate the nasal cavity, ethmoidal sinuses, retrobulbar region, and the foreign body itself by simulated dynamic computed visualization of the human head. A foreign body, 10 x 30 mm in size, partially protruded into the posterior ethmoidal cells and partially into the orbit, causing dislocation and compression of the medial rectus muscle and inferior rectus muscle. The other muscles and the optic nerve were intact.

Application of 3D computer-assisted techniques to sinonasal pathology--case report: war wounds of paranasal sinuses caused by metallic foreign bodies.

Foreign bodies in paranasal sinuses are found quite infrequently. They are usually detected after various types of head trauma and most commonly occur as a consequence of improper handling of firearms or explosives. In countries at war, eg, during the war in Croatia, adults and children were almost equally exposed to these injuries.

Tympanometric findings in cleft palate patients: influence of age and cleft type.

Tympanometry was analysed according to cleft type with respect to age in 239 cleft palate patients (57 with bilateral cleft lip and palate (BCLP)), 122 with unilateral cleft lip and palate (UCLP) and 60 with isolated cleft palate (ICP). The frequency of type B tympanograms was 46.5 per cent in the BCLP group, 50.

Congenital bony fixation of the malleus.

Bony fixation of the malleus seems to be one of the most controversial clinical entities among various congenital disorders of the auditory ossicles. According to various theories, it could be caused by trauma, chronic infection of the ear, otosclerosis or even development failures in the tympanic cavity itself. Histological analysis of 1,108 temporal bones showing a normal middle ear structure was performed.

Our experience with FESS in children.

Between 1993 and 1996 we operated on 50 children with one of the following surgical indications: 17 children with a complication of acute rhinosinusitis and the propagation of the process towards the orbit (periorbitis), six children with an ethmoid and sphenoid foreign body (shrapnels shells), 11 children with an antrochoanal polyp, four children with nasal polyposis in cystic fibrosis and 12 children with chronic rhinosinusitis after 2-4 acute reinfections. The surgery was done under endotracheal anesthesia with hypotension. CT axial and coronal tomograms were done during the preoperative treatment.

Effectiveness of ultrasonography in diagnosis of maxillary sinus disease: a prospective comparison with radiographic and sinusoscopic examinations.

Aim: To assess the diagnostic accuracy of ultrasonography in comparison to radiographic and sinusoscopic techniques of maxillary sinuses examinations in acute and chronic sinus inflammations.

Methods: Ninety diseased sinuses in 50 patients (32 male and 18 female) were examined radiographically, ultrasonographically, and sinusoscopically. Ultrasonography was performed with Sinuscan 102 Sinusprint with 3.

Hearing levels and age in cleft palate patients.

Tonal audiometry was used to compare hearing levels in patients with bilateral cleft lip and palate (BCLP) (57 patients). unilateral cleft lip and palate (UCLP) (124 patients) and isolated cleft palate (ICP) (62 patients), and according to age groups. Patients with isolated cleft palate showed greater improvement in hearing level with age than patients with UCLP and BCLP; as adults they showed the lowest frequency of ears with hearing level of less than 40 dB, and the highest frequency of ears with hearing levels of 11-20 dB.

Pierre Robin syndrome: characteristics of hearing loss, effect of age on hearing level and possibilities in therapy planning.

Hearing loss was studied in 22 patients with Pierre Robin syndrome (PRS) aged three to 12 years (median 5.0 years). The results were compared to those obtained in 62 patients with isolated cleft palate (ICP) aged one to 27 years (median 5.

Arachidonic acid metabolites and sinonasal polyposis. I. Possible prognostic value.

Purpose: The etiology of sinonasal polyps is sometimes obscure. This study was undertaken to evaluate the potential role of arachidonic acid metabolites (AAm) on recurrent polyposis.

Materials And Methods: Tissue production of prostaglandin E2 (PGE2), 6-keto-prostaglandin F1-alpha (PGI2), thromboxane A2 (TxA2), and leukotriene C4 (LTC4) by nasal mucosa was determined by radioimmunoassay in 27 patients with sinonasal polyposis (SNp) and in 10 volunteers.

A-mode diagnostic ultrasound of maxillary sinuses: possibilities and limitations.

The diagnostic possibilities and limitations of A-mode ultrasound of maxillary sinus diseases are presented. A group of 219 subjects suffering from various sinus diseases was examined. All cases were analyzed in parallel by means of X-rays, sinoscopy and ultrasonography.

Acute upper respiratory tract infections and indications for tonsillectomy in children. I. Immunoglobulin synthesis in the palatine tonsil tissue.

Current viewpoints and practice concerning indications for tonsillectomy are presented. The annual specific risk for upper respiratory infection in children aged up to 15 is 1.1.

CO2 laser anterior turbinectomy in the treatment of non-allergic vasomotor rhinopathia. A prospective study upon 78 patients.

Preliminary results obtained in the treatment of non-allergic vasomotor rhinopathia by CO2 laser are presented. A group of 78 subjects, 35 males and 43 females, aged 18-48 years, mean age 27.6 years, were followed: subjective assessment of nasal breathing quality, anterior rhinomanometry, cytologic findings and saccharine test of nasal clearance.

Rhinomanometrical findings after septoplasty in children.

40 children of both sexes, aged 5-12, with deviations or fractures of the nasal septum were tested. These children were selected for septoplasty on the basis of anamnestic data, ENT examination and anterior rhinomanometry with and without anamnestic data. The control group consisted of 15 children, of approx.