Rhinology and endoscopic skull base surgery

288 Pages·2013·22.7 MB·English

by  Devaiah

Rhinology and Endoscopic Skull Base Surgery
Thieme

Rhinology and Endoscopic Skull Base Surgery
Series Editors Volume Editors
Professor Emeritus Milind V. Kirtane, M.S. (ENT) Anand K. Devaiah, M.D., F.A.C.S.
Seth G. S. Medical College & KEM Hospital Associate Professor
P. D. Hinduja National Hospital & Research Centre Department of Otolaryngology - Head and Neck
Breach Candy Hospital Surgery
Prince Ali Khan Hospital Department of Neurological Surgery
Saifee Hospital Department of Ophthalmology
Mumbai, India Boston University School of Medicine
Boston Medical Center, Massachusetts, USA
Chris E. de Souza, M.S., D.O.R.L., D.N.B., F.A.C.S.
ENT Consultant Bradley F. Marple, M.D., F.A.A.O.A.
Lilavati Hospital Professor and Vice Chair Department of
Holy Family Hospital Otolaryngology
Holy Spirit Hospital University of Texas Southwestern Medical Center
Tata Memorial Hospital Dallas, Texas, USA
Mumbai, India
Associate Dean for Graduate Medical Education
Visiting Assistant Professor University of Texas Southwestern Medical Center
Department of Otoloaryngology Dallas, Texas, USA
SUNY Brooklyn, New York, USA
Department of Otolaryngology
LSUHSC, Shreveport, Louisiana, USA
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Rhinology and Endoscopic Skull Base Surgery/[edited by] Anand K. Devaiah and Bradley F. Marple.
Includes bibliographical references and index.
ISBN 978-93-82076-01-8
Devaiah, Anand K. II Marple, Bradley F.
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ISBN: 978-93-82076-01-8
eISBN: 978-93-82076-07-0
Rhinology and Endoscopic Skull Base Surgery
Published by Thieme Medical and Scientific Publishers Private Limited
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Foreword
This text comes at a time when important leaps in patient care are occurring in endoscopic skull base surgery and rhinology.
These disciplines encompass some of the most exciting areas of research, collaboration, and innovation. While team-based
care is in varying states of evolution for areas of medicine, there are not many areas where one sees such a rich and rapid
convergence of diverse multidisciplinary care and coordination. Similarly, when viewing endoscopic skull base surgery and
rhinology in an integrated way, we strive to create a foundation for learning, discussion, and development. It is our sincere
hope that residents, fellows, practitioners, and patients will find this text a necessary reference.
This text represents a truly international effort, with contributors from around the globe. This is most fitting, given that
innovation in endoscopic skull base surgery and rhinology is occurring on a worldwide scale, and it is the global community
of patients who we strive to help.
The many individuals who have contributed to this text cannot be thanked enough for giving their time and expertise.
Indeed, the editors and authors for the entire series of texts are to be congratulated on a world-class comprehensive reference.
The series editors, Drs. Kirtane and de Souza, have done an extraordinary job in putting this entire project together.
It is our delight and privilege to present this book to the reader, and hope that it serves you well in your pursuit of
knowledge and innovative patient care.
Anand K. Devaiah, M.D., F.A.C.S.
Bradley F. Marple, M.D., F.A.A.O.A.
Acknowledgments
It is impossible to acknowledge everyone I need to acknowledge, but a few individuals bear mention in the context of this
text.
My many mentors in training, particularly Drs. Larry Hoover, Doug Girod, and Terry Tsue, gave me opportunities to learn
the foundations and facets of endoscopic skull base surgery, open skull base surgery, and rhinology. This happened at a time
when many of the concepts, we now take for granted, were still being envisioned by them and others around the globe. My
partners in clinical care and research have been wonderful collaborators, both locally and worldwide. This also includes
the many exceptional residents who have been part of our program and care team for my patients over the years. Their
questions of “how” and “why” have been a great source of intellectual curiosity.
The patients and their families who put their trust in me cannot be thanked enough. It is ultimately because and for them
that this text exists. They have been my most important teachers.
No acknowledgment would be complete without recognizing the love and support from my wife, Manju; my boys, Jayanth
and Deven; and my parents, Kulachandra and Vani.
Anand K. Devaiah, M.D., F.A.C.S.
Otolaryngology is, and has always been, a close community. Those who train in our profession experience a unique
opportunity to not only read about its innovators but also learn directly from them. This way we are all linked by a common
professional heritage.
I feel fortunate to have undertaken my otolaryngology training at a time when endoscopic techniques were first
introduced in the United States. The inherent challenge of dim light sources, poor hemostasis, lack of equipment, and ill-
