Endoscopic trans-septal choanoplasty for congenital choanal atresia

To describe endoscopic trans-septal approach for treatment of choanal atresia. Prospective case series in a tertiary care center. Seventeen patients [7 with bilateral and 10 with unilateral choanal atresia] underwent trans-septal endoscopic choanoplasty. Removal of the vomer and shaving of the medial pterygoid plate were achieved by a small chisel with the use of a 4-mm 0 degree telescope. Nasal stents were not used following creation of the neochoanae. All cases were examined with the endoscopes 4 weeks postoperatively and any granulations or polyps at the site of the neochoanae were removed at that time. One year postoperatively, 16 [out of 17] patients had patent neochoanae. Granulation tissues were encountered in three cases and successfully managed on routine endoscopic examination. Endoscopic trans-septal approach is a direct, wide and safe one day surgery for repair of choanal atresia

Complications of anterior craniofacial resection for management of malignant Sino nasal tumors involving anterior skull base

Management of malignant Sino nasal tumors with skull base involvement constitutes a challenging problem for head and neck surgeons. Surgery in this area confronts with life threatening risks of infections, orbital complications and cerebrospinal fluid leaks. Avoidance of these complications demand the co-operation between head and neck surgeons, neurosurgeons and radiotherapists, high surgical experience as well as proper reconstruction of skull base. The aim of this work is to study retrospectively the complications of anterior craniofacial resection for malignant Sino nasal tumors involving anterior skull base and to find out how to minimize these complications. In this study, we reviewed retrospectively the complications of twenty-one craniofacial resections done in Otolaryngology department Mansoura University Hospital. From September 1996 lo January 2004 with median follow-up period of 22 months. From this study, we found that the overall complications rate was about 30%. Anosmia. and psychological changes were the commonest complications and infectious complications were the least. We concluded that most of the complications of craniofacial resection are avoidable by good selection of patients, high surgical experience, and proper reconstruction of the anterior cranial base and good postoperative care

Management of juvenile angiofibroma with intracranial extension

This study included 19 patients with angiofibromas with variable degrees of intracranial extension. Of those, patients with minimal intracranial-extradural extension [Fisch class IIIb] were managed through transmaxillary subcranial approach, while extensive intracranial extension [Fisch class IV] necessitated combined craniofacial approach through frontotemporal craniotomy with maxillary removal and reinsertion. The hospital stay, the blood loss, the operative time accessibility and complications of each approach were evaluated

Management of post-traumatic orbito-zygomatic deformities

In this study, 20 patients with post-traumatic orbitozygomatic deformities were clinically and radiologically evaluated and surgical correction was tried for every patient using craniofacial techniques. The details of soft tissues and skeletal reconstruction as well as functional and aesthetic results were discussed. Postoperative complications occurred in 20% of the cases, the most severe being loss of vision. Craniofacial techniques allowed proper correction of the post traumatic orbitozygomatic deformities and provided acceptable functional and aesthetic results