Objective The novel nasoseptal rescue flap has been proven to provide complete coverage of dural defects that may be encountered during endoscopic pituitary surgery through cadaveric studies. In this case series, the authors report outcomes from first cohort patients who had a raised prior surgery. Study Design Case series with chart review. Setting University North Carolina–Chapel Hill. Subjects and Methods Patients requiring flaps were identified senior author’s database. Results...

To investigate the extent of carotid artery exposure attained, including identification external branches and lower cranial nerves in five sequential approaches to parapharyngeal space, provide an anatomical algorithm.Anatomical study.Six latex-injected adult cadaver heads were dissected consecutive approaches: transcervical approach with submandibular gland removal, posterior extension approach, parotidectomy, parotidectomy lateral mandibulotomy, mandibulectomy. The degree branches,...

To examine the relationship between cerebrospinal fluid (CSF) rhinorrhea and obstructive sleep apnea (OSA).Retrospective chart review of patients who underwent surgical repair encephaloceles and/or CSF at a tertiary medical center over 12-year period.Pertinent demographic, clinical, data including age, sex, history were obtained. Patients classified by etiology leak into spontaneous group nonspontaneous group, which included with documented trauma, malignancy, or known iatrogenic injury.We...

Objective: To compare normal saline (NS) vs. NS+budesonide irrigations in post- functional endoscopic sinus surgery (FESS) patients with chronic rhinosinusitis polyposis (CRSwNP). Currently, no evidence exists for irrigation over NS alone. Study design: Prospective, single-blind, randomized controlled trial. Methods: Subjects were prospectively enrolled to or arms. Patients evaluated at pre-operative and three post-operative visits (POV): POV1 (1-2 weeks post-op), POV2 (3-8 POV3 (3-6 months...

Objective: To compare normal saline (NS) vs. NS + budesonide irrigations in post-functional endoscopic sinus surgery (FESS) patients with chronic rhinosinusitis polyposis (CRSwNP).Currently, no evidence exists for irrigation over alone.Study design: Prospective, single-blind, randomized controlled trial.Methods: Subjects were prospectively enrolled to or arms.Patients evaluated at pre-operative and three post-operative visits (POV): POV1 (1-2 weeks post-op), POV2 (3-8 POV3 (3-6 months...

Objective Sinonasal meningoencephalocele is a rare defect, with varying etiologies and treatment strategies. Here we present the largest published series from single institution of patients endoscopic repair. The primary goal to examine rates success consideration accompanying patient demographic data. secondary report results stratified by defect reconstruction type. Design Retrospective consecutive case series. Setting Tertiary care academic center. Subjects Methods Consecutive CPT codes...

The posterior skull base and the nasopharynx have historically represented technically difficult regions to approach surgically given their central anatomical locations. Through continued improvements in endoscopic instrumentation technology, expanded endonasal (EEA) has introduced a new array of surgical options management pathology involving these anatomically complex areas. Similarly, transoral robotic (TORS) was as minimally invasive option tongue base, nasopharyngeal, parapharyngeal,...

Basilar invagination and basilar impression both refer to the displacement of odontoid process into foramen magnum, although former is congenital latter due secondary etiology.1 Many etiologies for exist, including trauma, Paget's disease bone, osteogenesis imperfecta, rickets, rheumatoid pannus.2 To our knowledge there have been no reports caused by radiation fibrosis process. We present this case with subsequent novel indication an endonasal transclival odontoidectomy. A 66-year-old female...

Background Surprisingly, little literature exists evaluating the optimal duration of antibiotic treatment in “maximal medical therapy” for chronic rhinosinusitis (CRS). As such, we investigated whether 3 weeks vs 6 therapy resulted significant differences clinical response. Methods A prospective, randomized cohort study was performed with patients assigned to 3‐week or 6‐week cohorts. Our primary outcome failure and surgical recommendation. Secondary outcomes included changes pretherapy...

<b>Objective</b> To highlight key anatomical and technical considerations for facial artery identification, harvest transposition of the buccinator (FAB) flap to facilitate its future use in anterior skull base reconstruction. Only a few studies have evaluated reverse-flow FAB defects. <b>Design</b> Eight flaps were raised four cadaveric heads divided into thirds; artery's course at superior inferior borders was measured noting which incisional third it laid. The flap's reach cranial fossa,...

Objectives Neonates weighing &lt; 2.5 kg have known higher rates of surgical mortality and morbidity, but this remains unexamined specifically for tracheostomy. We present outcomes neonates undergoing tracheostomy stratified by weight. Methods Retrospective review the American College Surgeons National Surgical Quality Improvement Program–Pediatric from 2012 to 2014. Patients were included. Thirty‐day major/minor complication weight (group 1: kg; group 2: ≥ 4 3: kg). Patient comorbidities...

Traumatic perilymphatic fistula (PLF) is an uncommon cause of acute vestibular symptoms and hearing loss following head injury in children. We describe the management 3 pediatric patients with traumatic PLF using endoscopic ear surgery (EES) approach. Three underwent repair via EES approach between August October 2018. Patients included a 14-year-old female (oval window), 13-year-old male (round 10-month-old round window). Ossicular chain was identified repaired 2 patients. The patient...

Background The medial and inferior recti encompass the ideal surgical corridor to approach intraconal space endonasally. Here, we describe 3 different maneuvers achieve greater access orbital contents through an expanded endonasal (EEA). Methods Four human cadaver heads were dissected bilaterally (n = 8). EEA orbit was executed. following performed: (1) anterior: extraocular muscles control (EOM); (2) posterior: annulus of Zinn (AZ) release; (3) anterior/posterior combined. Measurements...

Objective: Our institution has performed endoscopic surgical repairs for over 125 encephaloceles and CSF leaks since December 2004, of which more than 40 cases have been identified as sphenoid or leaks, eight specifically in the lateral wall sinus originating Sternberg's canal. The success approach treatment is discussed. We a retrospective review diagnosed with canal history leak who were treated using approaches at Department Otolaryngology-Head Neck Surgery University North Carolina...

Background: The expanded endonasal approach (EEA) has previously been described to access the medial orbit for a variety of pathologies; however, intraconal approaches are still novel and evolving. In this study, we displace inferior rectus via external control, measure degree endoscopic allowed on fresh cadaveric specimens before after release Annulus Zinn (AZ). Measurements also made indicating increased anterior–posterior visualization optic nerve release.

Background: The expanded endonasal approach (EEA) has previously been described to access the medial orbit for a variety of pathology; however, intraconal approaches are still novel and evolving. Here, we study inferior rectus displacement via an external degree endoscopic it allows on fresh human cadaveric specimens.

Background: The endoscopic era has revealed the feasibility and safety of approach to skull base; subsequently, use open requires increasing justification. Endoscopic outcomes for malignancy are preliminary promising, yet no study quantitatively assessed factors associated with pursuing an open, rather than endoscopic, base cancer surgery.

Background: Open surgical approaches to the internal carotid artery (ICA) have been well described including extended transcervical and variations of infratemporal fossa approach. From bifurcation its entrance into canal, a multitude benign malignant pathology can often involve ICA requiring meticulous dissection progressive approaches. However, though operative described, direct comparisons exposure attained with various open techniques has not studied. In this cadaver study, we strive...