RSS Channels IndexMinimally-Invasive Head and Neck Surgery in Children
Embargo expired:
Source: American Academy of Otolaryngology Head and Neck Surgery (AAOHNS)
Release: Embargoed until September 24, 2000
Contact: Kenneth Satterfield
(202) 371-4517 (9/23-9/27)
703-519-1563
ksatterf@entnet.org
MINIMALLY-INVASIVE HEAD AND NECK SURGERY IN CHILDREN: COMPUTERS HELP SURGEONS TREAT KIDS
New computer technology allows surgeons to remove pediatric tumors, infections, and congenital abnormalities with more precision, less pain, and less time in the hospital.
Washington, DC -- Researchers at the Walter Reed Army Medical Center have completed a study which demonstrates that image guided surgery (IGS), integrating medical imaging, sensor technology, and computers, offers safe, effective, and minimally invasive surgical alternatives for children with select diseases of the head and neck. IGS has been shown to enhance endoscopic surgical safety and thoroughness for difficult sinus surgeries in adults. This technology now has been adapted from adults to children.
Children have disease processes that are much different from their adult counterparts. Pediatric tumors such as juvenile nasopharyngeal angiofibromas (extremely vascular tumors behind the nose) and rhabdomyosarcomas (aggressive malignant tumors seen in the head and neck) usually involve disfiguring operations. Surgery for deep neck abscesses in children commonly results in unsightly scars on the neck. Traditional surgery for congenital bony abnormalities such as choanal atresia (bone blocking the back of the nose causing breathing difficulties) may be technically difficult due to unfamiliar surgical landmarks. IGS promotes "keyhole" surgery in all these cases by minimizing endoscopic dissection, facilitating full excision of tumors, and reducing the need for facial or neck incisions.
The authors of this study, "New Applications for Image Guided Surgery in Children," are Ian McLeod, MD and Eric A. Mair, MD, of Walter Reed Army Medical Center in Washington, D.C. Their findings will be presented Tuesday, September 26th, 2000, at the Annual Meeting/Oto Expo of the American Academy of Otolaryngology -- Head and Neck Surgery Foundation, being held September 24-27, at the Washington D.C. Convention Center.
Methodology: From February 1999 to September 2000, 32 children (ages five months to 17 years) underwent pre-operative IGS scanning (InstaTrak) for a variety of pediatric otolaryngology diseases and anomalies. The study included 16 children with chronic sinusitis needing revision surgery (especially cystic fibrosis), four children with deep neck space abscesses, five young males with juvenile nasopharyngeal angiofibromas, five children with other skull base tumors, and two children with choanal atresia. Novel minimally-invasive endoscopic surgical techniques were made possible by the addition of IGS.
Results: IGS facilitates endoscopic removal of large juvenile nasopharyngeal angiofibromas, intraoral incision and drainage of selected parapharyngeal and retropharyngeal abscesses, endoscopic intranasal repair of choanal atresia, and difficult pediatric endoscopic sinus and skull base surgery. No IGS complications were encountered. Because these children had fewer incisions and less surgical dissection, they were able to go home sooner with less pain medication. The IGS system used by the authors (InstaTrak) is accurate to within two mm. Although the initial expenditure is high (up to $160,000), actual case expenses ($100 per case in disposable items) and system maintenance are cost-effective.
Conclusion: IGS offers safe and effective new surgical applications in pediatric otolaryngology. IGS extends well beyond basic sinus surgery applications in children and enhances surgical precision while minimizing
the invasiveness of diverse procedures in pediatric otolaryngology.
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