Juvenile nasopharyngeal angiofibroma: Analysis of 42 cases and important aspects of endoscopic approach

WOS: 000263665400009PubMed ID: 19124161Objective: To determine the general characteristics of 42 patients who were operated for juvenile nasopharyngeal angiofibroma (JNA); and to determine the important aspects and the advantages of endoscopic transnasal approach over other techniques. Methods: Forty-two patients with JNA, 12 of whom were operated with endoscopic transnasal, approach at a tertiary care center between March 1987 and February 2008 were evaluated retrospectively. The general characteristics of the patients, presenting signs and symptoms, the surgical approach performed, tumor stage, whether preoperative' embolization was performed and rates of recurrence were studied. Patients who underwent surgery with endoscopic transnasal. approach were compared to others who underwent surgery with different techniques. Results: One patient was female and the remaining 41 patients were mate. Twelve patients underwent endoscopic removal of the tumor. Lateral rhinotomy was used for 10 patients, degloving approach for 7 patients, transpalatal approach for 6 patients, combined approach for another 6 patients and finally midfacial. splitting for 1 patient. Seventeen percent of the patients had referred with recurrent diseases. According to staging system of Radkowski, about half of the patients belonged to stage IIA or IIC. The mean age was 16 and the most common presenting symptom was nasal obstruction. Preoperative embolization rate was 59.5% while recurrence rate in the postoperative period was 17%. In non-endoscopic approaches, the tumor contiguity and operative plan were determined via radiological data. In operations performed with endoscopic transnasal approach in patients with JNA, the radiological, data as well as a detailed endoscopic tumor examination were utilized and it was observed that tumor invaded the middle turbinate in 67% and both the septum and middle turbinate in 42% of the patients. While preoperative' embolization was performed only in larger tumors before 1998, it was recruited in all. subjects after 1998. Preoperative and postoperative hemorrhage were less, and durations of packing and hospitalization were shorter in patients operated with endoscopic approach plus preoperative embolization. Conclusion: Endoscopic transnasal approach has advantages of no non-cosmetic sequela, less hemorrhage and no disruption in facial skeleton. Besides, this method allows better visualization of tumor contiguity and enables dissection and ligature of vascular structures in JNA surgery. The rate of tumors associated with middle turbinate and septum is greater than that is assumed in patients with JNA. Starting the tumor excision with partial resection of the middle turbinate and subperiostal dissection of the septum and anterior sphenoidal wall, and avoiding direct contact with the tumor might decrease the amount of bleeding. (C) 2008 Elsevier Ireland Ltd. All rights reserved

A nasopharyngeal mass: leech in the nasopharynx

WOS: 000175992400012PubMed ID: 12020918This paper presents a case with a 4-month history of nasal obstruction and intermittent epistaxis. The cause was found to be a leech in the nasopharynx by means of endoscopic examination. Leech endoparasitism, although rare, may cause serious. even lethal. complications. A high index of suspicion of leech infestation must be entertained when faced with nasal obstruction and intermittent epistaxis in children, and should be investigated surgically as with all other foreign bodies, (C) 2002 Elsevier Science Ireland Ltd. All rights reserved

Endoscopic sinus surgery in the isolated paranasal sinus aspergilloma [La chirurgie endoscopique pour l'aspergillome d'un sinus paranasal]

PubMed ID: 10769567Fungal infections of the paranasal sinuses are in four clinical forms. Beside the acute fulminating form, chronic invasive form, allergic fungal sinusitis and fungus ball. Fungus ball is mostly encountered in only one paranasal sinus of an otherwise healthy person. Ten fungus balls of the paranasal sinuses are presented with their management and results

Dependence of the Structural, Electrical and Magnetic Properties of the Superconductive YBCO Thin Films on the Deposition Rate

International Conference on Superconductivity and Magnetism (ICSM) -- AUG 25-29, 2008 -- Ankara Univ, Side, TURKEYWOS: 000298993000016In this study, YBCO thin films on single crystal LaAlO(3) (100) substrates have been grown using DC inverted cylindrical magnetron sputtering technique and the effect of the deposition rate on these films is investigated. Three different deposition rates are used to produce superconducting YBCO thin films with 150 nm of thickness on (100) LaAlO(3) single crystal substrate at 780 degrees C. The samples are analyzed in detail by means of XRD, R-T, chi-T, M-H and AFM characterizations and also the critical current densities (J(c)) are derived from the magnetic hysteresis curves using the modified Bean formula [1]. The critical current density at 50 K was found to be in the range of 3.10(7) A/m(2) to 8. 10(7) A/m(2) with a deposition rate between 2nm/min and 1.2nm/min. A correlation has been obtained so that as the film deposition rate increases, the surface smoothness and crystalline quality of the films significantly deteriorate, resulting in a significant decrease in J(c)

Controlled hypotension and minimal inflation pressure: A new approach for pneumatic tourniquet application in upper limb surgery

Minimal inflation pressures are recommended for limb surgery to eliminate complications attributable to high inflation pressures with the pneumatic tourniquets. We applied controlled hypotension and a minimal inflation pressure (CHAMIP) technique to provide a bloodless surgical field. Thirty-six patients scheduled for upper extremity surgery were randomized equally to receive either normotensive anesthesia and conventional inflation pressures or controlled hypotension (systolic arterial blood pressure of 80-100 mm Hg and mean arterial blood pressure >60 mm Hg) and minimum inflation pressures. Anesthesia was induced with propofol IV bolus and remifentanil IV continuous infusion and maintained with propofol and remifentanil IV continuous infusion. To determine the minimal inflation pressure, the digital plethysmograph was applied to the second finger at the side of the operation and the tourniquet was inflated slowly until the arterial pulsations disappeared on the oscilloscope. A bloodless surgical field was obtained in almost all patients, even though systolic arterial blood pressures (100138 mm Hg versus 80-100 mm Hg) and applied tourniquet inflation pressures (270 nim Hg versus 110-140 mm Hg) were significantly lower in the hypotensive group. No complications associated with controlled hypotension were encountered. In conclusion, CHAMIP may be a safe and reliable method for upper extremity surgery performed with pneumatic tourniquets