The Experts below are selected from a list of 48909 Experts worldwide ranked by ideXlab platform
Christopher F Holsinger - One of the best experts on this subject based on the ideXlab platform.
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framework for prioritizing head and Neck Surgery during the covid 19 pandemic
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2020Co-Authors: Michael C Topf, Christopher F Holsinger, Jared A Shenson, Samuel H Wald, Lisa Cianfichi, Eben L Rosenthal, John B SunwooAbstract:The COVID-19 pandemic has placed an extraordinary demand on the United States health care system. Many institutions have canceled elective and non-urgent procedures to conserve resources and limit exposure. While operational definitions of elective and urgent categories exist, there is a degree of surgeon judgment in designation. In the present commentary, we provide a framework for prioritizing head and Neck Surgery during the pandemic. Unique considerations for the head and Neck patient are examined including risk to the oncology patient, outcomes following delay in head and Neck cancer therapy, and risk of transmission during otolaryngologic Surgery. Our case prioritization criteria consist of four categories: urgent-proceed with Surgery, less urgent-consider postpone > 30 days, less urgent-consider postpone 30 to 90 days, and case-by-case basis. Finally, we discuss our preoperative clinical pathway for transmission mitigation including defining low-risk and high-risk Surgery for transmission and role of preoperative COVID-19 testing.
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transoral endoscopic head and Neck Surgery ehns for minor salivary gland tumors of the oropharynx
Cancers of the Head & Neck, 2017Co-Authors: David W Schoppy, Michael E Kupferman, Amy C Hessel, Diana Bell, Elizabeth M Garland, Edward J Damrose, Christopher F HolsingerAbstract:Transoral endoscopic head and Neck Surgery (eHNS), including transoral laser microSurgery (TLM) and transoral robotic Surgery (TORS), provides access to subsites in the head and Neck that have traditionally been difficult to approach. Minor salivary gland tumors, while relatively uncommon, are frequently malignant and can occur at sites in the oropharynx accessible by transoral eHNS. Presented here is the largest review to date of patients with minor salivary gland tumors of the oropharynx managed with transoral eHNS as primary or salvage therapy. A retrospective chart review was performed, including data from 20 patients with minor salivary gland tumors of the oropharynx managed with transoral eHNS at 2 tertiary, academic medical centers. Details of tumor pathology, margin analysis, adjuvant therapy, and an assessment of oncologic outcome were included. The base of tongue was the most common tumor site (75%). Adenoid cystic carcinoma (ACC) accounted for most cases (35%), and negative margins were obtained in most (95%) through an endoscopic-only approach. Overall, 50% of patients received post-operative radiation therapy. Postoperative complications were limited, with one patient (5%) returning to the OR for control of post-operative oropharyngeal bleeding. On average follow-up of 36 months, 90% of patients were alive with no evidence of recurrence. In this experience, transoral eHNS provided a safe and consistent surgical approach to management of minor salivary gland malignancies, with low complication rates and good locoregional control. Thus, transoral eHNS may play a valuable role in the multi-disciplinary management of these malignancies. None/not applicable
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Transoral endoscopic head and Neck Surgery (eHNS) for minor salivary gland tumors of the oropharynx
BMC, 2017Co-Authors: David W Schoppy, Michael E Kupferman, Amy C Hessel, Elizabeth M Garland, Edward J Damrose, Diana M. Bell, Christopher F HolsingerAbstract:Abstract Background Transoral endoscopic head and Neck Surgery (eHNS), including transoral laser microSurgery (TLM) and transoral robotic Surgery (TORS), provides access to subsites in the head and Neck that have traditionally been difficult to approach. Minor salivary gland tumors, while relatively uncommon, are frequently malignant and can occur at sites in the oropharynx accessible by transoral eHNS. Presented here is the largest review to date of patients with minor salivary gland tumors of the oropharynx managed with transoral eHNS as primary or salvage therapy. Methods A retrospective chart review was performed, including data from 20 patients with minor salivary gland tumors of the oropharynx managed with transoral eHNS at 2 tertiary, academic medical centers. Details of tumor pathology, margin analysis, adjuvant therapy, and an assessment of oncologic outcome were included. Results The base of tongue was the most common tumor site (75%). Adenoid cystic carcinoma (ACC) accounted for most cases (35%), and negative margins were obtained in most (95%) through an endoscopic-only approach. Overall, 50% of patients received post-operative radiation therapy. Postoperative complications were limited, with one patient (5%) returning to the OR for control of post-operative oropharyngeal bleeding. On average follow-up of 36 months, 90% of patients were alive with no evidence of recurrence. Conclusion In this experience, transoral eHNS provided a safe and consistent surgical approach to management of minor salivary gland malignancies, with low complication rates and good locoregional control. Thus, transoral eHNS may play a valuable role in the multi-disciplinary management of these malignancies. Trial registration number None/not applicabl
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robotics in otolaryngology and head and Neck Surgery recommendations for training and credentialing a report of the 2015 ahns education committee aao hns robotic task force and aao hns sleep disorders committee
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2016Co-Authors: Neil D Gross, David M Goldenberg, Kathleen Yaremchuk, Christopher F Holsinger, Scott J Magnuson, Umamaheswar Duvvuri, Eric M Genden, Tamer Ghanem, Matthew C Miller, Eric J MooreAbstract:Training and credentialing for robotic Surgery in otolaryngology - head and Neck Surgery is currently not standardized, but rather relies heavily on industry guidance. This manuscript represents a comprehensive review of this increasingly important topic and outlines clear recommendations to better standardize the practice. The recommendations provided can be used as a reference by individuals and institutions alike, and are expected to evolve over time. © 2016 Wiley Periodicals, Inc. Head Neck 38: E151-E158.
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transoral endoscopic head and Neck Surgery and its role within the multidisciplinary treatment paradigm of oropharynx cancer robotics lasers and clinical trials
Journal of Clinical Oncology, 2015Co-Authors: Christopher F Holsinger, Robert L FerrisAbstract:Transoral endoscopic head and Neck Surgery is a new approach for the treatment of oropharyngeal tumors. Using either a robotic system and/or laser, surgeons gain access through the mouth via minimally invasive technique and thus have improved visualization of the tumors of the oropharynx, without disfiguring incisions. This transoral route of access minimizes long-term speech and swallowing dysfunction. Surgeons view this approach as a considerable technologic advance, analogous to the evolution in radiation therapy from conventional two- and three-dimensional conformal techniques to intensity-modulated techniques. Although the use of radiation with or without chemotherapy to treat oropharyngeal cancer (OPC) is supported by evidence from prospective clinical trials, there are no prospective data supporting the use of this new surgical approach for OPC. Here, we review the fundamentals of transoral endoscopic head and Neck Surgery, with robotics and laser technology, and discuss ongoing clinical trials for patients with OPC.
Shigeo Tanaka - One of the best experts on this subject based on the ideXlab platform.
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endoscopic Neck Surgery with lymph node dissection for papillary carcinoma of the thyroid using a totally gasless anterior Neck skin lifting method
Journal of The American College of Surgeons, 2003Co-Authors: Wataru Kitagawa, Kazuo Shimizu, Haruki Akasu, Shigeo TanakaAbstract:Conventional open Neck Surgery requires a cervical collar incision on the anterior Neck and leaves a scar in what is deemed to be a cosmetically undesirable location. In recent years, endoscopic Neck Surgery has been developed, first for parathyroidectomy by Gagner in 1996 and for thyroidectomy by Huscher and colleagues in 1997. These techniques reduce postoperative pain and the length of the hospital stay, and they provide an excellent cosmetic result. We developed a totally gasless endoscopic surgical treatment for thyroid and parathyroid tumors in 1998, and we have subsequently applied it to over 170 patients. We call this procedure the video-assisted Neck Surgery (VANS) method. Among these patients, almost all were given a diagnosis of benign thyroid nodule by fine-needle aspiration biopsy and underwent hemithyroidectomy without lymph node dissection. In eight patients, total hemithyroidectomy or subtotal thyroidectomy and lymph node dissection were performed for papillary carcinoma of the thyroid. The purpose of this study was to determine whether this surgical approach is feasible and safe for papillary carcinoma. In this article we report our experience applying endoscopic Neck Surgery to papillary carcinoma of the thyroid using a totally gasless anterior Neck skin lifting method.
