Browsing by Subject "Endoscopic"

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    Basic Functional Endoscopic Sinus Surgery (FESS): A Step-By-Step Guide With Surgical Videos and Illustrations of Anatomical Landmarks in Cadaveric Dissection
    (2025-03-25) Brand, Yves; Prepageran, Narayanan
    We consider four important landmarks in basic FESS. These landmarks are important to gain entry to the maxillary sinus, anterior ethmoid, posterior ethmoid and the sphenoid sinus. Each landmark serves as a gate to a defined space within the paranasal sinuses. This chapter presents an overview to better understand this Gate System. To visualise the different structures of the nose, the nasal cavity is decongested. This can be done with cotton ribbon gauze soaked in Moffat’s solution (1ml adrenaline 1:1000, 2mls 10% cocaine, 4mls 8.4% so-dium bicarbonate, 13mls water/saline) for several minutes. Alternatively, adrenaline 1:1000-soaked cotton ribbon gauze can be used. It is important to pack the middle meatus under endoscopic vision (A).
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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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    Endoscopic Ethmoidectomy (FESS) Surgical Technique
    (2025-03-08) Monteiro, Pedro; Lubbe, Darlene
    Endoscopic ethmoidectomy refers to exenteration of the anterior +/- posterior ethmoid cells. The ethmoids are in close proximity to the orbit and its contents, the optic nerve, the sphenoid sinus, the paper-thin cribriform plate with meninges above, the ethmoidal arteries and the olfactory nerves. Like all endoscopic sinus surgery, the anatomy and surgical technique are best learned on a cadaver, followed by surgery under direct supervision of an experienced endoscopic sinus surgeon. Ethmoidectomy done by a surgeon unfamiliar with the detailed anatomy of the nose and paranasal sinuses, especially in the absence of a CT scan or when unable to properly interpret a CT scan, or by a surgeon untrained in endoscopic sinus surgery, is high-risk. This chapter presents the relevant anatomy, indications for surgery, preoperative work-up, surgical instrumentation, anaesthesia, surgical technique, postoperative care and pitfalls of endoscopic ethmoidectomy.
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    Endoscopic Transnasal Optic Nerve Decompression
    (2025-03-08) Lanišnik, Boštjan; Ravnik, Janez
    This chapter focuses on the indications, decision making and surgical technique of endoscopic transnasal optic nerve decompression and presents some controversies relating to decompression for traumatic optic neuropathy. Endoscopic optic nerve decompression can be performed with little or no morbidity. It is done mainly for traumatic optic neuropathy. Other indications include skull base tumours e.g. meningiomas growing into the optic canal. or fibroosseous lesions of the skull base. Endoscopic optic nerve decompression is most suited to pathology located medial to the optic nerve. Lateral fractures of the sphenoid wing e.g. of the clinoid, are more easily accessed through a pterional approach.
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    Endoscopic Transorbital Surgery: Medial Orbital (Precaruncular) Approach
    (2025-03-08) Lubbe, Darlene
    Access to the ethmoidal arteries is required to ligate the vessels with nasoethmoid traumatic fractures or to assist with haemostasis prior to resecting sinonasal tumours. The Lynch-Howarth incision has been the gold standard to approach these arteries, with the frontoethmoidal suture line said to be the optimal way of finding these arteries. However, this external approach should be replaced by the precaruncular approach to access these arteries for the following reasons: Lynch-Howarth incision •External facial incision can cause cos-metically unacceptable scars •Dissection through skin, subcutaneous tissue, and orbicularis oculi muscle is required with suturing of the incision •Bleeding can be encountered from the angular vessels
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    The Transition from Microscopic to Endoscopic Transsphenoidal Surgery In High Case Load Neurosurgical Centers: The Groote Schuur Hospital Experience
    (2014) Semple, Patrik L
    Dott and Guiot first pioneered the transsphenoidal route for pituitary tumors during the 1950s and 1960s, and the microscope was introduced for the procedure by Hardy in the 1970s. The microscopic transsphenoidal approach to pituitary tumors was further developed by Wilson, Weiss, Laws, and others and became the procedure of choice for pituitary tumors. The advantages, outcomes, and risks for this procedure are well established, and it has been an effective and safe method for treating pituitary tumors as well as other pathologies that occur in the sellar/suprasellar region (1, 4, 7, 13).