Background: Inhalational anesthesia and total intravenous anesthesia (TIVA) are techniques used for maintenance of general anesthesia for endoscopic sinus surgery (ESS). Growing evidence exists that TIVA may be associated with decreased bleeding and improved surgical fields, yet data suggest it is used in a minority of sinus surgery cases. The objective of this study was to investigate perceptions and approaches to anesthetic maintenance techniques in ESS among anesthesia providers.
Methods: A total of 719 anesthesiology residents, faculty, and certified registered nurse anesthetists (CRNAs) at 3 tertiary academic centers in the United States were invited to participate in a survey of considerations and practice patterns for inhalational anesthesia and TIVA for ESS.
Results: Responses were received from 200 participants (28%). Sixty-five percent of respondents reported a lack of familiarity with current literature on TIVA for ESS. Many considered factors other than surgical field visualization when choosing a maintenance technique. Most were comfortable with performing TIVA but stated they would participate in additional training.
Conclusion: The majority of anesthesiology providers were unaware of the existing literature demonstrating advantage in improved surgical visualization with TIVA. Many used a combination of inhaled and intravenous anesthetics for maintenance. These findings suggest that future opportunities may exist to develop education, training, and practice approaches specific to anesthetic techniques for ESS.
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http://dx.doi.org/10.1002/alr.22500 | DOI Listing |
J Neurointerv Surg
January 2025
Neurology, Boston Medical Center, Boston University Chobanian and Aveidisian School of Medicine, Boston, Massachusetts, USA.
Background: Transverse sinus stenosis (TSS) and sigmoid sinus wall anomalies (SSWAs) are the most common causes of pulsatile tinnitus (PT). While these conditions may co-occur, they usually require different management approaches. This study aims to evaluate whether TSS stenting alone, without targeted treatment of SSWAs, is sufficient to resolve PT in patients presenting with PT, TSS, and SSWAs.
View Article and Find Full Text PDFCancer Control
January 2025
Department of Oncology, Suining Central Hospital, Suining, China.
Objective: Our study aimed to update demographic profiles of sinonasal adenocarcinoma (SNAC) between 2000 and 2020, identify independent prognostic risk factors, and devise a predictive nomogram for overall survival (OS).
Methods: Utilizing the Surveillance, Epidemiology, and End Results (SEER) database, cases of SNAC from 2000 to 2020 were analyzed for incidence trends. Univariate and multivariate Cox regression models helped pinpoint factors impacting patient survival.
Int J Pediatr Otorhinolaryngol
December 2024
Division of Otolaryngology-Head & Neck Surgery, Children's National Medical Center, Washington, D.C, USA. Electronic address:
Objectives: To examine safety and efficacy of very young patients under the age of six who underwent endoscopic sinus surgery (ESS) at our institution for the indications of either complicated acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS).
Methods: Retrospective cohort review of patients under six years old who underwent ESS for sinonasal pathology between 2016 and 2023 at a freestanding pediatric hospital. Age, sex, weight, diagnosis, laterality of disease, medications, types and number of surgical interventions, usage of image guidance, and outcomes were obtained from the medical record.
J Neurosurg Pediatr
January 2025
1Neurotology Unit, Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow; and.
Objective: The objective of this study was to discuss the characteristics of intracranial extension in patients with juvenile nasopharyngeal angiofibroma (JNA) and propose and an algorithm for its management.
Methods: A retrospective chart review of all patients with JNA who underwent operations between January 2013 and January 2023 was done, and those cases with intracranial extension categorized as stage IIIb, IVa, and IVb according to the Andrews modification of the Fisch staging classification were included in the study. Data were collected about age at presentation, symptoms, radiological findings, routes of intracranial extension, therapeutic management, and follow-up.
J Craniofac Surg
January 2025
Department of Oral and Maxillofacial Surgery, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Objective: To investigate the incidence and etiology of maxillofacial trauma (MFT) and its association with traumatic brain injury (TBI).
Background: Anecdotal evidence suggests that there is an association between MFT and TBI and that higher incidences of TBI are associated with frontal bone and mid-facial fractures. Despite the large volume of maxillofacial facial fractures treated in the authors' unit, no study has been undertaken to establish the relationship between TBI and maxillofacial fractures.
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