Utilization and Application of Modified Action Camera in Otorhinolaryngoloic Surgery / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: In recent years, surgical imaging has become important for legal and educational purposes. Significant improvements can be made from the surgeon's point of view in recording surgical procedures, particularly with respect to the action camera with high-definition video recordings. For otolaryngologic surgery, the surgical view is narrow, and there is a limit to proper imaging using the existing lens of the action camera. Therefore, we aimed to find out if we could obtain surgical images through simple modification of action camera. MATERIALS AND METHOD: The action camera was modified to match the surgical field. We selected a suitable lens for otolaryngology surgery using a calculation formula. The action camera was simply modified according to the design. The modified action camera can be mounted on the surgeon's head or the surgical light. We compared the images taken with the modified action camera and the images taken with the existing camcorder. The modified action camera was able to capture a narrow surgical field for otolaryngologic surgery. RESULTS: Unlike the existing method, we were able to obtain high-quality images using a modified action camera at the first person's viewpoint without auxiliary manpower. The action camera was considerably cost effective compared to other methods of recording surgery. CONCLUSION: The modified action camera allows for high-definition, cost-effective, and firstperson viewpoint for otolaryngologic surgery. The modified action camera allows for detailed videography that can enhance surgical teaching, presentation and patient education materials.

Efficacy of Tympanoplasty Without Mastoidectomy for Treating Chronic Otitis Media in Patients With Mastoid Cavity Opacification in Temporal Bone Computed Tomography Findings

OBJECTIVES: Combined mastoidectomy is generally preferred to tympanoplasty alone when treating patients with chronic otitis media (COM), particularly when temporal bone computed tomography (TBCT) shows that the mastoid cavity contains opacification of soft tissue density. However, in cases with Eustachian tube dysfunction, a mastoid cavity volume may be a burden to its function. We hypothesized that tympanoplasty alone might be better than tympanoplasty combined with mastoidectomy because soft tissue in the mastoid cavity is a sequel to a protective physiological response. Thus, we explored the efficacy of tympanoplasty without mastoidectomy in COM patients exhibiting mastoid air cell opacification on TBCT. METHODS: Between 2010 and 2014, a total of 33 patients, diagnosed with COM and with evidence of mastoid cavity opacification on TBCT, underwent tympanoplasty without mastoidectomy. All ears had been dry for ≥3 months before surgery. All procedures were performed by the same surgeon. We retrospectively analyzed the preoperative otoscopic findings, pre- and postoperative pure tone averages (PTAs; the mean of the values at 0.5, 1, 2, and 4 kHz), surgical procedures, and complications or recurrence. RESULTS: Of the 33 patients, 28 (84.8%) exhibited hearing improvement after surgery. The mean pre- and postoperative PTAs were 46.9±21.2 dB and 29.4±17.0 dB, respectively (P < 0.001). The air-bone gap decreased from 25.7±10.7 dB to 10.3±8.7 dB (P < 0.001). Thirty-two patients (97.0%) did not develop any COM recurrence or cholesteatoma; one patient developed attic retraction of the tympanic membrane. Other minor complications were transient otorrhea caused by myringitis (two cases) and a pinpoint perforation (one case). CONCLUSION: Tympanoplasty alone, i.e., without mastoidectomy, may adequately control COM, if it shows dry-up status for at least 3 months even though mastoid cavity opacification is detected in TBCT.

Early Experiences of Head and Neck Reconstruction: Appropriacy and Surgical Outcome / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The reconstruction of surgical defects in head and neck cancer patients requires thorough anatomical knowledge and considerable clinical experiences, hence it is a demanding job for un-experienced reconstructive surgeons. We evaluated the appropriateness and the surgical outcome of a one-year experience of head and neck reconstruction carried out in a tertiary hospital setting. SUBJECTS AND METHOD: We performed a retrospective review of the medical records of 73 patients who underwent reconstructive surgery at the Otolaryngology Department and Plastic Surgery from January, 2012 to September, 2016. RESULTS: Twenty-eight of 42 patients underwent free-flap reconstruction, including anterolateral thigh, radial forearm, or fibula free-flap by a head and neck surgeon. The rest of the patients underwent pedicled-flap surgery including pectoralis major or latissimus dorsi myocutanous flap. The mean operation time was 209.5 minutes and an average of 1.2 days intensive care unit- and 37.2 days of hospital stay were required in the free-flap cases. The flap failure happened in three patients, two in free-flap and one in pedicled flap. These surgical outcomes were comparable to those of the plastic surgery patient group. CONCLUSION: The technical appropriacy and acceptable outcome of head and neck reconstruction by head and neck surgeons was proven in this investigation. We propose that reconstructive surgery should be performed by head and neck surgeons as they could reduce operation time or complications because of their familiarity with complex surgical anatomy and early decision making competency.