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The first endoscopic approach to parathyroid glands was reported by Gagner in 1996. Since then, different accesses have been described that use either CO 2 insufflation or external retraction. Other widespread procedures are the lateral access, proposed by Henry, and the central gasless access, proposed by Paolo Miccoli, called minimally invasive video-assisted parathyroidectomy. Minimally...
Central compartment lymph node dissection is mandatory in several thyroid tumors together with total thyroidectomy: medullary thyroid carcinoma and high-risk papillary carcinomas are the most common indications. Minimally invasive video assisted thyroidectomy is not indicated for high risk carcinomas; only low-risk papillary carcinomas and prophylactic thyroidectomy in RET gene mutation carriers,...
Rhinoplasty continues to behoove even the most experienced facial plastic surgeons in achieving long-term predictable success. To achieve the goals of a natural, refined, and esthetically flattering appearance of the nose while maintaining a functionally patent nasal airway, surgeons must adhere to certain guiding principles: preservation of favorable structural components, reorientation and augmentation...
Surgical robotics is a rapidly developing field. The application of robotic technology to head and neck procedures potentially offers patients alternatives to conventional open surgical procedures with decreased morbidity. Additionally, transoral robotic surgery (TORS) may extend minimally invasive head and neck surgery beyond transoral laser microsurgery with the ability to work around corners while...
Minimally invasive video-assisted thyroidectomy is suitable for selected patients undergoing thyroidectomy. The procedure is gasless and performed with the assistance of an endoscope via a small (<2 cm) neck incision. Results are encouraging with similar complication rates to conventional thyroidectomy but with superior cosmesis, less postoperative pain, and reduced hospital stay. An expected learning...
In recent years there has been a considerable movement among thyroid surgeons to both standardize and minimize the open thyroid incision. This trend reflects the increasing ambitions of modern surgical practice to produce less morbidity and improved cosmesis. These advances have been predicated on the development of more sophisticated surgical techniques and instruments. We present the development...
Resection of the submandibular gland is performed traditionally through a lateral cervical incision. The lateral cervical approach results in a visible scar and carries associated morbidities, such as the damage of the marginal mandibular branch of facial nerve. The evolution and advancement of endoscopic sinus surgical technique in recent years has led to its application to skull base and neck space...
There is an increasing demand for sentinel lymphadenectomy, which was developed to reduce the extent of surgical interventions in cancer patients. Among surgical techniques, endoscopic technology has evolved to become an integral part of the surgical approach. However, the application of endoscopic surgery in the neck, except for thyroid surgery, has so far failed to gain widespread acceptance. The...
The use of the ultrasonic dissector in head and neck surgery is becoming more prevalent. Although initially designed for use in laparoscopic abdominal surgery, potential advantages such as reduced incision size, hemostasis and reduced operative time has helped ultrasonic dissector use become more widespread. The ultraincision allows a simultaneous cut and coagulation at reduced energy, providing a...
Surgical robotics first emerged in the field of otolaryngology in a series of experimental articles published starting in 2003. Building on work that paved the way for endoscopic neck surgery, the incorporation of the robot facilitated the demanding manipulation that is necessary in the limited space of the neck compartments. There appears to be a promising future for robotic application in the head...
After more than 100 years of approaching thyroid surgery in the manner described by Theodore Kocher in the 19th century, thyroidectomy has undergone tremendous change during the past 6 to 8 years. Chief among them have been the development of minimally invasive surgical methods and the emergence of reliable laryngeal nerve monitoring techniques. The author describes a logical approach that exploits...
Augmentation rhinoplasty using silicone prostheses is a procedure that has gained wide acceptance, particularly in Asia, but has been met with resistance among Western surgeons. Much of the reluctance to employ this method is related to misconceptions regarding planning and executation of the operation. The basic principles of nasal augmentation stressing operative philosophy as well as technical...
The management of acute soft-tissue trauma can be very challenging for the facial plastic surgeon. The goals of management of facial trauma are the preservation of form and function. These goals are particularly important in facial soft-tissue trauma, where injuries can cause not only esthetic deformities but also can affect neural function, normal mastication, visual fields, and salivary outflow...
Maxillary-mandibular fixation (MMF) methods are important in the surgical management of the lower facial skeleton. Various techniques have been described to fixate these bones during treatment of facial trauma, reconstruction, and orthognathic surgery. The utilization and technique of placement for Erich arch bars, Ivy loops, Ernst ligatures, and fixation screws are reviewed.
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