Endoscopic Repair of Traumatic Perilymphatic Fistula in Children: A Case Series.

Traumatic perilymphatic fistula (PLF) is an uncommon cause of acute vestibular symptoms and hearing loss following head injury in children. We describe the management of 3 pediatric patients with traumatic PLF using an endoscopic ear surgery (EES) approach. Three pediatric patients with traumatic PLF underwent repair via an EES approach between August and October 2018.

Analysis of anterior and posterior maneuvers to enhance intraconal exposure.

Background: The medial and inferior recti encompass the ideal surgical corridor to approach the intraconal space endonasally. Here, we describe 3 different maneuvers to achieve greater access to orbital contents through an expanded endonasal approach (EEA).

Methods: Four human cadaver heads were dissected bilaterally (n = 8).

Considering a Weight Criterion for Neonatal Tracheostomy: An Analysis of the ACS NSQIP-P.

Objectives: Neonates weighing < 2.5 kg have known higher rates of surgical mortality and morbidity, but this remains unexamined specifically for tracheostomy. We present outcomes of neonates undergoing tracheostomy stratified by weight.

Carotid artery and lower cranial nerve exposure with increasing surgical complexity to the parapharyngeal space.

Objectives/hypothesis: To investigate the extent of carotid artery exposure attained, including the identification of the external carotid branches and lower cranial nerves in five sequential external approaches to the parapharyngeal space, and to provide an anatomical algorithm.

Study Design: Anatomical study.

Methods: Six latex-injected adult cadaver heads were dissected in five consecutive approaches: transcervical approach with submandibular gland removal, posterior extension of the transcervical approach, transcervical approach with parotidectomy, parotidectomy with lateral mandibulotomy, and parotidectomy with mandibulectomy.

Trends in medical malpractice claims in patients with cleft or craniofacial abnormalities in the United States.

Objective: To describe medical malpractice trends in patients with cleft and/or craniofacial abnormalities.

Methods And Materials: A modified Delphi approach was used to gather search terms. Search settings included "all jury verdicts and settlements", with jurisdiction of "all states" and "all federal courts" (by court and circuit).

Endoscopic Resection of Sinonasal Malignancy: A Systematic Review and Meta-analysis.

Objectives: The use of endoscopic approaches for sinonasal malignancy resection has increased, but survival data are limited secondary to disease rarity and new surgical technique. Here we present a systematic review and meta-analysis of endoscopic endonasal resection of sinonasal malignancy.

Data Sources: MEDLINE, PubMed Central, NCBI Bookshelf, Cochrane Library, clinicaltrials.

The Reverse-Flow Facial Artery Buccinator Flap for Skull Base Reconstruction: Key Anatomical and Technical Considerations.

Objective To highlight key anatomical and technical considerations for facial artery identification, and harvest and transposition of the facial artery buccinator (FAB) flap to facilitate its future use in anterior skull base reconstruction. Only a few studies have evaluated the reverse-flow FAB flap for skull base defects. Design Eight FAB flaps were raised in four cadaveric heads and divided into thirds; the facial artery's course at the superior and inferior borders of the flap was measured noting in which incisional third of the flap it laid.

Post-operative budesonide irrigations for patients with polyposis: a blinded, randomized controlled trial.

Objective: To compare normal saline (NS) vs. NS+budesonide irrigations in post- functional endoscopic sinus surgery (FESS) patients with chronic rhinosinusitis with polyposis (CRSwNP). Currently, no evidence exists for NS+budesonide irrigation over NS irrigation alone.

A prospective randomized cohort study evaluating 3 weeks vs 6 weeks of oral antibiotic treatment in the setting of "maximal medical therapy" for chronic rhinosinusitis.

Background: Surprisingly, little literature exists evaluating the optimal duration of antibiotic treatment in "maximal medical therapy" for chronic rhinosinusitis (CRS). As such, we investigated whether 3 weeks vs 6 weeks of antibiotic therapy resulted in significant differences in clinical response.

Methods: A prospective, randomized cohort study was performed with patients assigned to 3-week or 6-week cohorts.

Pre-operative simulation of pediatric mastoid surgery with 3D-printed temporal bone models.

Objectives: As the process of additive manufacturing, or three-dimensional (3D) printing, has become more practical and affordable, a number of applications for the technology in the field of pediatric otolaryngology have been considered. One area of promise is temporal bone surgical simulation. Having previously developed a model for temporal bone surgical training using 3D printing, we sought to produce a patient-specific model for pre-operative simulation in pediatric otologic surgery.

Endoscopic sinonasal meningoencephalocele repair: a 13-year experience with stratification by defect and reconstruction type.

Objective: Sinonasal meningoencephalocele is a rare defect, with varying etiologies and treatment strategies. Here we present the largest published series from a single institution of patients with endoscopic repair. The primary goal is to examine rates of success with consideration to accompanying patient demographic data.

The combined endonasal and transoral approach for the management of skull base and nasopharyngeal pathology: a case series.

The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation and technology, the expanded endonasal approach (EEA) has introduced a new array of surgical options in the management of pathology involving these anatomically complex areas. Similarly, the transoral robotic surgical (TORS) approach was introduced as a minimally invasive surgical option to approach tongue base, nasopharyngeal, parapharyngeal, and laryngeal lesions.

Obstructive sleep apnea in patients undergoing endoscopic surgical repair of cerebrospinal fluid rhinorrhea.

Objectives/hypothesis: To examine the relationship between cerebrospinal fluid (CSF) rhinorrhea and obstructive sleep apnea (OSA).

Study Design: Retrospective chart review of patients who underwent surgical repair of encephaloceles and/or CSF rhinorrhea at a tertiary medical center over a 12-year period.

Methods: Pertinent demographic, clinical, and surgical data including age, sex, and medical and surgical history were obtained.

Evidence-based practice: endoscopic skull base resection for malignancy.

Successful outcomes of endoscopic approaches to benign sinonasal tumors have launched interest in expanding its use for sinonasal malignancy. Because of the heterogeneity and rarity of sinonasal malignancy, evidence for clinical outcomes of endoscopic approaches versus traditional craniofacial resection is low. Using the Oxford Center for Evidence-based Medicine guidelines, we present the existing evidence comparing both techniques for a variety of sinonasal malignancies.

Minimizing morbidity in endoscopic pituitary surgery: outcomes of the novel nasoseptal rescue flap technique.

Objective: The novel nasoseptal rescue flap has been proven to provide complete coverage of dural defects that may be encountered during endoscopic pituitary surgery through cadaveric studies. In this case series, the authors report outcomes from the first cohort of patients who had a nasoseptal rescue flap raised prior to surgery.

Study Design: Case series with chart review.