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Endoscopic and external sinus surgery: Technique and anatomy
Otolaryngology Head and Neck Surgery Volume 112 Number 5
COURSE 3714-1 One-period course ($20)
Instruction Courses-- Tuesday
Room NOCC-63 3:00-4:00
Avoiding Perils and Pitfalls in Pediatric Bronchoscopy GLENN C. I$AACSON, MD, and SHARON M. TOMASKI,MD Philadelphia, Pa., and Honolulu, Hawaii
Educational objectives: To summarize current concepts in pediatric airway endoscopy and highlight various anesthetic techniques and their uses, depending on airway pathology and select optimal pediatric airway instrumentation and to avoid and manage complications of pediatric airway endoscopy and improve surgical outcome.
Children are not "mini-adults," and a more cautious approach is required when one is evaluating a pediatric airway. A child's airway is more unforgiving because of its smaller size, diminished pulmonary reserve, and increased risk of laryngospasm or bronchospasm. This mini-course will outline the appropriate workup and evaluation of the premature infant, neonatal, and pediatric airway. State-of-the-art pediatric laryngoscopic and bronchoscopic equipment will be highlighted, and proper assembly and use will be demonstrated. Suggested techniques of anesthesia, laryngoscopy, and bronchoscopy in the obstructed and unobstructed airway will be detailed. Methods of telescopic photodocumentaion will be shown and actual pediatric airway endoscopy videos will be seen. This course will be invaluable for residents, the occasional pediatric airway endoscopist, and operating room personnel. Participants are invited to bring challenging cases for discussion.
COURSE 3715-1 One-period course ($20)
Room NOCC-64 3:00-4:00
Endoscopic and External Sinus Surgery: Technique and Anatomy FRANK N. RITI'ER,MD, and JEFFREYTERRELL,MD Ypsilanti and Ann Arbor, Mich.
Educational objectives: To know the anatomy of the paranasal sinus region and adjacent structures and to surgically eradicate sinus disease by external or intranasat endoscopic technique.
Every surgeon relies heavily on a keen knowledge of the original anatomy during the performance of a surgical operation. This is especially true regarding the paranasal sinuses, where congenital or developmental changes, infection, neoplasm, bleeding, injury or prior surgery may distort the salient landmarks and increase the risk of complications. This course stresses the precise anatomic landmarks to guide the surgeon performing external or endoscopic sinus surgery. Slides of anatomic dissections, CT scans, and videotaped dissections will be used to stress the important landmarks for the sinus surgeon. Special attention will also be
P 139
given to the relevant anatomy for endoscopic surgery on the paranasal sinuses and pertinent anatomy and clinical pearls for external or endoscopic control of epistaxis, endoscopic orbital decompression, optic nerve decompression, and endoscopic DCRs. This is a practical course with time for open discussion, questions, and answers.
COURSE 3716-2 Two-period course ($40)
Room NOCC-65 3:00-5:15
Pediatric Airway--Assessment and Management of Stridor SETHPRANSKY,MD, and DONALD B. KEARNS,MD San Diego, Calif.
Educational objectives: To be able to comfortably recognize and treat a multiplicity of pediatric airway problems, to be familiar and comfortable with all modes of endoscopic evaluation of the pediatric airway, and to understand the variety of surgical techniques available for the treatment of pediatric airway problems.
This course is designed to provide the practitioner with improved expertise in the assessment and management of stridor in the pediatric patient. Evaluation of these problems can be difficult and management of airway compromise challenging. The course will review the pediatric airway, beginning in the nose and ending in the lungs. We will concentrate on accurate diagnosis and appropriate intervention with clinical "pearls" described for each case of stridor. Various assessment strategies will be described, including the use of age, airway location, characteristics of stridor, congenital versus acquired lesions, and the clinical picture. The assessment and management protocols will include the premature or previously intubated neonate and extend through causes of stridor in older children. Diagnostic modalities to be described will include the roles of office evaluation including fiberoptic nasopharyngolaryngoscopy, the appropriate use of imaging, and operative endoscopic techniques including microsuspension laryngoscopy, video endoscopy, and laryngeal EMG techniques. There will be a thorough review of instrumentation appropriate for the pediatric airway. The use of microsuspension laryngoscopy with laser for a variety of problems (including supraglottic edema, severe laryngomalacia, subglottic cysts and webs, laryngeal papillomatosis, and subglottic hemangiomata) will be delineated. There will be video tape recordings to exemplify a variety of these procedures. Our approach to the single-stage laryngotracheal reconstruction will be described in detail. Medical management of airway difficulties will also be described, including discussion of less commonly recognized problems such as pediatric gastroesophageal reflux and neonatal rhinitis. We will also describe our use of steroids for pediatric airway problems and in the perioperative period. The successful endoscopic evaluation and treatment of airway abnormalities in children is dependent on a close
COURSE 3714-1 One-period course ($20)
Instruction Courses-- Tuesday
Room NOCC-63 3:00-4:00
Avoiding Perils and Pitfalls in Pediatric Bronchoscopy GLENN C. I$AACSON, MD, and SHARON M. TOMASKI,MD Philadelphia, Pa., and Honolulu, Hawaii
Educational objectives: To summarize current concepts in pediatric airway endoscopy and highlight various anesthetic techniques and their uses, depending on airway pathology and select optimal pediatric airway instrumentation and to avoid and manage complications of pediatric airway endoscopy and improve surgical outcome.
