Objectives: To determine the possibility of performing complete resections of rhinosinusal hemangiomas greater than 2cm treated by an endonasal approach assisted with endoscopes. Study design: Descriptive, retrospective Methods: We analyzed the clinical histories of all adult patients who underwent an endonasal approach with endoscopes, for having hemangiomas of the nasal cavity and paranasal sinuses in the Italian Hospital of Buenos Aires, between June 2006 and December 2016. We excluded patients with hemangiomas who were less than 18 years old, with small tumors (less than 2 cm), vascular malformations, and those who underwent surgical procedures performed externally. The surgeries were performed under general anesthesia, with endoscopes of 0° and 30°, conventional surgical instruments were used for rhinosinusal endoscopic surgery. The follow-up was performed by nasal endoscopy, computed tomography and/or magnetic resonance with contrast. Results: Four patients were treated for nasal cavity (1/4) and paranasal sinuses (3/4) hemangiomas through an endonasal approach with endoscopes. There were no complications. The follow-up was greater than 5 years in two, 2 years in one and 1 year in another patient. No recurrences were detected. Conclusión: Trans-nasal surgery assisted with endoscopes of paranasal sinus and nasal cavity hemangiomas greater than 2 cm in adults, allowed perform complete resections in 100% of treated patients. In extensive hemangiomas and when it was not possible to detect the site of vascular tumor implantation, it was important to previously devascularize the lesion by preoperative embolization and cauterization of the vascular pedicles before resecting the tumor.
Objectives: To determine the possibility of performing complete resections of rhinosinusal hemangiomas greater than 2cm treated by an endonasal approach assisted with endoscopes. Study design: Descriptive, retrospective Methods: We analyzed the clinical histories of all adult patients who underwent an endonasal approach with endoscopes, for having hemangiomas of the nasal cavity and paranasal sinuses in the Italian Hospital of Buenos Aires, between June 2006 and December 2016. We excluded patients with hemangiomas who were less than 18 years old, with small tumors (less than 2 cm), vascular malformations, and those who underwent surgical procedures performed externally. The surgeries were performed under general anesthesia, with endoscopes of 0° and 30°, conventional surgical instruments were used for rhinosinusal endoscopic surgery. The follow-up was performed by nasal endoscopy, computed tomography and/or magnetic resonance with contrast. Results: Four patients were treated for nasal cavity (1/4) and paranasal sinuses (3/4) hemangiomas through an endonasal approach with endoscopes. There were no complications. The follow-up was greater than 5 years in two, 2 years in one and 1 year in another patient. No recurrences were detected. Conclusión: Trans-nasal surgery assisted with endoscopes of paranasal sinus and nasal cavity hemangiomas greater than 2 cm in adults, allowed perform complete resections in 100% of treated patients. In extensive hemangiomas and when it was not possible to detect the site of vascular tumor implantation, it was important to previously devascularize the lesion by preoperative embolization and cauterization of the vascular pedicles before resecting the tumor.
Objectives: To determine the efficacy and incidence of complications in tumors and in other diseases involving the tongue base treated by transoral surgery with the assistance of endoscopes. Methods:Patients treated for pathologies that compromised the tongue base using a transoral approach with the assistance of endoscopes in the head and neck section of the Otorhinolaryngology service of the Hospital Italiano de Buenos Aires between March 2005 and April 2019 were selected.Central glossectomies and hemiglosectomies were performed with this technique, and through a ventral approach to the tongue, epidermal cysts that compromised the entire extension of the tongue were removed.Results: Three malignant tumors, one lingual thyroid, two epidermal cysts and a central resection of the tongue in a Down patient with severe sleep apnea were performed.In malignant tumors the resections were complete with free margins, and in the others the region could be exposed very well and the pathologies resolved. Conclusion:The use of endoscopes to perform transoral resections of tumors and other pathologies that compromised the tongue base allowed a good exposure of the posterior region of the tongue to the lingual aspect of the epiglottis and made it possible to perform complete resections or perform surgery according to preoperative planning without complications.
bjectives: To determine the result of reconstruction with local or regional flaps of skin defects in the temporo-parotid region, after resection of malignant parotid gland and ear tumors, and to establish a reconstruction algorithm according to the size of the defect. Methods: The electronic medical records of the patients who underwent surgery for malignant tumors of the parotid gland and ear with invasion of the skin of the region, and who had reconstructions of the skin defect with local and regional flaps, were selected. The surgeries were performed by the surgical team of the Otorhinolaryngology service of the Italian hospital in Buenos Aires between 2005 and 2018. Results: Five patients were included.There were two malignant parotid gland tumors with histology of adenoid cystic carcinoma and squamous cell carcinoma, and three temporal bone tumors: squamous cell carcinoma, basal cell carcinoma in another and adenoid cystic carcinoma. The reconstructions were made with local or regional flaps. In skin defects smaller than 8cm the reconstructions were made with cervical and scalp flaps. In skin defects larger than 8cm the pectoralis major musculoctaneous flap were used. No patient had partial or total necrosis of the flaps. Conclusions: The results of the reconstructions with local and regional flaps of the skin defects caused by the resection of malignant tumors of the ear and the parotid gland were very good, since they allowed the repair of the defect with a good aesthetic result, without the need to perform grafts in the donor area and with few minor complications. In patients with advanced malignant tumors of the ear and parotid gland with infiltration of the surrounding skin, it is better to do the reconstruction with local or regional flaps due to the greater simplicity and speed of the surgical technique, similar aesthetic results and few complications.
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