Location of the Sphenoid Sinus Ostium in Relation to Adjacent Anatomical Landmarks.

Purpose: The variability of sphenoid pneumatization and its relationship with the surrounding structures has been suggested. The aim of this study was to examine the effect of the surrounding bony structures on the position of the sphenoid ostium (SO).

Methods: A prospective radiological review of computed tomography images of paranasal sinuses of 150 patients (300 sides) was conducted.

A Surgical Variant of the Pre-Lacrimal Approach to the Maxillary Sinus.

Introduction: When dealing with maxillary sinus pathology, some areas of the sinus remain difficult to examine. In this regard, the pre-lacrimal approach is a minimally invasive technique to reach anterolateral areas of the maxillary sinus while preserving the physiological nasal function.

Materials And Methods: The present study aimed to provide technical hints related to pre-lacrimal approach acquired through a large number of performed procedures.

Benefits in pain perception, ability function and health-related quality of life in patients with failed back surgery syndrome undergoing spinal cord stimulation in a clinical practice setting.

Background: Failed back surgery syndrome (FBSS) represents one main cause of chronic neuropathic or mixed pain, functional disability and reduced Health Related Quality of Life (HRQoL). Spinal Cord Stimulation (SCS) can be a value for money option to treat patients refractory to conventional medical management (CMM). We estimated from real-world data: 1) the amount of reduced levels of HRQoL of target patients compared to general population, 2) the relationship between pain intensity, functional disability, and overall HRQoL, and 3) the improvement of patients’ health from SCS intervention, and 4) we give some insights and make some suggestions on the selection of a battery of patients’ reported health instruments for use in routine clinical practice.

Thyroglossal Duct Cyst at the Base of Tongue: The Emerging Role of Transoral Endoscopic-Assisted Surgery.

Cystic lesions involving the tongue base are rare, generally presenting in pediatric patients, and they may encompass different pathologies such as ranula, lingual ectopic thyroid, thyroglossal duct cyst (TDC), dysontogenetic cysts, benign, and malignant tumors.This paper describes the case of a 19-year-old girl with phonation impairment and mild dysphagia due to limited tongue protrusion and movements. Radiologic examinations revealed a bulky cystic lesion at the base of tongue with displacement of extrinsic lingual muscles.

Endoscopic-assisted transoral-transpharyngeal approach to parapharyngeal space and infratemporal fossa: focus on feasibility and lessons learned.

The parapharyngeal space (PPS) is a challenging anatomical region, rich in vascular and nervous vital structures. Surgery is considered the treatment of choice for the majority of PPS lesions. Herein, we present a retrospective evaluation on ten patients with various types of lesions of the parapharyngeal and infratemporal fossa (ITF) regions operated on via an endoscopic-assisted transoral-transpharyngeal approach (EATTA), focusing on feasibility and safety.

Transorbital endoscopic assisted management of intraorbital lesions: lessons learned from our first 9 cases.

Background: The management of intraorbital lesions is challenging and it is strongly dependent to their nature, position and biological behaviour. Traditionally, the superior and lateral compartments of the orbit are addressed via lateral orbitotomy or transcranial approaches. Herein we present our preliminary experience in the management of selected supero-lateral intraorbital lesion through an endoscopic-assisted superior-eyelid approach.

Multiportal combined transnasal transoral transpharyngeal endoscopic approach for selected skull base cancers.

Background: Minimally invasive endoscopic endonasal approaches to the ventral skull base have evolved considerably over the past several years. However, where there is a lateral extension of tumors as far as the parapharyngeal spaces with inferior extension below the level of the soft palate, limitations remain for an exclusive transnasal approach.

Methods: A combined endoscopic-assisted transnasal-transoral-transpharyngeal multiportal approach was performed to resect selected skull base malignancies that could not be adequately managed using a single approach.

Adult onset of ganglioneuroblastoma of the adrenal gland: case report and review of the literature.

Ganglioneuroblastoma (GBN) is a malignant neoplasm of the autonomic nervous system. Adult onset of ganglioneuroblastoma is extremely rare. Only 16 cases have been reported in English literature, to date.

Treatment strategies for primary early-stage sinonasal adenocarcinoma: A retrospective bi-institutional case-control study.

Objective: To investigate different treatment strategies for primary early-stage (pT1-T2) sinonasal adenocarcinomas.

