What is the insights of endoscopic endonasal tumor resection Compared with traditional external approach surgery??5 answersThe endoscopic endonasal approach to tumor resection offers several advantages over traditional external approaches. It allows for precise tumor localization, especially in anterior skull base meningiomas, reducing the need for extensive bone drilling and manipulation of critical structures. Additionally, this approach is increasingly used for pediatric suprasellar tumors, emphasizing radical tumor resection while preserving visual and cognitive functions, with the aid of techniques like the "4-hand technique" and additional procedures like posterior clinoidectomy and upper clivectomy. Furthermore, cases of rare tumors like supratentorial hemangioblastomas within the infundibulum have been successfully resected using the endoscopic endonasal approach, showcasing its efficacy even in challenging locations. Overall, endoscopic endonasal tumor resection presents a promising alternative with improved outcomes and reduced invasiveness compared to traditional external approaches.
Are there protocols for malignant external otitis?4 answersThere are no standardized protocols for the management of malignant otitis externa (MOE). The lack of standardized diagnostic criteria and treatment regimes for MOE poses challenges in its management. Different centers employ different diagnostic and treatment approaches, including the use of radionuclide investigations, clinical parameters, CT scans, and microbiologic tests. Empiric treatment is often initiated based on hospital protocols. Early diagnosis and early initiation of treatment are critical in reducing hospital stay, mortality, and morbidity. Clinical symptoms and signs, along with radiological imaging and inflammatory markers, are used to evaluate the eradication of the disease. The high incidence of Ciprofloxacin resistance in MOE cases is a growing concern. Access to higher antibiotics may be restricted in rural areas, leading to the use of alternative drugs with promising results.
Is internal nasal splint needed for septorhinoplasty?5 answersInternal nasal splints are commonly used in septorhinoplasty procedures to provide internal stabilization, prevent septal hematoma, promote hemostasis, prevent synechiae, and aid in flap positioning. However, there is a lack of consensus regarding the necessity of nasal splints in septorhinoplasty. Some studies suggest that the use of nasal splints may not be necessary and can even lead to complications such as discomfort, sleep disturbances, and increased pain. On the other hand, other studies indicate that the use of intranasal splints can reduce the formation of synechiae after septoplasty, potentially improving postoperative outcomes. Therefore, the decision to use internal nasal splints in septorhinoplasty should be based on individual patient factors, surgeon preference, and the specific goals of the procedure. Further research is needed to determine the optimal use of nasal splints in septorhinoplasty.
What are some advantages of using an external approach for sinus surgery?3 answersAn external approach for sinus surgery offers several advantages. It allows for the removal of diseased tissue or neoplastic processes that cannot be reached by endoscopic methods. External procedures can provide increased exposure to the sinuses, especially in cases where inflammation and edema limit endoscopic visualization. Additionally, external approaches may be useful for recalcitrant inflammatory sinus disease that has not been adequately addressed by prior endoscopic procedures or when the disease is far lateral and inaccessible through endoscopic approaches. External techniques can also be valuable for patients with malignancies, benign tumors, fractures, and CSF leaks. Furthermore, open procedures may offer a faster and more definitive option in cases where endoscopic techniques would require significantly longer operative time for a successful outcome.
What is Lynch procedure of frontal sinus surgery?3 answersThe Lynch procedure of frontal sinus surgery is a modified operation that differs from the original technique described by Lynch. It involves an intranasal anterior ethmoidectomy, preservation of certain structures such as the middle turbinate and normal-appearing mucosa of the frontal-ethmoid complex, and limited bone removal in most cases. Additionally, soft, nonreactive material (thin Silastic® sheeting) is used to stent the nasal-frontal passageway. The procedure has been observed in patients for a period of 5 to 20 years, with an increase in the incidence of failures over time. The Lynch procedure aims to achieve a good postoperative result without the need for complete removal of all the mucosa of the frontal-ethmoid-sphenoid complex.
What is external capability?5 answersExternal capability refers to the organizational competence and agility in terms of customer and supply chain knowledge, as well as the ability to challenge industry norms and source innovation from outside the industry. It is a critical strategic leadership capability for both individuals and organizations, allowing them to compete effectively in today's business conditions. External intelligence capability is a keystone advantage that helps companies interpret and act on overwhelming amounts of business information in volatile and uncertain environments. It plays a crucial role in achieving superior performance by influencing strategy formulation and implementation outcomes. Additionally, external capability can also refer to the ability to process queries against external data sources using dynamically allocated partitions and worker nodes, allowing for efficient retrieval and processing of data.