Objective:To report the use of a 3 mm rigid nasal endoscope in primary endoscopic stapedotomy and clinical and audiological outcomes.Materials and methods:Thirty patients diagnosed with primary otosclerosis underwent ...Objective:To report the use of a 3 mm rigid nasal endoscope in primary endoscopic stapedotomy and clinical and audiological outcomes.Materials and methods:Thirty patients diagnosed with primary otosclerosis underwent endoscopic stapedotomy that was performed using a 3 mm nasal endoscope(Karl Storz).At 6 months follow-up,the patients were evaluated for intraoperative findings,postoperative hearing outcomes and complications.Results:Canaloplasty was performed in 2(6.66%)patients,and no curettage of the canal wall was required in 12(40%)patients.Transposition of the chorda tympani nerve was conducted in 11(36.66%)patients.The average duration of surgery was 36 min(range 31e65 min).The air-bone gap(ABG)was 35 dB(range 24e50 dB)preoperatively and 14.63 dB(range 9e20 dB)postoperatively(p?0.00).At 6 months follow-up,<20 dB ABG was achieved in 93.33%of the patients.No major intraoperative/postoperative complications were detected.Conclusion:A 3 mm rigid nasal endoscope can be effectively used in stapedotomy to obtain adequate audiological outcomes.It can be considered as a better alternative to the standard microscope or 4 mm endoscope in preserving the posterior canal wall and chorda tympani nerve while minimizing operative time without causing significant complications.展开更多
Objective:The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site,fewer donor site morbidity and the cost effectiveness...Objective:The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site,fewer donor site morbidity and the cost effectiveness of the procedure.Methods:A total of 30 patients with squamous cell carcinoma of the oral cavity were included in the study from July 2012 to August 2015 in a tertiary care referral hospital.Patients with clinical staging Ⅰ/Ⅱ/Ⅲ (T1/T2/T3,N0) oral malignancy were included in the study.Patients with nodal metastasis irrespective of the stage of disease and patients with chronic medical illness/revision cases were excluded from the study.Submental island flap was utilized for the reconstruction of the soft tissue defect in each patient.Patients were followed at monthly interval till 6 months in the postoperative period.Results:The buccal mucosa (12 patients),tongue (10 patients) and floor of mouth (8 patients) were the subsites in the oral cavity.Partial and complete skin necrosis was found in 4 and 2 patients respectively.Postoperative chemoradiation was required in 5 patients.None of the patients had loco regional recurrence till 6 months of follow-up.Conclusion:The submental island flap is considered to be the reliable option for the soft tissue reconstruction in oral cancer because of dependent vascular pedicle,less donor site morbidity and the lower cost compared to the free flaps,often preferred in patients with a lower socioeconomic condition.展开更多
Background:Although the utility of laser fiber in microscopic stapes surgery has been documented in the past,their role can be highly emphasized in endoscopic stapes surgery,especially in difficult anatomical situatio...Background:Although the utility of laser fiber in microscopic stapes surgery has been documented in the past,their role can be highly emphasized in endoscopic stapes surgery,especially in difficult anatomical situations.Methods:This is a retrospective analysis of cases where a total of 46 patients(22 in conventional stapedotomy and 24 in CO_(2) laser‐assisted stapedotomy)were included in the study.The clinical parameters were assessed both in the preoperative and postoperative periods in the respective groups and later compared 12 weeks after stapedotomy.Results:A total of 90.90%(20/22)of the patients in the conventional stapedotomy and 95.83%(23/24)of patients in laser‐assisted stapedotomy had<20 dB of AB gap in the postoperative period(P=0.71).Canaloplasty was required in six patients in the conventional stapedotomy and none of the patients in the laser group needed the same(P=0.01).Chorda tympani nerve was manipulated in 59.09%(13/22)and 25.00%(6/24)of cases in the conventional group and in the CO_(2) laser group,respectively(P=0.01).Conclusion:Although the audiological outcomes with fiber‐enabled CO_(2) laser in endoscopic stapedotomy are comparable to conventional surgery,it is a better tool in a narrow auditory canal,requiring minimal manipulation of the chorda tympani nerve.展开更多
Objective:Excision of the nerve sheath tumours of head and neck is always a challenge to the surgeon because of their close proximity of the neurovascular structures.Methods:It is a retrospective study contained 13 co...Objective:Excision of the nerve sheath tumours of head and neck is always a challenge to the surgeon because of their close proximity of the neurovascular structures.Methods:It is a retrospective study contained 13 consecutive patients of nerve sheath tumours involving the head and neck from March 2013 to February 2017 in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care referral hospital The retrospective clinical data,diagnostic procedures,surgical approaches and their complications are analyzed after 12 months of surgery.Results:Total 13 patients,7 were females and 6 were males.Painless neck swelling was the most common presentation found in 6 and the most common site of origin was the vagus nerve in the parapharyngeal space (6 patients).Transcervical excision of the tumour was performed in 7 patients.Six needed combined surgical approach for the excision of the tumours.Neurovascular injury was detected in 3 patients,and one patient had recurrent disease during the follow-up period.Conclusions:Excision of the nerve sheath tumours of head and neck is always a challenge to the surgeon because of their close proximity of the neurovascular structure.Although the transcervical approach is commonly practiced for the majority of the tumours,combined approaches can be effectively applied for extensive nerve sheath tumours with the satisfactory clinical outcome.展开更多
