OBJECTIVE: This study was designed to evaluate the possibility of predicting the minimum size of septal resection for safe tumor extraction in transnasal paraseptal pituitary adenoma resection from preoperative computed tomography scans. METHODS: A retrospective CT scan analysis was performed on 20 patients who underwent endoscopic pituitary surgery at the University Hospital in Ostrava. Virtual insertion of the straight instrument into the sphenoid cavity was simulated using a CT scan. The minimum septal resection size was predicted and compared to various diameters in the nasal cavity. The results were then compared with cadaveric dissections, in which septal resections were performed at 1 cm and 2 cm distances from the anterior sphenoid wall. The association between cadaver dissections and CT scan results was studied. RESULTS: A total of 20 patients who underwent endoscopic transnasal surgery for pituitary adenoma between the years 2020 and 2021 were enrolled in the study. The mean virtual posterior septal size resection needed to reach the medial edge of the ICA with the straight instrument, without infracturing the nasal septum, was 13.2 mm. In cadavers with a 1 cm posterior septal resection, the medial edge of the ICA was reached with the straight instrument. In 2 cm resections, it was possible to reach beyond the lateral edge of the ICA. CONCLUSION: There is no significant correlation between the minimum septal size resection and measured diameters in the nasal cavity. According to our study, a 1 cm resection is sufficient for a non-extended pituitary tumor extraction. More extensive septal resections allow for better maneuverability and overview in the surgical field.
- MeSH
- adenom * diagnostické zobrazování chirurgie patologie MeSH
- endoskopie metody MeSH
- lidé MeSH
- nádory hypofýzy * diagnostické zobrazování chirurgie patologie MeSH
- nosní dutina diagnostické zobrazování chirurgie patologie MeSH
- počítačová rentgenová tomografie MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- balónková okluze MeSH
- biokompatibilní materiály klasifikace terapeutické užití MeSH
- epistaxe ošetřování terapie MeSH
- hemostatické techniky * klasifikace ošetřování MeSH
- léčivé přípravky klasifikace MeSH
- lidé MeSH
- okluzivní ošetření rány MeSH
- polyvinylalkohol terapeutické užití MeSH
- vnitřní tamponáda * klasifikace metody MeSH
- želatina terapeutické užití MeSH
- Check Tag
- lidé MeSH
- MeSH
- arterie chirurgie MeSH
- chirurgie nosu * metody škodlivé účinky MeSH
- epistaxe * chirurgie MeSH
- lidé MeSH
- sinus ethmoidalis chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- arteria carotis interna anatomie a histologie MeSH
- arteriae carotides anatomie a histologie MeSH
- lidé MeSH
- nos * anatomie a histologie krevní zásobení MeSH
- nosní dutina * anatomie a histologie krevní zásobení MeSH
- nosní skořepy anatomie a histologie MeSH
- paranazální dutiny anatomie a histologie MeSH
- sinus sphenoidalis anatomie a histologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Iatrogenic injury of the internal carotid artery (ICA) is a rare, and probably underreported, complication of transnasal endoscopic skull base surgery. Although treatment algorithms have been suggested, there is no definite consensus or guideline for the management of this severe complication. We describe a case of ICA injury that occurred during a transsphenoidal biopsy of a tumor in the cavernous sinus and we present a treatment algorithm for managing this complication. We reviewed the articles published from 1998 to 2021, reporting on major vascular injury during transnasal endoscopic skull base surgery and endonasal endoscopic surgery, and we compare the methods and results of ICA injury management reported in the literature with the presented case. The most promising treatment for ICA injury might be packing with a muscle graft initially, then performing an endovascular intervention.
- Publikační typ
- kazuistiky MeSH
The aim of this study was to compare the success of endoscopic dacryocystorinostomy with and without bicanalicular intubation in the treatment of distal nasolacrimal duct obstruction.METHODS: In a prospective, randomized, comparative study, endoscopic dacryocystorinostomy without bicanalicular silicone intubation (Group I) and endoscopic dacryocystorinostomy with intubation (Group II) were performed in patients with distal nasolacrimal duct obstructions. The tubes were removed 3 months after surgery in Group II, and the patients were followed up for 6 months after surgery. Therapeutic success was defined as the fluorescein dye disappearance test grade 0-1 corresponding with a complete resolution of symptoms. RESULTS: Thirty patients, aged 23-86 years, were included in the study. The success rate was 13/15 (86.67%) in Group I and in 14/15 (93.33%) in Group II. The difference between the two groups was not statistically significant (p = 0.483). Most common complications were granulations that occurred in 1/15 (6.67%) patient in Group I and in 2/15 (13.33%) patients in Group II. Adhesions in rhinostomy with epiphora and persistent secretion were observed in 1/15 (6.67%) patient in Group II. CONCLUSIONS: Bicanalicular intubation does not significantly increase the success rate of EDCR in distal nasolacrimal obstruction in adults.
