Document Detail


Perioperative and intraoperative maneuvers to optimize surgical outcomes in skull base surgery.
MedLine Citation:
PMID:  20599078     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Daniel Timperley; Raymond Sacks; Richard J Parkinson; Richard J Harvey
Related Documents :
8673328 - Complications of conscious sedation.
22567228 - Natural orifice transesophageal endoscopic surgery: state of the art.
7270528 - Endoscopic upper gastrointestinal polypectomy. report of 73 polypectomies in 63 patients.
20645228 - [how did lacrimal endoscopy influence lacrimal surgery?].
3421758 - Continent urinary diversion. a 5 1/2 year experience.
22551588 - Cerebral venous sinus thrombosis complicating traumatic head injury.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otolaryngologic clinics of North America     Volume:  43     ISSN:  1557-8259     ISO Abbreviation:  Otolaryngol. Clin. North Am.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0144042     Medline TA:  Otolaryngol Clin North Am     Country:  United States    
Other Details:
Languages:  eng     Pagination:  699-730     Citation Subset:  IM    
Affiliation:
Rhinology and Skull Base, Department of Otolaryngology/Skull Base Surgery, St Vincent's Hospital, 354 Victoria Street, Sydney, NSW 2010, Australia.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Blood Coagulation Disorders / 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


Previous Document:  Pitfalls and artefacts in performance and interpretation of contrast-enhanced MR angiography of the ...
Next Document:  Preoperative computed tomography evaluation in sinus surgery: a template-driven approach.