Children are not "mini-adults," and a more cautious approach is required when one is evaluating a pediatric airway. A child's airway is more unforgiving because of its smaller size, diminished pulmonary reserve, and increased risk of laryngospasm or bronchospasm. This mini-course will outline the appropriate workup and evaluation of the premature infant, neonatal, and pediatric airway. State-of-the-art pediatric laryngoscopic and bronchoscopic equipment will be highlighted, and proper assembly and use will be demonstrated. Suggested techniques of anesthesia, laryngoscopy, and bronchoscopy in the obstructed and unobstructed airway will be detailed. Methods of telescopic photodocumentaion will be shown and actual pediatric airway endoscopy videos will be seen. This course will be invaluable for residents, the occasional pediatric airway endoscopist, and operating room personnel. Participants are invited to bring challenging cases for discussion.
COURSE 3715-1 One-period course ($20)
Room NOCC-64 3:00-4:00
Endoscopic and External Sinus Surgery: Technique and Anatomy FRANK N. RITI'ER,MD, and JEFFREYTERRELL,MD Ypsilanti and Ann Arbor, Mich.
Educational objectives: To know the anatomy of the paranasal sinus region and adjacent structures and to surgically eradicate sinus disease by external or intranasat endoscopic technique.
Every surgeon relies heavily on a keen knowledge of the original anatomy during the performance of a surgical operation. This is especially true regarding the paranasal sinuses, where congenital or developmental changes, infection, neoplasm, bleeding, injury or prior surgery may distort the salient landmarks and increase the risk of complications. This course stresses the precise anatomic landmarks to guide the surgeon performing external or endoscopic sinus surgery. Slides of anatomic dissections, CT scans, and videotaped dissections will be used to stress the important landmarks for the sinus surgeon. Special attention will also be
P 139
given to the relevant anatomy for endoscopic surgery on the paranasal sinuses and pertinent anatomy and clinical pearls for external or endoscopic control of epistaxis, endoscopic orbital decompression, optic nerve decompression, and endoscopic DCRs. This is a practical course with time for open discussion, questions, and answers.
COURSE 3716-2 Two-period course ($40)
Room NOCC-65 3:00-5:15
Pediatric Airway--Assessment and Management of Stridor SETHPRANSKY,MD, and DONALD B. KEARNS,MD San Diego, Calif.
Educational objectives: To be able to comfortably recognize and treat a multiplicity of pediatric airway problems, to be familiar and comfortable with all modes of endoscopic evaluation of the pediatric airway, and to understand the variety of surgical techniques available for the treatment of pediatric airway problems.
This course is designed to provide the practitioner with improved expertise in the assessment and management of stridor in the pediatric patient. Evaluation of these problems can be difficult and management of airway compromise challenging. The course will review the pediatric airway, beginning in the nose and ending in the lungs. We will concentrate on accurate diagnosis and appropriate intervention with clinical "pearls" described for each case of stridor. Various assessment strategies will be described, including the use of age, airway location, characteristics of stridor, congenital versus acquired lesions, and the clinical picture. The assessment and management protocols will include the premature or previously intubated neonate and extend through causes of stridor in older children. Diagnostic modalities to be described will include the roles of office evaluation including fiberoptic nasopharyngolaryngoscopy, the appropriate use of imaging, and operative endoscopic techniques including microsuspension laryngoscopy, video endoscopy, and laryngeal EMG techniques. There will be a thorough review of instrumentation appropriate for the pediatric airway. The use of microsuspension laryngoscopy with laser for a variety of problems (including supraglottic edema, severe laryngomalacia, subglottic cysts and webs, laryngeal papillomatosis, and subglottic hemangiomata) will be delineated. There will be video tape recordings to exemplify a variety of these procedures. Our approach to the single-stage laryngotracheal reconstruction will be described in detail. Medical management of airway difficulties will also be described, including discussion of less commonly recognized problems such as pediatric gastroesophageal reflux and neonatal rhinitis. We will also describe our use of steroids for pediatric airway problems and in the perioperative period. The successful endoscopic evaluation and treatment of airway abnormalities in children is dependent on a close