- Publikační typ
- časopisecké články MeSH
INTRODUCTION: The clinical management of parasellar meningiomas (PM) is challenging due to their intimate association with critical neurovascular structures. Consensus regarding the recommended treatment protocol is lacking. This study will evaluate patients' visual outcomes following endoscopic transnasal optic nerve decompression (ETOND) and will investigate the possibility of reducing the rate of complications associated with stereotactic radiosurgery (SRS). METHODS: Retrospective analysis was conducted on all patients who underwent ETOND for PM between 2013 and 2020. The study comprised 12 patients (7 women and 5 men aged 36-75 years; mean, 55.2 years; median, 57.6 years) in which 14 optic nerve decompression procedures were carried out. Patients were followed up for 6 to 86 months (mean, 29.3 months; median, 25 months). There were five cases of spheno-orbital meningioma, four cases of cavernous sinus meningioma, and one case each of petro-clival meningioma, optic nerve sheath meningioma, and planum sphenoidale/tuberculum sellae meningioma. Visual outcome was evaluated and any postoperative complications noted. RESULTS: Improvements in visual acuity were noted in 10 of 14 eyes (71.4%) 3 to 6 months postoperation. Visual acuity remained stable in the remaining four eyes. No deterioration of visual acuity was noted during the follow-up period. In total, 9 of the 12 patients underwent SRS. No tumor growth was determined, while reduction in tumor volume was noted in five patients following SRS. No complications associated with SRS or the surgical procedure were noted. CONCLUSIONS: ETOND appears to be a promising technique for increasing rates of improved visual function, while reducing the risk of post SRS-related complications. In combination with subsequent SRS, it is an ideal treatment modality in the management of parasellar meningiomas. Confirmation of our findings would require a larger, prospective multicenter study.
- MeSH
- dekomprese MeSH
- lidé MeSH
- meningeální nádory * komplikace radioterapie chirurgie MeSH
- meningeom * komplikace radioterapie chirurgie MeSH
- nádory baze lební * komplikace patologie chirurgie MeSH
- nervus opticus chirurgie MeSH
- prospektivní studie MeSH
- radiochirurgie * škodlivé účinky metody MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
Although extensive research has shown the pathological effect of fine and ultrafine airborne particles, clear evidence of association of environmental exposure to them and inflammatory changes in human nasal mucosa is missing. Meanwhile, pathogenesis of chronic rhinosinusitis, despite being a disease with high prevalence in the population, is still unclear. The increasing evidence of the pro-inflammatory properties of these particles raises the question of their possible role in chronic rhinosinusitis. The presented study focused on detection of microsized anorganic particles and clusters of nanosized anorganic particles in the nasal mucosa of patients with chronic rhinosinusitis by Raman microspectroscopy and comparison of their composition to histologic findings. The results were compared to the findings in mucosa obtained from cadavers with no history of chronic rhinosinusitis. Solid particles were found in 90% of tissue samples in the group with chronic rhinosinusitis, showing histologic signs of inflammation in 95%, while in the control group, the particles were found in 20% of samples, with normal histologic findings in all of them. The main detected compounds were graphite, TiO2, amorphous carbon, calcite, ankerite and iron compounds. The results are in accordance with the premise that exogenous airborne particles interact with the nasal mucosa and possibly deposit in it in cases where the epithelial barrier is compromised in chronic rhinosinusitis.
- MeSH
- chronická nemoc MeSH
- lidé MeSH
- nosní sliznice patologie MeSH
- rýma * MeSH
- sinusitida * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
<b>Aim:</b> The aim of this study was to compare the odontogenic and tonsillar origins of deep neck infection (DNI) as a negative prognostic factor for developing complications. </br></br> <b>Methods:</b> This was a retrospective study of 544 patients with tonsillar and odontogenic origins of DNI treated between 2006 and 2015 at 6 ENT Departments and Departments of Oral and Maxillofacial Surgery. Complications from DNI (descending mediastinitis, sepsis, thrombosis of the internal jugular vein, pneumonia, and pleuritis) were evaluated in both groups and compared. Associated comorbidities (cardiovascular involvement, hepatopathy, diabetes mellitus respiratory involvement, gastroduodenal involvement) were reviewed. </br></br> <b>Results:</b> Five hundred and forty-four patients were analyzed; 350/544 males (64.3%) and 19/544 females (35.7%). There were 505/544 cases (92.8%) with an odontogenic origin and 39/544 cases (7.2%) with a tonsillar origin of DNI. Complications occurred more frequently in the group with tonsillar origin of DNI (P < 0.001). There was no difference in diabetes mellitus between the two groups. </br></br> <b>Conclusions:</b> Currently, the tonsillar origin of DNI occurs much less frequently; nevertheless, it carries a much higher risk of developing complications than cases with an odontogenic origin. We recommend that these potentially high-risk patients with a tonsillar origin of deep neck infections should be more closely monitored.
- MeSH
- krční mandle MeSH
- krk * chirurgie MeSH
- lidé MeSH
- mediastinitida * etiologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