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video assisted Neck Surgery endoscopic resection of thyroid tumors with a very minimal Neck wound
Journal of The American College of Surgeons, 1999Co-Authors: Kazuo Shimizu, Shigeo Akira, Ali Yaakub Jasmi, Yutaka Kitamura, Wataru Kitagawa, Haruki Akasu, Shigeo TanakaAbstract:In recent years, endoscopic Surgery has been widely applied with a view to minimizing tissue trauma and wound-related complications and improving cosmetic outcomes. Reports on its use in thyroid Surgery are extremely scarce particularly with regard to exploiting the advantage of eliminating unattractive scars that we sometimes encounter in conventional operations on the exposed anterior part of the Neck. We initially experimented and practiced endoscopic Neck Surgery on animals until we gained enough confidence for clinical application. After obtaining informed consent from patients and their families we began performing this new technique on patients with thyroid nodules; we termed this technique Video-Assisted Neck Surgery (VANS). We hereby report our early experience of VANS in the endoscopic resection of thyroid tumors in five patients, mainly looking at technical feasibility and the ability to reduce Neck wounds to a minimum.
Neerav Goyal - One of the best experts on this subject based on the ideXlab platform.
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risk factors for surgical site infection after supraclavicular flap reconstruction in patients undergoing major head and Neck Surgery
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2016Co-Authors: Neerav Goyal, Kevin S Emerick, Daniel G Deschler, Derrick T Lin, Bharat B Yarlagadda, Debbie L Rich, Marlene L DurandAbstract:Background Surgical site infections can adversely affect flaps in head and Neck reconstruction. The purpose of this study was to evaluate the risk factors of surgical site infections in supraclavicular artery island flap reconstructions. Methods Records of patients undergoing head and Neck Surgery from 2011 to 2014 with supraclavicular artery island flap reconstruction at a single specialty hospital were reviewed; surgical site infections ≤30 days postoperatively were noted. Results Of 64 patients, 86% underwent resection for malignancy, 55% previously received radiation. Sixty-three percent of surgeries were clean-contaminated. Seven patients (11%) developed recipient site surgical site infections, all in patients who underwent clean-contaminated Surgery for malignancy. There was no complete flap loss. No significant differences in demographics or perioperative factors were noted. Oral cavity and laryngeal reconstructions (p = .014) and clean-contaminated Surgery (p = .04) were factors associated with increased surgical site infection risk on univariate but not multivariate analysis. Patients with surgical site infections had longer hospitalizations (p = .003). Conclusion The supraclavicular artery island flap can be used for head and Neck reconstruction with a low rate of surgical site infection. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708–1716, 2016
Shoji Natsugoe - One of the best experts on this subject based on the ideXlab platform.
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Upgraded bidirectional approach video-assisted Neck Surgery (BAVANS) using a rigid endoscope with variable viewing direction for advanced endoscopic lymph node dissection in thyroid cancer patients
Surgery Today, 2019Co-Authors: Akihiro Nakajo, Koji Minami, Yoshiaki Shinden, Hiroko Toda, Tadahiro Hirashima, Ayako Nagata, Yuki Nomoto, Kosei Maemura, Shoji NatsugoeAbstract:In 2011, we developed bidirectional approach video-assisted Neck Surgery (BAVANS) for endoscopic thyroid cancer Surgery. BAVANS combines two different approach pathways at 180 degrees to the cervical lesion for endoscopic thyroidectomy and complete cervical lymphadenectomy. We reported previously that the cranio-caudal approach is extremely useful for endoscopic complete lymph node dissection around the trachea. In 2014, we upgraded the initial BAVANS for better maneuverability and quality of lymph node dissection. A new high-tech rigid endoscope with a variable viewing direction (EndoCAMeleon™), has enabled us to reduce the camera port in the anterior Neck while keeping the easy maneuverability and the same quality of central lymph node dissection (LND) as with the initial BAVANS. Endoscopic thyroid cancer Surgery is now evolving concurrently with new visual technology.
