The Experts below are selected from a list of 585 Experts worldwide ranked by ideXlab platform
Toru Kikawada - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic posterior nasal neurectomy: an alternative to Vidian neurectomy
Clinical & Experimental Allergy Reviews, 2009Co-Authors: T. Kanaya, Toru KikawadaAbstract:Summary Although Vidian neurectomy is very effective as a means of alleviating symptoms of chronic rhinitis (allergic rhinitis and vasomotor rhinitis), it is presently seldom used because of a high incidence of complications such as disturbed lacrimal secretion and sensory disorders of the cheek and gum. In 1997, Kikawada succeeded in endoscopically cutting the posterior nasal nerve (a ramus of the Vidian nerve) at the level of the Sphenopalatine Foramen under clear vision. This technique has since been improved into one that allows safe and rapid completion of the operation using a bipolar device. This new technique of endoscopic posterior nasal neurectomy with a bipolar device will be presented in this paper.
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Endoscopic posterior nasal neurectomy: An alternative to vidian neurectomy
Operative Techniques in Otolaryngology-Head and Neck Surgery, 2007Co-Authors: Toru KikawadaAbstract:Vidian neurectomy is a proven surgical treatment for the symptoms of allergic and nonallergic rhinitis. However, complications such as dry eye, cheek and dental numbness, disturbance of eye movements, and even blindness remain. I describe a method for endoscopic resection of the posterior superior and inferior nasal nerves. My approach exposes postganglionic parasympathetic nerve fibers (the posterior superior nasal nerve) at the Sphenopalatine Foramen to allow resection of a segment of the nerve under direct vision. The surgeon is able to control intraoperative bleeding without resection of the Sphenopalatine artery and achieve the effectiveness of vidian neurectomy without the complications.
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Endoscopic Endonasal Vidian Neurectomy
JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY, 1996Co-Authors: Toru KikawadaAbstract:The effectiveness of vidian neurectomy in relieving the symptoms of vasomotor and allergic rhinitis is well established. Since the first description by Golding Wood, various surgical techniques have been reported, namely the transmaxillary, the transpalatal, the trans-septal, and the transnasal. Because they give patients some operative stress and have technical problems, however, they are applied to a very limited number of cases. In this article, a new technique of endonasal vidian neurectomy through a control hole is described. The advantages of this technique include : 1) There is no risk of bleeding from the Sphenopalatine artery during the surgery because in this procedure the vidian nerve is approached through the control hole, not the Sphenopalatine Foramen ; 2) It is possible to operate even on children using the 4mm endoscope because the Sphenopalatine Foramen is approached from the middle meatus, which is larger than the superior meatus ; 3) There are only two proceduresmaking a short incision on the middle meatal mucosa and creating a small control hole on the vertical lamina of the palatine bone-necessary to reach the vidian nerve ; 4) The blood supply to the nasal mucosa can be preserved normally after surgery because there is no need to ligate the Sphenopalatine artery to reach the vidian nerve.
Richard Louis Voegels - One of the best experts on this subject based on the ideXlab platform.
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Surgical Implication for the Endoscopic Anatomy of the Sphenopalatine Foramen Region
2015Co-Authors: Francini Grecco, Melo Pádua, Richard Louis VoegelsAbstract:Introduction: The failure rate of the Sphenopalatine artery ligation has been described varying from 2 to 10%, and it may occur because of anatomical variations found in these region. Objective: To describe the anatomy of the Sphenopalatine Foramen region and observe possible surgical implications during the ligation of the Sphenopalatine artery. Method: The Sphenopalatine forame region of 122 cadavers nasal fossae were endoscopic dissected. Presenc
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severe posterior epistaxis endoscopic surgical anatomy
Laryngoscope, 2008Co-Authors: Francini Grecco De Melo Padua, Richard Louis VoegelsAbstract:Objective: To describe the anatomy of the Sphenopalatine Foramen (SPF) region and possible anatomical variations. Study Design: Prospective study accomplished from September, 2006, to January, 2007. Methods: The Sphenopalatine Foramen (SPF) of 61 cadavers were carefully dissected. Presence of the ethmoidal crest, location of Sphenopalatine and accessory Foramens, and the number of arterial branches emerging through Foramens were observed. Data were analyzed in relation to gender, racial group, and symmetry of the cadaver. Prediction of the presence of accessory Foramen was evaluated. Results: Mixed race cadavers prevailed in 122 nasal fossae dissected (75% males). Ethmoidal crest was present in 100% of the cadavers, being anterior to the SPF in 98.4% of the cases. The most frequent SPF location was the transition of the middle and superior meatus (86.9%). Mean distance from the SPF and accessory Foramen to anterior nasal spine was 6.6 cm and 6.7 cm, respectively. Accessory Foramen was present in 9.83% of the cases. A single arterial stem emerged through the SPF in 67.2% of the cases, and 100% through accessory Foramens. The prevalence analyses showed no differences that were statistically significant (P > 0.05) between gender and racial group. The symmetry analyses showed a strong conformity (P 0.05) association with the presence of the accessory Foramen. Conclusions: There are anatomical variations in the lateral nose wall that should be considered for successful endoscopic surgical treatment of severe epistaxis.
