Turkish Archives of Otorhinolaryngology (Dec 2012)
Juvenile nasopharyngeal angiofibroma, patulous eustachian tube, pediatric nasal septum deviation, closed technique rhinoplasty, choanal atresia, submandibular masses and chronic sialadenitis: Endoscope assisted surgery excluding sinus surgery
Abstract
Objectives: The aim of this study is to discuss advantages of endoscopy use in ENT diseases other than sinus surgery.Methods: Thirteen patients [8 men (62%) and 5 women (38%)] who underwent endoscopic surgery between 2011 and 2012 were included to the study. Patients who underwent endoscopic sinus surgery were excluded. All patients were operated by using endoscopy under general anesthesia. External skin incision wasn’t performed in any patient. Endoscopic video recordings were captured during surgery. Rigid telescopes with angles of 0, 30, 70 and 90° were used in different angles and operations depending on the necessities.Results: Mean age was 21.77±15.51 (min.7-max.60) years and mean duration of complaints was 32.92±62.87 (min.1- max.240) months. Total excision was performed in 2 patients due to juvenile nasopharyngeal angiofibroma (JNA) via combined transoral and transnasal approach; graft placement was performed in one patient due to a displaced nasal fracture via closed rhinoplasty technique; pediatric septoplasty was performed in 4 patients; choanal atresia was opened via endonasal approach in one patient; hyaluronic acid injection to tuba auditiva was performed in one patient due to a patulous Eustachian tube; mass excision was performed in one patient due to a giant pleomorphic adenoma at soft palate; gland excision was performed in 2 patients due to chronic sialadenitis via transoral approach; and mass excision was performed in one patient via transoral submandibular retroglandular approach. In one patient who underwent JNA excision, a bone defect was observed at the skull base and it was endoscopically repaired by bone graft in the same session. Pathology result was reported as lymphoma in submandibular mass, while it was compatible to chronic sialadenitis in submandibular glands. Patient satisfaction was high in all these approaches without skin incision, while length of hospital stay was minimum.Conclusion: Endoscopy assisted surgery is being increasingly used in ENT field because these techniques are minimal invasive; require shorter hospitalization; and have low morbidity. By using endoscopy, not only good cosmetic results are achieved but also video recordings and photographs can be captured in restricted areas for both medico-legal and educational issues.
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