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Yamamoto K, Okuni T, Kurose M, Akiyama Y, Takano K. Extracapsular Dissection With Narrow-Band Imaging Using the Transnasal Endoscopic Tri-port Approach for Extracranial Trigeminal Schwannoma: A Case Report. Cureus 2024; 16:e58200. [PMID: 38741849 PMCID: PMC11090376 DOI: 10.7759/cureus.58200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 05/16/2024] Open
Abstract
The pterygopalatine fossa and infratemporal fossa are often approached through an external incision because of their deep facial location, but this can present problems such as facial scarring and deformity. In schwannoma surgery, intraneural dissection is a useful surgical technique for achieving gross total resection while preserving the capsule, including the nerves. For appropriate enucleation and preservation of the functional nerve, it is indispensable to distinguish between the pseudocapsule and the tumor capsule. This case report presents a case of endonasal surgical intervention for an extracranial trigeminal schwannoma employing the tri-port approach and narrow-band imaging.
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Affiliation(s)
- Keisuke Yamamoto
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo, JPN
| | - Tsuyoshi Okuni
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo, JPN
| | - Makoto Kurose
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo, JPN
| | - Yukinori Akiyama
- Department of Neurosurgery, Sapporo Medical University School of Medicine, Sapporo, JPN
| | - Kenichi Takano
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Medical University School of Medicine, Sapporo, JPN
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2
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Canevari FR, Giorli A, Monti G, Biagini C, Bagnasco D, Cavaliere C, Pipolo C, De Corso E, Gelardi M, Gramellini G, Ioppi A, La Mantia I, Malvezzi L, Bignami M, Dehgani-Mobaraki P, Seccia V, Maggiore G, Macchi A. Diagnostic therapeutic assistance pathway (PDTA) of type 2 chronic rhinosinusitis. FRONTIERS IN ALLERGY 2023; 4:1237131. [PMID: 37841050 PMCID: PMC10570804 DOI: 10.3389/falgy.2023.1237131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 09/06/2023] [Indexed: 10/17/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is a complex and heterogeneous disorder whose etiopathogenetic picture is not yet completely known and is classically divided into CRS with (CRSwNP) and without nasal polyps (CRSsNP). But today the distinction is made with type 2 and nontype 2 variants. A rational and defined pathway for the diagnosis of chronic rhinosinusitis is an indispensable means to be able to arrive at a correct identification of the patient. This typing is essential to be able to arrive at the correct course of treatment, which turns out to be different for different types of patients. For this reason, the realization of a diagnostic therapeutic pathway represents a fundamental way for the otolaryngologist specialist but not only, since today diagnostics has a multidisciplinary framework. In the present work, precise indications have been developed to arrive at a correct diagnosis. The various diagnostic pathways and processes to arrive at a correct therapeutic framing have been highlighted. Therapy ranging from medical therapy to surgical therapy without neglecting the new biological therapies. It does not represent a guideline but a diagnostic method that can be adapted to all the various territorial realities.
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Affiliation(s)
- Frank Rikki Canevari
- Unit of Otorhinolaryngology – Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
| | - Alessia Giorli
- Otolaryngology Department, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Giulia Monti
- ENT Department, ASST Sette Laghi, University of Insubria, Varese, Italy
| | - Cesare Biagini
- Otolaryngology Department, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Diego Bagnasco
- Allergy and Respiratory Diseases, Department of Internal Medicine (DIMI), IRCCS Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Carlo Cavaliere
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Carlotta Pipolo
- Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, University of Milan, Milan, Italy
| | - Eugenio De Corso
- Unit of Otorhinolaryngology and Head-Neck Surgery, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | - Matteo Gelardi
- Department of Otolaryngology, University Hospital of Foggia, Foggia, Italy
| | - Giulia Gramellini
- ENT Deptartement, Asst Grande Ospedale Metropolitano Niguarda, Ear, Nose and Throat Unit of Sant'Orsola-Malpighi Hospital, Bologna, Italy
| | - Alessandro Ioppi
- Unit of Otorhinolaryngology – Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Italy
- Department of Otorhinolaryngology-Head and Neck Surgery, “S. Chiara” Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy
| | - Ignazio La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, ENT Section, University of Catania, Catania, Italy
| | - Luca Malvezzi
- Otorhinolaryngology, Head and Neck Surgery Unit, Humanitas Research Hospital, IRCCS, Milan, Italy
| | - Maurizio Bignami
- Department of Otorhinolaryngology, Department of Surgery, ASST Lariana, University of Insubria, Como, Italy
| | | | - Veronica Seccia
- Otolaryngology Audiology and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine,Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | | | - Alberto Macchi
- ENT Department, ASST Sette Laghi, University of Insubria, Varese, Italy
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Pollastri F, Locatello LG, Bruno C, Maggiore G, Gallo O, Pecci R, Giannoni B. Otoendoscopy in the era of narrow-band imaging: a pictorial review. Eur Arch Otorhinolaryngol 2023; 280:1683-1693. [PMID: 36129549 PMCID: PMC9988719 DOI: 10.1007/s00405-022-07656-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/12/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Otoendoscopy represents the initial non-invasive diagnostic cornerstone for external and middle ear disorders. Recently, new techniques of enhanced imaging such as narrow-band imaging (NBI) have been introduced but their role as a potential aid in otological practice remains unproven. In this pictorial review, we want to present the potential application of this endoscopic method, highlight its limitations, and give some hints regarding its future implementation. METHODS Representative cases of external and/or middle ear pathologies were selected to illustrate the role of NBI in this regard. RESULTS NBI may represent a useful aid in the otological work-up, in the differential diagnosis of ear tumor-like masses, and, possibly, in the prognosis of tympanic perforations. For other ear disorders, instead, this technique does not seem to add anything to the standard clinical practice. CONCLUSIONS NBI might prove useful in the assessment of selected external and middle ear disorders but its role must be prospectively validated.