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Severe Posterior Epistaxis–Endoscopic Surgical Anatomy†‡§
The Laryngoscope, 2008Co-Authors: Francini Grecco De Melo Padua, Richard Louis VoegelsAbstract:Objective: To describe the anatomy of the Sphenopalatine Foramen (SPF) region and possible anatomical variations. Study Design: Prospective study accomplished from September, 2006, to January, 2007. Methods: The Sphenopalatine Foramen (SPF) of 61 cadavers were carefully dissected. Presence of the ethmoidal crest, location of Sphenopalatine and accessory Foramens, and the number of arterial branches emerging through Foramens were observed. Data were analyzed in relation to gender, racial group, and symmetry of the cadaver. Prediction of the presence of accessory Foramen was evaluated. Results: Mixed race cadavers prevailed in 122 nasal fossae dissected (75% males). Ethmoidal crest was present in 100% of the cadavers, being anterior to the SPF in 98.4% of the cases. The most frequent SPF location was the transition of the middle and superior meatus (86.9%). Mean distance from the SPF and accessory Foramen to anterior nasal spine was 6.6 cm and 6.7 cm, respectively. Accessory Foramen was present in 9.83% of the cases. A single arterial stem emerged through the SPF in 67.2% of the cases, and 100% through accessory Foramens. The prevalence analyses showed no differences that were statistically significant (P > 0.05) between gender and racial group. The symmetry analyses showed a strong conformity (P 0.05) association with the presence of the accessory Foramen. Conclusions: There are anatomical variations in the lateral nose wall that should be considered for successful endoscopic surgical treatment of severe epistaxis.
Zhang Hua - One of the best experts on this subject based on the ideXlab platform.
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Applied anatomy and clinical significance of the vidian canal by transnasal endoscopic approach
Journal of Xinjiang Medical University, 2009Co-Authors: Zhang HuaAbstract:Objective: To provide anatomical basis of clinical transnasal endoscopic approach to the vidian canal by endoscopic anatomical study of vidian canal region.Methods: To observe vidian canal important anatomic landmarks and the neurovascular structures via transnasal endoscopic approach in ten fresh cadaveric heads.Results:(1)The vidian canal is located the posterior wall of pterygopalatine fossa medially and the inferolateral wall of the sphenoid sinus.The vidian canal region compartment includes the third segment of the internal maxillary artery,the pterygopalatine ganglions and vidian nerve.(2) Sphenopalatine Foramen,crista vidian canal,Foramen rotundum are the important landmarks of bone.(3) The distance was about(13.80±1.99) mm from anterior opening of vidian canal to posterior opening.Conclusions: It is useful to minimize complications for operation of vidian canal region to be familiar with anatomy of the vidian canal and surrounding structure.
Kornkiat Snidvongs - One of the best experts on this subject based on the ideXlab platform.
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Endoscopic Sphenopalatine Foramen cauterization is an effective treatment modification of endoscopic Sphenopalatine artery ligation for intractable posterior epistaxis
European Archives of Oto-Rhino-Laryngology, 2020Co-Authors: Wirach Chitsuthipakorn, Kachorn Seresirikachorn, Dichapong Kanjanawasee, Kornkiat SnidvongsAbstract:Purpose Endoscopic Sphenopalatine artery ligation (ESPAL) is known as an effective treatment for posterior epistaxis. Anatomical variations of the intranasal branching may result in long operative time and possible inadequate cauterization. A modification of ESPAL by cauterization at the Sphenopalatine Foramen (SPF), has been performed by our group. Our study assessed the clinical benefit of endoscopic Sphenopalatine Foramen cauterization (ESFC) and compared it to ESPAL. Method A retrospective study was conducted. Patients who received ESFC for posterior epistaxis from 2016 to 2018 at a tertiary hospital were recruited. Middle meatal antrostomy was done. After ethmoidal crest was identified and nipped, pterygopalatine fossa was entered through the SPF. Sphenopalatine artery (SPA) and its branches within the SPF were cauterized without identification of any SPA distal branches in the nasal cavity. Patients receiving conventional ESPAL by the same surgeon were recruited and compared as control. Patients were followed-up for 3 months. Success rate, operative time, and complication were assessed. Results Thirty-four patients were identified. Recurrent epistaxis was absent in 90.0% and 100% of patients receiving ESPAL (9/10 patients) and ESFC (24/24 patients) respectively, p = 0.294. Median operative time was 115 and 60 min, respectively, p
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Endoscopic Sphenopalatine Foramen cauterization is an effective treatment modification of endoscopic Sphenopalatine artery ligation for intractable posterior epistaxis
