Assuntos
Implante Coclear , Implantes Cocleares , Surdez , Análise Custo-Benefício , Surdez/cirurgia , HumanosRESUMO
OBJECTIVES/HYPOTHESIS: To present a modified endoscopic medial maxillectomy (MEMM) approach to control maxillary sinus pathologies. METHODS: MEMM was completed in 13 fresh-frozen specimens. An MEMM includes cutting the nasolacrimal duct, inferior meatus flap, and repositioning the inferior turbinate (IT). The following measurements were obtained: length of IT, height from the nasal floor to valve of Hasner, height of the IT at the level of valve of Hasner, height of the IT at the insertion of the middle turbinate, and distance from the piriform aperture to the posterior wall of maxillary sinus and to the posterior border of palatine bone. Similar measurements were also performed on craniofacial computed tomography (CT) scans (n = 50). The surgical technique was performed in a case series (n = 8). RESULTS: The mean of the specimens was 82 (range 70-95) years old. The average area of the harvested inferior meatus flap area was 9.6 ± 1.0 cm2. In the radiologic study, the mean maximum antrostomy area was 8.8 ± 1.7 cm2 and the IT area overlapping the antral window was 5.8 ± 1.1 cm2, the area allowing a double window control was 3.1 ± 1.9 cm2, the posterior IT insertion length was 0.7 ± 0.4 cm, and the inferior meatus flap covering the inferior meatotomy had an area measuring 6.7 ± 1.7 cm2. Eight patients underwent MEMM for various benign conditions showing no recurrence after 26 month follow-up. CONCLUSION: The proposed modifications of MEMM provide a "double" window maxillary sinus control with access to all maxillary walls and preservation of the IT.
Assuntos
Neoplasias do Seio Maxilar , Ducto Nasolacrimal , Idoso , Idoso de 80 Anos ou mais , Endoscopia , Humanos , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Neoplasias do Seio Maxilar/diagnóstico por imagem , Neoplasias do Seio Maxilar/cirurgia , Recidiva Local de NeoplasiaAssuntos
Implante Coclear/métodos , Implantes Cocleares/economia , Análise Custo-Benefício/estatística & dados numéricos , Surdez/cirurgia , Implante Coclear/economia , Implante Coclear/estatística & dados numéricos , Implantes Cocleares/estatística & dados numéricos , Humanos , Anos de Vida Ajustados por Qualidade de Vida , Resultado do TratamentoAssuntos
Implante Coclear/economia , Análise Custo-Benefício/normas , Perda Auditiva Bilateral/cirurgia , Perda Auditiva Neurossensorial/cirurgia , Guias de Prática Clínica como Assunto , Implante Coclear/instrumentação , Implante Coclear/normas , Implantes Cocleares/economia , Análise Custo-Benefício/métodos , Custos de Cuidados de Saúde/normas , Perda Auditiva Bilateral/economia , Perda Auditiva Bilateral/psicologia , Perda Auditiva Neurossensorial/economia , Perda Auditiva Neurossensorial/psicologia , Humanos , Otolaringologia/economia , Otolaringologia/normas , Qualidade de Vida , Anos de Vida Ajustados por Qualidade de Vida , Resultado do Tratamento , Estados UnidosRESUMO
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