Methods: Retrospective case-control study. From 2000 to 2011, 61 cases were radically resected using an endoscopic endonasal approach.

Cost-Effectiveness and Cost-Utility Analysis of Spinal Cord Stimulation in Patients With Failed Back Surgery Syndrome: Results From the PRECISE Study.

Objective: To assess the cost-effectiveness and cost-utility of Spinal Cord Stimulation (SCS) in patients with failed back surgery syndrome (FBSS) refractory to conventional medical management (CMM).

Materials And Methods: We conducted an observational, multicenter, longitudinal ambispective study, where patients with predominant leg pain refractory to CMM expecting to receive SCS+CMM were recruited in 9 Italian centers and followed up to 24 months after SCS. We collected data on clinical status (pain intensity, disability), Health-Related Quality-of-Life (HRQoL) and on direct and indirect costs before (pre-SCS) and after (post-SCS) the SCS intervention.

Aerosol antibiotic therapy in children with chronic upper airway infections: a potential alternative to surgery.

Tonsillectomy and adenoidectomy remain the first choice treatment of chronic or recurrent acute infections of the upper respiratory tract in children. The aim of this study is to investigate the efficacy of the combination of thiamphenicol glycinate acetylcysteinate plus beclomethasone, administered as aerosol, in children awaiting tonsillectomy and/or adenoidectomy. The study comprised 204 children, aged 1 to 12 years, with chronic adenotonsillitis who had been listed for surgery due to obstructive symptoms and recurrent acute infections.

Endoscopic endonasal management of encephaloceles in children: an eight-year experience.

Objective: Skull base encephaloceles are difficult to diagnose and to treat. Traditionally, they are approached externally via craniotomic routes. Endoscopic management of skull base defects is the standard treatment in adults.

Endoscopic endonasal management of petroclival cerebrospinal fluid leaks: anatomical study and preliminary clinical experience.

Background: Endonasal management of most anterior cranial fossa cerebrospinal fluid leaks is a well established procedure, and even some middle cranial fossa cerebrospinal fluid leaks can be managed safely endonasally. Endonasal endoscopic management of leakages of the posterior cranial fossa represents an unique challenge.

Objective: The aim of this study was to assess the feasibility of an endoscopic endonasal approach for treating well-selected cerebrospinal fluid leaks of the petroclival region.

Endovascular treatment of isolated iliac artery aneurysms: 2-year follow-up.

Purpose: The aim of this study was to assess the effectiveness of endovascular treatment of isolated iliac artery aneurysms (IAAs).

Materials And Methods: Between March 1999 and March 2004, 15 isolated IAAs in 13 patients (mean age: 71.8 years) were selected for endovascular repair by means of a covered stent or stent-graft: 12 were in the common iliac artery (2 with the proximal end 12 mm from the aortic bifurcation and 2 involving the distal hypogastric artery), and three were in the external iliac artery.

Endonasal endoscopic resection and radiotherapy in olfactory neuroblastoma: our experience.

Background: Our aim was to evaluate the efficacy of a bimodal method of treatment consisting in endoscopic resection followed by radiotherapy in patients with olfactory neuroblastoma (ON).

Methods: This is a retrospective review on 10 patients with ON treated at a tertiary referral center. All the patients were treated with endonasal endoscopic resection, and 1 refused postoperative radiotherapy.

Endonasal endoscopic repair of Sternberg's canal cerebrospinal fluid leaks.

Objectives: Management of cerebrospinal fluid leaks or encephaloceles of Sternberg's canal is challenging. Transnasal visualization of this area is difficult, especially when large pneumatization is present. External approaches to this region involve aggressive surgery and are often associated with significant morbidity.

Intraoperative aspects and complications for the anesthesiologist in the management of patients undergoing thoracic surgery for lung cancer.

Surgery, when feasible, rappresents the treatment of choice for lung cancer. Several problems can come to the attention of the anesthesiologist in relation to the respiratory function with implications in airway control (double-lumen tube for lung collapse required for better surgical exposure of the pulmonary tissue), mechanical and gas-exchange aspects (increase in airway pressure of the dependent lung, increased blood shunt). The effect of these disorders, with no compensatory mechanism (pulmonary hypoxic vasoconstriction) and in the absence of an anesthesiologist (higher FiO2, low tidal volumes, allowing "permissive hypercapnia", CPAP to the non-dependent lung), normal arterial oxygenation (hypoxemia) is impaired.