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated wi, 2020Co-Authors: Wirach Chitsuthipakorn, Kachorn Seresirikachorn, Dichapong Kanjanawasee, Kornkiat SnidvongsAbstract:Endoscopic Sphenopalatine artery ligation (ESPAL) is known as an effective treatment for posterior epistaxis. Anatomical variations of the intranasal branching may result in long operative time and possible inadequate cauterization. A modification of ESPAL by cauterization at the Sphenopalatine Foramen (SPF), has been performed by our group. Our study assessed the clinical benefit of endoscopic Sphenopalatine Foramen cauterization (ESFC) and compared it to ESPAL. A retrospective study was conducted. Patients who received ESFC for posterior epistaxis from 2016 to 2018 at a tertiary hospital were recruited. Middle meatal antrostomy was done. After ethmoidal crest was identified and nipped, pterygopalatine fossa was entered through the SPF. Sphenopalatine artery (SPA) and its branches within the SPF were cauterized without identification of any SPA distal branches in the nasal cavity. Patients receiving conventional ESPAL by the same surgeon were recruited and compared as control. Patients were followed-up for 3 months. Success rate, operative time, and complication were assessed. Thirty-four patients were identified. Recurrent epistaxis was absent in 90.0% and 100% of patients receiving ESPAL (9/10 patients) and ESFC (24/24 patients) respectively, p = 0.294. Median operative time was 115 and 60 min, respectively, p
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endoscopic Sphenopalatine Foramen cauterization is an effective treatment modification of endoscopic Sphenopalatine artery ligation for intractable posterior epistaxis
European Archives of Oto-rhino-laryngology, 2020Co-Authors: Wirach Chitsuthipakorn, Kachorn Seresirikachorn, Dichapong Kanjanawasee, Kornkiat SnidvongsAbstract:Endoscopic Sphenopalatine artery ligation (ESPAL) is known as an effective treatment for posterior epistaxis. Anatomical variations of the intranasal branching may result in long operative time and possible inadequate cauterization. A modification of ESPAL by cauterization at the Sphenopalatine Foramen (SPF), has been performed by our group. Our study assessed the clinical benefit of endoscopic Sphenopalatine Foramen cauterization (ESFC) and compared it to ESPAL. A retrospective study was conducted. Patients who received ESFC for posterior epistaxis from 2016 to 2018 at a tertiary hospital were recruited. Middle meatal antrostomy was done. After ethmoidal crest was identified and nipped, pterygopalatine fossa was entered through the SPF. Sphenopalatine artery (SPA) and its branches within the SPF were cauterized without identification of any SPA distal branches in the nasal cavity. Patients receiving conventional ESPAL by the same surgeon were recruited and compared as control. Patients were followed-up for 3 months. Success rate, operative time, and complication were assessed. Thirty-four patients were identified. Recurrent epistaxis was absent in 90.0% and 100% of patients receiving ESPAL (9/10 patients) and ESFC (24/24 patients) respectively, p = 0.294. Median operative time was 115 and 60 min, respectively, p < 0.001. Ipsilateral hard palatal or anterior palatal numbness were found in one and three patients, respectively. All resolved spontaneously within 2 weeks. ESFC is effective in treating posterior epistaxis. It requires significantly less amount of time while the success rate was comparable to conventional ESPAL.
Daniel M. Prevedello - One of the best experts on this subject based on the ideXlab platform.
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Surgical anatomy and nuances of the expanded transpterygoid approach to the pterygopalatine fossa and upper parapharyngeal space: a stepwise cadaveric dissection.
Acta neurochirurgica, 2020Co-Authors: Giuliano Silveira-bertazzo, Rafael Martinez-perez, Ricardo L. Carrau, Daniel M. PrevedelloAbstract:Superb knowledge of anatomy and techniques to remove the natural barriers preventing full access to the most lateral aspect of the skull base determines the ease of using the transpterygoid approach (ETPA) as the main gateway for all the coronal planes during endonasal surgeries. Throughout stepwise image-guided cadaveric dissections, we describe the surgical anatomy and nuances of the ETPA to the pterygopalatine fossa (PPF) and upper parapharyngeal space (UPPS). The ETPA represents a lateral extension of the midline corridor and provides a valuable route to access the PPF/UPPS. Major landmarks for this EEA are the infraorbital canal, Sphenopalatine Foramen, and vidian nerve. It comprises the removal of the palatine bone, posterior wall of the maxillary sinus, and PPF transposition to drill the pterygoid process.
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Surgical anatomy and nuances of the expanded transpterygoid approach to the pterygopalatine fossa and upper parapharyngeal space: a stepwise cadaveric dissection
Acta Neurochirurgica, 2020Co-Authors: Giuliano Silveira-bertazzo, Rafael Martinez-perez, Ricardo L. Carrau, Daniel M. PrevedelloAbstract:Background Superb knowledge of anatomy and techniques to remove the natural barriers preventing full access to the most lateral aspect of the skull base determines the ease of using the transpterygoid approach (ETPA) as the main gateway for all the coronal planes during endonasal surgeries. Methods Throughout stepwise image-guided cadaveric dissections, we describe the surgical anatomy and nuances of the ETPA to the pterygopalatine fossa (PPF) and upper parapharyngeal space (UPPS). Conclusion The ETPA represents a lateral extension of the midline corridor and provides a valuable route to access the PPF/UPPS. Major landmarks for this EEA are the infraorbital canal, Sphenopalatine Foramen, and vidian nerve. It comprises the removal of the palatine bone, posterior wall of the maxillary sinus, and PPF transposition to drill the pterygoid process.