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#17466147   2007/04/30 Save this To Up

An attractive approach to magnets adherent across the nasal septum.

We report a case of an 8-year-old boy who presented to the emergency department with small jewelry magnets adherent across his nasal septum. Prompt removal of these foreign bodies is important to avoid septal necrosis and perforation. We report our success in using the metal handle of bayonet forceps to break the attraction between the magnets. The magnets were removed painlessly and without trauma to the nasal septum.

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#17007373   2006/09/29 Save this To Up

[Endonasal anatomy of lacrimal sac and its clinical significance in dacryocystorhinostomy].

To explore the intranasal surface localization of the lacrimal sac in endoscopic dacryocystorhinostomy.

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#11696881   2001/11/06 Save this To Up

Ultrasound-guided aspiration of brain abscesses through a single burr hole.

Surgical aspiration and/or drainage of brain abscesses is considered to be the first-line treatment for abscesses larger than 25 mm. This is ususally performed with the aid of CT-guided stereotaxy. A method of ultrasound guidance is presented that allows a single burr hole approach with real-time imaging of the whole procedure. A bayonet-like shaped ultrasound probe with tip dimension of 8 x 8 mm only (EUP-NS 32, Hitachi/Ecoscan) with frequencies of 3.5 and 5 MHz is used. After placement of a burr hole the target is identified by transdural insonation, a guideline is adjusted and a mounted puncture-adapter guides the cannula towards the lesion under real-time imaging control. Up to now 12 abscesses in 10 patients were treated. Visualization was always excellent. A second aspiration had to be performed twice. One abscess did not contain enough pus to be cured by aspiration and was removed by open surgery, another could not be tapped by the blunt cannula and was aspirated under stereotactic control using a sharp trocar. Outcome was excellent in 6 patients and fair in 2 patients but this was due to the pre-existing disease. Two patients admitted in deep coma died despite an emergency operation. The presented method has proven to be a very powerful guiding tool in the surgical treatment of brain abscesses through a single burr hole approach.

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#3833903   1986/05/30 Save this To Up

[Value of surgical hysteroscopy in the treatment of myomas and intracavitary fibrous polyps. Evaluation of 26 operations].

Out of a total of 121 hysteroscopies carried out in this unit between December 1981 and June 1984, 26 were operative hysteroscopies. Each of these procedures consisted in removing intra-uterine structures (that could not be removed with a curette) under visual control. All cases had a normal sized or slightly enlarged uterus. There were 7 patients aged 41 years or younger and 19 older than 41. The endoscope used was the "bayonet" Wolf apparatus which is 7 mm in diameter and has two separate canals; one for insufflation and the other for introducing the 3 mm biopsy forceps. This small punch makes it possible to cut the implantation on uterine wall without needing coagulation. The tissue is then removed using a soft curette or a polyp forceps after the cervix has been further dilated. There was no case in which heavy bleeding occurred during or after the operation. Using this technique we were able to remove 18 fibroid polyps, 13 submucous fibroids (8 smaller than 2 cm in diameter and 5 between 2 and 4 cm), 3 old retained portions of placenta; removal was complete in 21 cases and only partial in 5 cases. Out of these 2 had to have hysterectomy. On the other hand abdominal myomectomy or hysterectomy could be avoided in 11 cases. This series shows how often fibrous polyps and small sub-mucous fibroids can be removed under hysteroscopic control when using this kind of apparatus and a relatively simple technique.

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