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trans oral video assisted Neck Surgery tovans a new transoral technique of endoscopic thyroidectomy with gasless premandible approach
Surgical Endoscopy and Other Interventional Techniques, 2013Co-Authors: Akihiro Nakajo, Hideo Arima, Munetsugu Hirata, Tadao Mizoguchi, Yuko Kijima, Shinichiro Mori, Sumiya Ishigami, Shinichi Ueno, Heiji Yoshinaka, Shoji NatsugoeAbstract:Background Endoscopic thyroidectomy is a well-established surgical technique. We have been utilizing precordial video-assisted Neck Surgery (VANS) with a gasless anterior Neck skin lifting method. Recently, natural orifice transluminal endoscopic Surgery (NOTES) has generated excitement among surgeons as potentially scar-free Surgery. We developed an innovative gasless transoral technique for endoscopic thyroidectomy that incorporated the concept of NOTES in a VANS-technique.
Wataru Kitagawa - One of the best experts on this subject based on the ideXlab platform.
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endoscopic Neck Surgery with lymph node dissection for papillary carcinoma of the thyroid using a totally gasless anterior Neck skin lifting method
Journal of The American College of Surgeons, 2003Co-Authors: Wataru Kitagawa, Kazuo Shimizu, Haruki Akasu, Shigeo TanakaAbstract:Conventional open Neck Surgery requires a cervical collar incision on the anterior Neck and leaves a scar in what is deemed to be a cosmetically undesirable location. In recent years, endoscopic Neck Surgery has been developed, first for parathyroidectomy by Gagner in 1996 and for thyroidectomy by Huscher and colleagues in 1997. These techniques reduce postoperative pain and the length of the hospital stay, and they provide an excellent cosmetic result. We developed a totally gasless endoscopic surgical treatment for thyroid and parathyroid tumors in 1998, and we have subsequently applied it to over 170 patients. We call this procedure the video-assisted Neck Surgery (VANS) method. Among these patients, almost all were given a diagnosis of benign thyroid nodule by fine-needle aspiration biopsy and underwent hemithyroidectomy without lymph node dissection. In eight patients, total hemithyroidectomy or subtotal thyroidectomy and lymph node dissection were performed for papillary carcinoma of the thyroid. The purpose of this study was to determine whether this surgical approach is feasible and safe for papillary carcinoma. In this article we report our experience applying endoscopic Neck Surgery to papillary carcinoma of the thyroid using a totally gasless anterior Neck skin lifting method.
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video assisted Neck Surgery endoscopic resection of thyroid tumors with a very minimal Neck wound
Journal of The American College of Surgeons, 1999Co-Authors: Kazuo Shimizu, Shigeo Akira, Ali Yaakub Jasmi, Yutaka Kitamura, Wataru Kitagawa, Haruki Akasu, Shigeo TanakaAbstract:In recent years, endoscopic Surgery has been widely applied with a view to minimizing tissue trauma and wound-related complications and improving cosmetic outcomes. Reports on its use in thyroid Surgery are extremely scarce particularly with regard to exploiting the advantage of eliminating unattractive scars that we sometimes encounter in conventional operations on the exposed anterior part of the Neck. We initially experimented and practiced endoscopic Neck Surgery on animals until we gained enough confidence for clinical application. After obtaining informed consent from patients and their families we began performing this new technique on patients with thyroid nodules; we termed this technique Video-Assisted Neck Surgery (VANS). We hereby report our early experience of VANS in the endoscopic resection of thyroid tumors in five patients, mainly looking at technical feasibility and the ability to reduce Neck wounds to a minimum.
