| Perioperative and intraoperative maneuvers to optimize surgical outcomes in skull base surgery. | |
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MedLine Citation:
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PMID: 20599078 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There are many approaches to obtaining a workable endoscopic surgical field in sinus surgery. With extended sinus and transdural endoscopic surgery, a more rigid approach must be taken. There are 3 main factors that invariably lead to poor surgical outcomes in endoscopic sinus and skull base surgery: bleeding, inadequate access, and unidentified anatomic anomalies. Bleeding is arguably the most common reason for incomplete resection. An understanding of microvascular and macrovascular bleeding allows a more structured approach to improve the surgical field in extended endoscopic surgery. The endoscopic surgeon should always be comfortable in performing the same procedure as an open operation. However, converting or abandoning an endoscopic procedure should rarely occur because much of this decision making should take place preoperatively. Along with poor hemostasis, inadequate access is an important cause of poor outcome. Evaluation of the anatomy involved by pathology but also the anatomy that must be removed to allow adequate exposure is important. This article reviews the current techniques used to ensure optimal surgical conditions and outcomes. |
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Authors:
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Daniel Timperley; Raymond Sacks; Richard J Parkinson; Richard J Harvey |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Otolaryngologic clinics of North America Volume: 43 ISSN: 1557-8259 ISO Abbreviation: Otolaryngol. Clin. North Am. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-05 Completed Date: 2010-10-08 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0144042 Medline TA: Otolaryngol Clin North Am Country: United States |
Other Details:
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Languages: eng Pagination: 699-730 Citation Subset: IM |
Affiliation:
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Rhinology and Skull Base, Department of Otolaryngology/Skull Base Surgery, St Vincent's Hospital, 354 Victoria Street, Sydney, NSW 2010, Australia. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Blood Coagulation Disorders
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therapy Dietary Supplements Embolization, Therapeutic Endoscopy* Head-Down Tilt Hemostasis, Surgical* Hemostatic Techniques Humans Intraoperative Period Magnetic Resonance Imaging Maxillary Artery / surgery Nose / blood supply Paranasal Sinuses / surgery* Skull Base / surgery* Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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