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Midfacial approach to the sinuses and skull base
P64
Otolaryngology Head and Neck Surgery
May 1995
InstructionCourses -- Sunday
COURSE 1826- I One-period course ($20)
Room
NOCC-88 4:15-5:15
Midfacial Approach to the Sinuses and Skull Base GADY HAR-EL,MD
Brooklyn, N.Y.
Educational objectives: To understand the indications, limitations, and patient selection for MFD and to use the MFD technique to approach the nose, paranasal sinuses, nasopharynx, and skull base.
The midfacial degloving (MFD) approach is a surgical technique used for the management of neoplastic, vascular or traumatic lesions of the midface, nose, sinuses, nasopharynx, and anterior and middle compartments of the skull base. This technique does not require any facial skin incisions. The avoidance of facial scars may be extremely important for some patients and does not compromise the exposure and the efficiency of the technique. The most common operation performed using the MFD approach is medial maxillectomy and ethmoidectomy for inverted papilloma. However, MFD may also be used for wide resection of carcinoma, esthesioneuroblastoma and angiof'throma, as well as for the management of large dentogenic lesions, penetrating trauma and foreign bodies of the skull base, and massive midfacial and skull base fractures. The course will discuss in detail the indications, contraindications and patient selection for MFD. The surgical technique will be described in a step-by-step fashion, including the indications for unilateral or bilateral transection of the nasolacrimal duct. Possible complications (including nasal vestibular stenosis) and their prevention and management will also be discussed. After attending this course, the participants will be able to a d d the MFD technique to their surgical armamentafium. Our extensive experience with this technique has shown that it provides excellent exposure to all paranasal sinuses, cribriform plate, fovea ethmoidalis, orbits, pituitary gland, carotid arteries, optic nerve, clivus, and pterygopalatine fossae.
COURSE 1828- I
One-period course ($20)
Room NOCC-90 4:15-5:15
How to Evaluate and Purchase Medical Billing Software KEVIN KAVANAGH, MD
Somerset, Ky.
Educational objective: To select medical billing software that best fits the user's needs.
This course will provide a systematic approach to the evaluation and purchase of medical billing software. The three major types will be discussed, including st ~tware for medical record storage, managing accounts payable, and managing accounts receivable. Basic features such as user support, data backup, and hardware selection will be dis-
cussed. It is stressed that the main emphasis of evaluation should be placed on the software and not the hardware. The type of software purchased will depend on the type of practice environment and the type of accounting used: that is, group versus single practice; associateship versus partnership; cash-based accounting versus accrual-based accounting. The method of patient billing is also important. Invoices may be sent to patients at the same time as insurance billing or only after the insurance billing cycle has been completed. The advantages and disadvantages of posting payments to the patient's account, to the patient's invoices and to the invoice's line items will also be discussed. A review of basic software features, methods of data location and retrieval, along with required reports will be presented and given to the course participant in the form of a checklist. Advanced features such as multiuser systems, methods of linking distant locations, and differences in local area networks using minicomputers and microcomputers will also be discussed.
COURSE 1830- !
One-period course ($20)
Room NOCC-93 4:15-5:15
Rigid and Contact Video Endoscopy MARIO ANDREA, MD, and OSCAR DIAS, MD
Lisbon, Portugal
Educational objective: To perform this endoscopic technique.
The evaluation of benign and malignant lesions of the larynx, namely of the vocal cord, have benefited from the systematic use of rigid endoscopes (0, 30, 70, and 120 degrees) during microlaryngoscopies (REMS). Besides the access to particular areas of the endolarynx--anterior commissure, inferior surface and border of the vocal cord, and subglottis--all laryngeal pathology is evaluated with higher magnification and definition. The form, dimensions, limits, extension, color, relief, and vascular abnormalities are valued with greater detail. Contact endoscopy (CEMS), using 60x and 150x magnification and a vital colorant (methylene blue), gives direct access to the cells, performing an in vivo and in situ study of the superficial epithelium of the larynx. The regulaxity of the epithelium, dimensions and color of the nucleus, nucleus cytoplasmic ratio, contours, presence of nucleolus, mitosis, cytoplasmic inclusions, and keratosis allow the definition of normal and specific epithelial patterns-chronic laryngitis, Reinke's edema, dysplasia, papilloma, and malignant tumors. With CEMS, microvascular patterns of the larynx in normal and pathologic conditions are observed, and with 150x magnification blood flow can be studied. REMS and CEMS techniques have repercussions in etiopathology, diagnosis, performance of biopsies, treatment, and follow-up. In this course slides and videotapes are used to illustrate the fundamentals of REMS and CEMS and "how to do it."