defined procedures served to stimulate innovation, development, and opportunity. This, in turn, provided the foundation for
a paradigm shift that has become contemporary rhinology and endoscopic skull base surgery.
With this in mind, I would like to take this opportunity to acknowledge a few of the many individuals who have not only
contributed to my personal growth and development but also meaningfully contributed to the field of Rhinology. Drs. Steve
Schaefer and Lanny Close taught me the early techniques of ESS, but more importantly instilled a drive to develop and move
those same techniques forward. Role models, such as Drs. Peter Roland, Scott Manning, and Matthew Ryan, taught me the
value of critical thinking and the importance of maintaining just a hint of skepticism. Richard Mabry, M.D., deserves special
recognition for continually reminding me that as a Rhinologist it is critical to consider the entire patient.
Bradley F. Marple, M.D., F.A.A.O.A.
A Note from Series Editors
Rhinology as a separate scientific discipline has gained credence with the development of endoscope, allowing excellent
visualization of structures which was not possible earlier. External approaches to the nasal cavity that had external incisions
have now become endoscopic surgeries with no disfiguring external incisions. This has all been possible because of the
endoscope, marvelous optics, robotics and navigation systems, and newer generations of CT scans and MRIs. Rhinology is
finally coming into its own. Debates still rage. However, as time passes by and patients are closely followed up, it will become
clear what paths we need to follow to treat effectively and competently.
Otology as a science has predated that of rhinology. This is evidenced as it was only in 2004 that Dr. Linda Buck and
Dr. Richard Axel were awarded the Nobel Prize for their seminal work on olfaction. The Nobel Prize for the physiology of
hearing was given almost 45 years ago. The technology and expertise to treat nasal and paranasal problems has evolved
very quickly. There are now many centers that treat rhinologic problems and have expanded their applications to include
the anterior skull base. This has caused closer cooperation between rhinologists and neurosurgeons. This is an exciting new
field. Technology, optics, and dedicated training in this area has led to the development and refining of Rhinology not only
as a science but also as an art as well.
The editors and authors of this excellent book are well aware that we are on a continuum. All efforts of this book are
directed to smoothing the path of rhinologists by providing current, easy to understand, and up-to-date information to
the reader. This book will help prepare the rhinologist well so that when a patient presents in the office with a rhinologic
complaint the reader of this book will be better prepared to understand how to go about giving expert treatment. For this
we thank the editors and authors of this book.
Milind V. Kirtane, M.S.
Chris E. de Souza, M.S., D.O.R.L., D.N.B., F.A.C.S.
Introduction
Rhinology is one of the most dynamic and exciting subspecialties within Otorhinolaryngology—head and neck surgery.
Driving forces have been technological advances in endoscopic instrumentation and image-guided navigation, improved
understanding of endoscopic anatomy, parallel advancements in related surgical disciplines, and a spirit of collaboration.
There has been a rapid evolution of surgical techniques with expansion to the skull base, orbit, and beyond.
Rapid change brings new challenges. How do rhinologists keep abreast of the latest medical and surgical advances? There
is a need to incorporate best practices into decision making and not simply follow the latest fad. The authors in this book
are all experts in their respective topics and offer medical and surgical solutions based on a wealth of clinical experience
as well as a balanced sense of current practices. Rhinologic surgery does not exist in isolation. The rhinologic surgeon must
be mindful of the anatomical and medical foundations of rhinology so that proper decisions are made and nonsurgical
alternatives are considered. It follows that good surgical outcomes are dependent on a holistic approach to management
and surgical intervention is just one aspect of patient care. Increasingly, care is provided by a multidisciplinary team and the
rhinologic surgeon must be conversant with divergent practices and philosophies.
In this volume, Drs. Devaiah and Marple have succeeded in assembling a premier list of international authors who are all
thought leaders in rhinology. The content is logically divided into three sections: Foundations of Rhinology and Endoscopic
Skull Base Surgery, Rhinology and Paranasal Sinus Surgery, and Endoscopic Skull Base Surgery and Related Skull Base Surgery.
These chapters provide a comprehensive snapshot of the current state of the art and offer hints of future directions.
Carl H. Snyderman, M.D., M.B.A.