A Cadaveric Model for Balloon-Assisted Endoscopic Paranasal Sinus Dissection without Fluoroscopy
| Autor: | Martin J. Citardi, Seth J. Kanowitz |
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| Rok vydání: | 2007 |
| Předmět: |
Models
Anatomic medicine.medical_specialty Maxillary sinus Pilot Projects Dissection (medical) Catheterization 03 medical and health sciences 0302 clinical medicine Paranasal Sinuses Cadaver Paranasal Sinus Diseases medicine Humans Prospective Studies 030223 otorhinolaryngology Sinus (anatomy) business.industry Ethmoidectomy Balloon catheter Reproducibility of Results Endoscopy Sinus ostium Functional endoscopic sinus surgery medicine.disease Surgery Ostium medicine.anatomical_structure Otorhinolaryngology Fluoroscopy 030220 oncology & carcinogenesis Radiology business |
| Zdroj: | American Journal of Rhinology. 21:579-583 |
| ISSN: | 1539-6290 1050-6586 |
| DOI: | 10.2500/ajr.2007.21.3081 |
| Popis: | Background Recently, balloon catheter (BC) dilatation of paranasal sinus ostia has been introduced. In this procedure, a balloon-tipped catheter is placed across a sinus ostium over a flexible wire under fluoroscopic guidance, and inflation of the balloon enlarges the ostium. Some rhinologists have criticized this procedure for its failure to remove tissue and bone, especially in the setting of sinonasal polyposis. This project seeks to develop strategies for incorporating BC technology into standard functional endoscopic sinus surgery procedures. Methods Endoscopic sinus dissection of three human cadaveric heads was performed with conventional instruments supplemented by lacrimal duct BCs (LacriCATH; Quest Medical, Allen, TX). No fluoroscopy was used. Each dissection was videotaped for later review. Results For frontal recess dissection, these steps were performed under endoscopic visualization: (1) passage of the BC between frontal recess partitions, (2) BC inflation, and (3) removal of fractured frontal recess partitions with conventional instruments. This approach was used successfully in each frontal recess. Under endoscopic visualization, a BC was passed into the sphenoid ostium and inflated; this maneuver successfully dilated each sphenoid ostium. It was not feasible to reliably pass the BC through the natural maxillary ostium. Each BC was inflated to 8 atm for 30 seconds. No evidence of orbital or skull base injury was noted. No fluoroscopy was used. Conclusion BCs may be used as adjunctive instrumentation for endoscopic sinus dissection without fluoroscopy. This strategy warrants additional technical and clinical development. |
| Databáze: | OpenAIRE |
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