Browsing by Author "Bleier, Benjamin"

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    Endoscopic Approach to Orbital Cavernous Haemangioma (OCH) and Intraconal Tumours: Surgical Anatomy and Techniques
    (2025-03-08) Banks, Catherine; Bleier, Benjamin
    The position of intraconal tumors relative to the optic nerve dictates the choice of surgical approach. Tumours with their epicenter medial to the optic nerve or “below a plane of resectability” (POR), which represents a plane subtended by the contralateral nostril and the long axis of the optic nerve, are amenable to an endoscopic approach. The feasibility and safety of this approach has been demonstrated in the literature. Tumours located lateral and superior to the POR are not candidates for an exclusively endoscopic resection. The composition of the surgical team var-ies depending on the institution. However, a multidisciplinary team including an oto-laryngologist, oculoplastic surgeon and in some cases, a neurosurgeon, is invaluable. The endoscopic approach to intraconal tumours will be described in this chapter using orbital cavernous haemangioma (OCH) as an example, as is it the most common primary orbital tumour in adults, with a reported incidence of 5-15% of all orbital tumours (Figure 1).
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    Repair of Nasal Septal Perforations
    (2025-03-11) Sedaghat, Ahmad; Bleier, Benjamin
    The most common causes of nasal septal perforations are trauma, iatrogenic e.g. septoplasty, and pharmacologic e.g. intranasal corticosteroids and cocaine abuse. Other aetiologies such as vasculitis, malignancy and infection should be considered when investigating a patient when a cause is not apparent. Most septal perforations go unnoticed. The most troublesome signs and symptoms include a whistling sound, crusting and epistaxis; these are consequences of disrupttion of laminar airflow and its desiccating effect on the nasal tissues. In some cases with e.g. vasculitis or chronic picking at nasal crusts, septal perforations may grow in size and cause collapse of the dorsal or caudal supports leading to nasal deformity. Despite its varied aetiology, the common mechanism for developing a septal perforation is disruption of blood flow and devitalisation of the septum. Despite its rich blood supply in the form of Kiesselbach’s plexus, perforations most commonly involve the anterior septum; this plexus is comprised of the terminal branches of the superior labial, greater palatine and anterior ethmoidal arteries and does not tolerate vascular insults well.
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    Septoplastia para Desvio do Septo Nasal
    (Edutech, 2017) Sedaghat, Ahmad; Bleier, Benjamin; Fagan, Johan
    Este capítulo descreve a septoplastia como procedimento cirúrgico para corrigir o desvio do septo nasal e melhorar o fluxo aéreo nasal. Apresenta as indicações para a cirurgia, a anatomia cirúrgica relevante, a técnica operatória passo a passo e os cuidados pós-operatórios. O capítulo também aborda as principais complicações associadas ao procedimento, incluindo hematoma septal, perfuração septal, obstrução nasal persistente e deformidade nasal. Este recurso destina-se a profissionais de saúde e estudantes envolvidos na otorrinolaringologia e cirurgia da cabeça e pescoço.
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    Septoplasty for Deviation of the Nasal Septum
    (2025-03-20) Sedaghat, Ahmad; Bleier, Benjamin
    Septoplasty refers to surgical manipulation and/or removal of deviated septal cartilage and/or bone to correct a nasal septal deformity. Up to 90% of people have nasal septal deviations (Figure 1), but the majority is asymptomatic. Septal deviation may cause nasal obstruction only when the nasal mucosa is swollen due to e.g. inflammation, allergic rhinitis, pharmacologic factors such as rhinitis medicamentosa or hormonal changes during pregnancy; in such cases obstruction may resolve either spontaneously or with medical therapy e.g. intranasal or systemic steroids, antihistamines and decongestants.