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Affiliation(s)
- Federica Pollastri
- Unit of Audiology, Oncological and Robotic Head and Neck Surgery, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy. .,Department of Neuroscience, Psychology, Drug's Area and Child's Health, University of Florence, Florence, Italy.
| | | | - Chiara Bruno
- Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy
| | | | - Oreste Gallo
- Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy
| | - Rudi Pecci
- Unit of Audiology, Oncological and Robotic Head and Neck Surgery, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy
| | - Beatrice Giannoni
- Unit of Audiology, Oncological and Robotic Head and Neck Surgery, Careggi University Hospital, Largo Brambilla 3, 50134, Florence, Italy.,Department of Neuroscience, Psychology, Drug's Area and Child's Health, University of Florence, Florence, Italy
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Xu Z, Zhang X, Dou X, Lin C, Wang H, Song S, Yu C, Cui X, Gao X. Flexible endoscopy in the visualization of 3D-printed maxillary sinus and clinical application. Surg Endosc 2022; 36:7827-7838. [PMID: 35882666 PMCID: PMC9485168 DOI: 10.1007/s00464-022-09410-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/19/2022] [Indexed: 11/25/2022]
Abstract
Background During postoperative follow-up, the visible range of maxillary sinus (MS) is limited, even combining 0° and 70° rigid endoscopes together. Flexible endoscope has been used in larynx examinations for a long time, but rarely in nasal cavity and sinus. We aimed to evaluate the application values of rigid and flexible endoscopes for visualization of MS. Methods We followed up 70 patients with lesions in MS via both rigid and flexible endoscopes. In addition, we used thin-slice CT image of the sinus to create a MS model and divided it into two parts for 3D printing. The inner surface of the 3D-printed sinus was marked with grid papers of the same size (5 mm × 5 mm), then the visual range under rigid endoscopes with different angle and flexible endoscopes was calculated and analyzed. Results In clinical follow-up, we found that flexible endoscopy can reach where rigid endoscopy cannot, which is more sensitive than medical imaging. Endoscopes showed the largest observation range of the posterolateral wall, more than half of which can be visualized by 0° endoscope. Almost all of the posterolateral wall can be revealed under 45° endoscope, 70° endoscope and flexible endoscope. The visual range of each wall under flexible endoscope is generally greater than that under rigid endoscopes, especially of the anterior wall, medial wall and inferior wall. Conclusion There was obviously overall advantage of using flexible endoscope in postoperative follow-up of MS lesions. Flexible endoscopy can expand the range of observation, and improve the early detection of the recurrent lesion. We recommend flexible endoscope as a routine application. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00464-022-09410-8.
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Affiliation(s)
- ZhengRong Xu
- Department of Otolaryngology Head and Neck Surgery, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,Research Institute of Otolaryngology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Zhang
- Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Dou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - ChuanYao Lin
- Department of Otolaryngology Head and Neck Surgery, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,Research Institute of Otolaryngology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - HanDong Wang
- Department of Otolaryngology Head and Neck Surgery, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,Research Institute of Otolaryngology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - ShengHua Song
- Department of Otolaryngology Head and Neck Surgery, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,Research Institute of Otolaryngology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - ChenJie Yu
- Department of Otolaryngology Head and Neck Surgery, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China. .,Research Institute of Otolaryngology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
| | - XinYan Cui
- Department of Otorhinolaryngology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, China.
| | - Xia Gao
- Department of Otolaryngology Head and Neck Surgery, Jiangsu Provincial Key Medical Discipline (Laboratory), Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China. .,Research Institute of Otolaryngology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
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The Role of Elective Neck Treatment in the Management of Sinonasal Carcinomas: A Systematic Review of the Literature and a Meta-Analysis. Cancers (Basel) 2021; 13:cancers13081842. [PMID: 33924359 PMCID: PMC8069890 DOI: 10.3390/cancers13081842] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 12/28/2022] Open
Abstract
The impact of elective neck treatment (ENT), whether by irradiation or dissection, on the prognosis of patients with cN0 sinonasal carcinomas (SNCs) remains an understudied issue. METHODS: A systematic review and meta-analysis of the literature were performed according to PRISMA guidelines in order to assess regional nodal relapse rate after ENT compared to observation in cN0 SNCs patients. Twenty-six articles for a total of 1178 clinically N0 patients were analyzed. Globally, the 5-year overall survival was 52%; 34.6% of patients underwent ENT and 140 regional recurrences were registered (5.9% in the ENT cohort and 15% in the observation group). ENT appears to confer a lower risk of regional recurrence compared to observation alone, with a cumulative OR of 0.38 (95% CI 0.25-0.58). Our meta-analysis supports the efficacy of ENT for reducing the risk of regional recurrence, but its overall impact on survival remains uncertain.
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