ICAR: endoscopic skull‐base surgery

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THE EFFICACY OF A MARRIAGE ENRICHMENT WEEKEND ONLY VS. A MARRIAGE ENRICHMENT PLUS FOLLOW-UP SUPPORT

The purpose of this study was to determine whether or not changes occurred for subjects who participated in a marriage enrichment experience. Five variables were measured: affective attitudes, effective communication behaviors, problem-solving cognitions, self:mate concurrence, and relationship satisfaction. Two research questions were investigated: (1) Were there marked differences between pretest and posttest scores of the five variables measured for couples who participated in a marriage enrichment experience? (2) Were there marked differences between posttest and follow-up posttest scores for couples who participated in a four-month follow-up support group following the marriage enrichment experience and those who did not? The conclusions of this study were: (1) A marriage enrichment weekend will be perceived as a positive experience by couples. Most who do not continue with follow-up support will still perceive the experience positively four months later, but will have found it difficult to practice the skills and behaviors they learned on the weekend without support of a group. (2) More men than women express an increase in relationship satisfaction immediately after the weekend. (3) The higher the trust and intimacy level, the better the perceived communication or vice versa, and the more an individual\u27s perception of self concurred with his or her mate. (4) The trust and intimacy level and perceived communication will increase after a marriage enrichment experience and maintain above the weekend level for couples with no follow-up. Behavioral skills will not maintain as well, and post-weekend relationship satisfaction is maintained better for men than women. (5) A follow-up support group is helpful in stimulating and providing opportunities for couple communication and will increase couples\u27 trust and intimacy level, their perceived communication skills, self:mate concurrence, and relationship satisfaction and will maintain their problem solving cognitions and skills. (6) A follow-up support group of four months does not increase empathic communication behaviors or the ability to make self-awareness statements without specific evaluated practice

Adjunctive endonasal procedures with dacryocystorhinostomy

Considering the wide breadth of nasal disorders commonly encountered in the general population, it is not surprising to find overlap with patients presenting with lacrimal ailments. In fact, within the subset of patients in whom surgical intervention is deemed prudent, it is occasionally necessary to perform simultaneous endonasal procedures at the time of dacryocystorhinostomy. In addition to septal deviation requiring septoplasty for access to the lacrimal system, one must also assess for various other nasal diseases including turbinate hypertrophy, nasal polyposis, rhinosinusitis, and multiple other neighboring disease processes. Emphasis must be placed on proper preoperative evaluation of concurrent disease to ensure the surgical candidate is properly consented prior to the day of surgery.Joseph Brunworth, Alkis James Psaltis, and Peter-John Wormal

Congenital dacryocele with large intranasal cyst: efficacy of cruciate marsupialization, adjunctive procedures, and outcomes

PURPOSE: To evaluate the safety and efficacy of a new technique of medial wall cruciate marsupialization of large intranasal cysts associated with dacryocele and to evaluate the outcomes. METHODS: A prospective, interventional consecutive case series of 7 patients with large intranasal cysts were included in this study. All patients underwent endoscopic marsupialization by a single surgeon (MJA) using a new technique involving a medial wall cruciate incision. Patients were followed up for a minimum of 6 months and analyzed for the resolution of dacryocele and intranasal cysts and anatomical and functional success. RESULTS: The mean age at presentation was 5.9 weeks with a female preponderance (71.4%). All patients presented with a subcutaneous swelling in lacrimal sac region. Acute dacryocystitis was noted in 42.8% (3/7). Associated lacrimal anomalies were noted in 28.5% (2/7), and associated respiratory distress was noted in 57.1% (4/7) of the patients. At a mean follow up of 10.8 months, anatomical patency and resolution of intranasal cyst were achieved in all cases, and functional success was noted in all except 1 patient. CONCLUSIONS: Endoscopic evaluation of all dacryoceles is recommended. Medial wall cruciate marsupialization is a safe and effective modality in the management of large intranasal cysts. Early diagnosis and appropriate quick referral are likely to prevent acute dacryocystitis, progression of dacryocele, and may aid in better outcomes.Mohammad Javed Ali, Alkis James Psaltis, Joe Brunworth, Milind N. Naik, and Peter-John Wormal

International assessment of inter- and intrarater reliability of the International Frontal Sinus Anatomy Classification system

Published 2018. This article is a U.S. government work and is in the public domain in the USA Background: Inconsistencies in the nomenclature of structures of the frontal sinus have impeded the development of a validated “reference standard” classification system that surgeons can reliably agree upon. The International Frontal Sinus Anatomy Classification (IFAC) system was developed as a consensus document, based on expert opinion, attempting to address this issue. The purposes of this study are to: establish the reliability of the IFAC as a tool for classifying cells in the frontal recess among an international group of rhinologists; and improve communication and teaching of frontal endoscopic sinus surgery (ESS). Methods: Forty-two computed tomography (CT) scans, each with a marked frontal cell, were reviewed by 15 international fellowship-trained rhinologists. Each marked cell was classified into 1 of 7 categories described in the IFAC, on 2 occasions separated by 2 weeks. Inter- a