Otolaryngology Head and Neck Surgery
May 1995
InstructionCourses -- Sunday
COURSE 1826- I One-period course ($20)
Room
NOCC-88 4:15-5:15
Midfacial Approach to the Sinuses and Skull Base GADY HAR-EL,MD
Brooklyn, N.Y.
Educational objectives: To understand the indications, limitations, and patient selection for MFD and to use the MFD technique to approach the nose, paranasal sinuses, nasopharynx, and skull base.
The midfacial degloving (MFD) approach is a surgical technique used for the management of neoplastic, vascular or traumatic lesions of the midface, nose, sinuses, nasopharynx, and anterior and middle compartments of the skull base. This technique does not require any facial skin incisions. The avoidance of facial scars may be extremely important for some patients and does not compromise the exposure and the efficiency of the technique. The most common operation performed using the MFD approach is medial maxillectomy and ethmoidectomy for inverted papilloma. However, MFD may also be used for wide resection of carcinoma, esthesioneuroblastoma and angiof'throma, as well as for the management of large dentogenic lesions, penetrating trauma and foreign bodies of the skull base, and massive midfacial and skull base fractures. The course will discuss in detail the indications, contraindications and patient selection for MFD. The surgical technique will be described in a step-by-step fashion, including the indications for unilateral or bilateral transection of the nasolacrimal duct. Possible complications (including nasal vestibular stenosis) and their prevention and management will also be discussed. After attending this course, the participants will be able to a d d the MFD technique to their surgical armamentafium. Our extensive experience with this technique has shown that it provides excellent exposure to all paranasal sinuses, cribriform plate, fovea ethmoidalis, orbits, pituitary gland, carotid arteries, optic nerve, clivus, and pterygopalatine fossae.
COURSE 1828- I
One-period course ($20)
Room NOCC-90 4:15-5:15
How to Evaluate and Purchase Medical Billing Software KEVIN KAVANAGH, MD
Somerset, Ky.
Educational objective: To select medical billing software that best fits the user's needs.
This course will provide a systematic approach to the evaluation and purchase of medical billing software. The three major types will be discussed, including st ~tware for medical record storage, managing accounts payable, and managing accounts receivable. Basic features such as user support, data backup, and hardware selection will be dis-
cussed. It is stressed that the main emphasis of evaluation should be placed on the software and not the hardware. The type of software purchased will depend on the type of practice environment and the type of accounting used: that is, group versus single practice; associateship versus partnership; cash-based accounting versus accrual-based accounting. The method of patient billing is also important. Invoices may be sent to patients at the same time as insurance billing or only after the insurance billing cycle has been completed. The advantages and disadvantages of posting payments to the patient's account, to the patient's invoices and to the invoice's line items will also be discussed. A review of basic software features, methods of data location and retrieval, along with required reports will be presented and given to the course participant in the form of a checklist. Advanced features such as multiuser systems, methods of linking distant locations, and differences in local area networks using minicomputers and microcomputers will also be discussed.
COURSE 1830- !
One-period course ($20)
Room NOCC-93 4:15-5:15
Rigid and Contact Video Endoscopy MARIO ANDREA, MD, and OSCAR DIAS, MD
Lisbon, Portugal
Educational objective: To perform this endoscopic technique.
The evaluation of benign and malignant lesions of the larynx, namely of the vocal cord, have benefited from the systematic use of rigid endoscopes (0, 30, 70, and 120 degrees) during microlaryngoscopies (REMS). Besides the access to particular areas of the endolarynx--anterior commissure, inferior surface and border of the vocal cord, and subglottis--all laryngeal pathology is evaluated with higher magnification and definition. The form, dimensions, limits, extension, color, relief, and vascular abnormalities are valued with greater detail. Contact endoscopy (CEMS), using 60x and 150x magnification and a vital colorant (methylene blue), gives direct access to the cells, performing an in vivo and in situ study of the superficial epithelium of the larynx. The regulaxity of the epithelium, dimensions and color of the nucleus, nucleus cytoplasmic ratio, contours, presence of nucleolus, mitosis, cytoplasmic inclusions, and keratosis allow the definition of normal and specific epithelial patterns-chronic laryngitis, Reinke's edema, dysplasia, papilloma, and malignant tumors. With CEMS, microvascular patterns of the larynx in normal and pathologic conditions are observed, and with 150x magnification blood flow can be studied. REMS and CEMS techniques have repercussions in etiopathology, diagnosis, performance of biopsies, treatment, and follow-up. In this course slides and videotapes are used to illustrate the fundamentals of REMS and CEMS and "how to do it."