文摘Objective:To report the use of a 3 mm rigid nasal endoscope in primary endoscopic stapedotomy and clinical and audiological outcomes.Materials and methods:Thirty patients diagnosed with primary otosclerosis underwent endoscopic stapedotomy that was performed using a 3 mm nasal endoscope(Karl Storz).At 6 months follow-up,the patients were evaluated for intraoperative findings,postoperative hearing outcomes and complications.Results:Canaloplasty was performed in 2(6.66%)patients,and no curettage of the canal wall was required in 12(40%)patients.Transposition of the chorda tympani nerve was conducted in 11(36.66%)patients.The average duration of surgery was 36 min(range 31e65 min).The air-bone gap(ABG)was 35 dB(range 24e50 dB)preoperatively and 14.63 dB(range 9e20 dB)postoperatively(p?0.00).At 6 months follow-up,<20 dB ABG was achieved in 93.33%of the patients.No major intraoperative/postoperative complications were detected.Conclusion:A 3 mm rigid nasal endoscope can be effectively used in stapedotomy to obtain adequate audiological outcomes.It can be considered as a better alternative to the standard microscope or 4 mm endoscope in preserving the posterior canal wall and chorda tympani nerve while minimizing operative time without causing significant complications.
文摘Objective:The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site,fewer donor site morbidity and the cost effectiveness of the procedure.Methods:A total of 30 patients with squamous cell carcinoma of the oral cavity were included in the study from July 2012 to August 2015 in a tertiary care referral hospital.Patients with clinical staging Ⅰ/Ⅱ/Ⅲ (T1/T2/T3,N0) oral malignancy were included in the study.Patients with nodal metastasis irrespective of the stage of disease and patients with chronic medical illness/revision cases were excluded from the study.Submental island flap was utilized for the reconstruction of the soft tissue defect in each patient.Patients were followed at monthly interval till 6 months in the postoperative period.Results:The buccal mucosa (12 patients),tongue (10 patients) and floor of mouth (8 patients) were the subsites in the oral cavity.Partial and complete skin necrosis was found in 4 and 2 patients respectively.Postoperative chemoradiation was required in 5 patients.None of the patients had loco regional recurrence till 6 months of follow-up.Conclusion:The submental island flap is considered to be the reliable option for the soft tissue reconstruction in oral cancer because of dependent vascular pedicle,less donor site morbidity and the lower cost compared to the free flaps,often preferred in patients with a lower socioeconomic condition.
文摘Background:Although the utility of laser fiber in microscopic stapes surgery has been documented in the past,their role can be highly emphasized in endoscopic stapes surgery,especially in difficult anatomical situations.Methods:This is a retrospective analysis of cases where a total of 46 patients(22 in conventional stapedotomy and 24 in CO_(2) laser‐assisted stapedotomy)were included in the study.The clinical parameters were assessed both in the preoperative and postoperative periods in the respective groups and later compared 12 weeks after stapedotomy.Results:A total of 90.90%(20/22)of the patients in the conventional stapedotomy and 95.83%(23/24)of patients in laser‐assisted stapedotomy had<20 dB of AB gap in the postoperative period(P=0.71).Canaloplasty was required in six patients in the conventional stapedotomy and none of the patients in the laser group needed the same(P=0.01).Chorda tympani nerve was manipulated in 59.09%(13/22)and 25.00%(6/24)of cases in the conventional group and in the CO_(2) laser group,respectively(P=0.01).Conclusion:Although the audiological outcomes with fiber‐enabled CO_(2) laser in endoscopic stapedotomy are comparable to conventional surgery,it is a better tool in a narrow auditory canal,requiring minimal manipulation of the chorda tympani nerve.
文摘Objective:Excision of the nerve sheath tumours of head and neck is always a challenge to the surgeon because of their close proximity of the neurovascular structures.Methods:It is a retrospective study contained 13 consecutive patients of nerve sheath tumours involving the head and neck from March 2013 to February 2017 in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care referral hospital The retrospective clinical data,diagnostic procedures,surgical approaches and their complications are analyzed after 12 months of surgery.Results:Total 13 patients,7 were females and 6 were males.Painless neck swelling was the most common presentation found in 6 and the most common site of origin was the vagus nerve in the parapharyngeal space (6 patients).Transcervical excision of the tumour was performed in 7 patients.Six needed combined surgical approach for the excision of the tumours.Neurovascular injury was detected in 3 patients,and one patient had recurrent disease during the follow-up period.Conclusions:Excision of the nerve sheath tumours of head and neck is always a challenge to the surgeon because of their close proximity of the neurovascular structure.Although the transcervical approach is commonly practiced for the majority of the tumours,combined approaches can be effectively applied for extensive nerve sheath tumours with the satisfactory clinical outcome.