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Application of surgical navigation in styloidectomy for treating Eagle's syndrome.

Dou G, Zhang Y, Zong C, Chen Y, Guo Y, Tian L - Ther Clin Risk Manag (2016)

Bottom Line: Postoperatively, the amount of bleeding, duration of operation and hospitalization, and the length of resected styloid process (SP) were measured and compared with those cases that had traditional styloidectomy without the help of surgical navigation (SN).The visual analog scale analysis showed that the discomfort in all patients was relieved, while ten patients' symptoms were improved greatly, and two patients had some improvement.The higher accuracy of surgery, lesser amount of bleeding, decreased duration of surgery and hospitalization, absence of complications, and improved subjective symptoms indicated that SN is an effective and minimally invasive surgical procedure suitable for resection of ESP for treating Eagle's syndrome.

View Article: PubMed Central - PubMed

Affiliation: The First Brigade of Students, The Fourth Military Medical University, Xi'an, People's Republic of China.

ABSTRACT

Purpose: The present study aimed to evaluate the feasibility, accuracy, and clinical effect of intraoperative navigation for resection of elongated styloid process (ESP) in Eagle's syndrome.

Patients and methods: Twelve patients with Eagle's syndrome with clinically and radiologically established diagnoses of ESP were included in this study. Preoperatively, all patients accepted three-dimensional computed tomography scan, and their skulls' digital imaging and communications in medicine data were inputed into the navigation system workstation to make a virtual surgical plan in advance. During surgery, the intraoperative navigation was performed to excise the ESP accurately for both intraoral (without tonsillectomy) and extraoral approaches following the virtual plan. Postoperatively, the amount of bleeding, duration of operation and hospitalization, and the length of resected styloid process (SP) were measured and compared with those cases that had traditional styloidectomy without the help of surgical navigation (SN). A simple visual analog scale questionnaire was also used to assess patients' satisfaction and the surgery effect after 3 months.

Results: In total, 17 SPs from 12 patients were precisely resected by intraoral parapharyngeal approach and small cervical approach with the aid of SN. No severe complications occurred in any patients. The length of resected SPs was 21.93±14.26 mm. The average amount of bleeding and duration of operation were 22.50±8.54 mL and 40.35±11.81 minutes, respectively, which were all less than with traditional styloidectomy. The visual analog scale analysis showed that the discomfort in all patients was relieved, while ten patients' symptoms were improved greatly, and two patients had some improvement.

Conclusion: The higher accuracy of surgery, lesser amount of bleeding, decreased duration of surgery and hospitalization, absence of complications, and improved subjective symptoms indicated that SN is an effective and minimally invasive surgical procedure suitable for resection of ESP for treating Eagle's syndrome.

No MeSH data available.


Related in: MedlinePlus

The resected giant elongated styloid process and the small cervical skin scar after extraoral approach.Notes: The styloid process was excised in integrity (A). The small cervical skin wound healed well after 1 month and the patient was satisfied with the cosmetic result (B).
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f6-tcrm-12-575: The resected giant elongated styloid process and the small cervical skin scar after extraoral approach.Notes: The styloid process was excised in integrity (A). The small cervical skin wound healed well after 1 month and the patient was satisfied with the cosmetic result (B).

Mentions: A 43-year-old woman was referred to our department for persistent serious throat discomfort, swallowing pain, and dysphasia. She also felt tight in the neck when turning her head to the left. Her discomforts were thought to be related to chronic pharyngitis and were managed by conservative therapy, but no obvious improvement was gained. We gave her detailed physical examinations, and her symptoms of pain had localized to the left submandibular region. Then, a differential diagnosis of Eagle’s syndrome was made. 3D-CT scan was adopted to evaluate the status of her SP and found surprisingly a giant SP of length 70.7 mm (Figure 4). Therefore, the patient was encouraged to have her giant SP resected to relieve her symptoms. The virtual surgical plan was made in the method described earlier (Figure 4). Because the SP was too strong to be taken out of the mouth whilst maintaining its integrity, a 2.5 cm submandibular incision was adopted under the guide of the navigation system. After the SP was fully exposed, a fine round bur was used to cut this strong SP. To make sure the bur only worked on the SP and the adjacent anatomical structures were protected, we set a dynamic reference frame on the handle of the bur and matched it with the navigation machine so that the bur could be used as an EM pointer. In this way, we could simultaneously see the exact movement and position of the round bur on the screen, which minimized the risk of injury of other surrounding structures (Figure 5). Then, a 61 mm section of the elongated right SP was excised according to the preoperative plan, in 43 minutes, with very little bleeding. The patient made an uneventful recovery without any complications. She was relieved of all her symptoms and subsequently discharged (Figure 6).


Application of surgical navigation in styloidectomy for treating Eagle's syndrome.

Dou G, Zhang Y, Zong C, Chen Y, Guo Y, Tian L - Ther Clin Risk Manag (2016)

The resected giant elongated styloid process and the small cervical skin scar after extraoral approach.Notes: The styloid process was excised in integrity (A). The small cervical skin wound healed well after 1 month and the patient was satisfied with the cosmetic result (B).
© Copyright Policy
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4835116&req=5

f6-tcrm-12-575: The resected giant elongated styloid process and the small cervical skin scar after extraoral approach.Notes: The styloid process was excised in integrity (A). The small cervical skin wound healed well after 1 month and the patient was satisfied with the cosmetic result (B).
Mentions: A 43-year-old woman was referred to our department for persistent serious throat discomfort, swallowing pain, and dysphasia. She also felt tight in the neck when turning her head to the left. Her discomforts were thought to be related to chronic pharyngitis and were managed by conservative therapy, but no obvious improvement was gained. We gave her detailed physical examinations, and her symptoms of pain had localized to the left submandibular region. Then, a differential diagnosis of Eagle’s syndrome was made. 3D-CT scan was adopted to evaluate the status of her SP and found surprisingly a giant SP of length 70.7 mm (Figure 4). Therefore, the patient was encouraged to have her giant SP resected to relieve her symptoms. The virtual surgical plan was made in the method described earlier (Figure 4). Because the SP was too strong to be taken out of the mouth whilst maintaining its integrity, a 2.5 cm submandibular incision was adopted under the guide of the navigation system. After the SP was fully exposed, a fine round bur was used to cut this strong SP. To make sure the bur only worked on the SP and the adjacent anatomical structures were protected, we set a dynamic reference frame on the handle of the bur and matched it with the navigation machine so that the bur could be used as an EM pointer. In this way, we could simultaneously see the exact movement and position of the round bur on the screen, which minimized the risk of injury of other surrounding structures (Figure 5). Then, a 61 mm section of the elongated right SP was excised according to the preoperative plan, in 43 minutes, with very little bleeding. The patient made an uneventful recovery without any complications. She was relieved of all her symptoms and subsequently discharged (Figure 6).

Bottom Line: Postoperatively, the amount of bleeding, duration of operation and hospitalization, and the length of resected styloid process (SP) were measured and compared with those cases that had traditional styloidectomy without the help of surgical navigation (SN).The visual analog scale analysis showed that the discomfort in all patients was relieved, while ten patients' symptoms were improved greatly, and two patients had some improvement.The higher accuracy of surgery, lesser amount of bleeding, decreased duration of surgery and hospitalization, absence of complications, and improved subjective symptoms indicated that SN is an effective and minimally invasive surgical procedure suitable for resection of ESP for treating Eagle's syndrome.

View Article: PubMed Central - PubMed

Affiliation: The First Brigade of Students, The Fourth Military Medical University, Xi'an, People's Republic of China.

ABSTRACT

Purpose: The present study aimed to evaluate the feasibility, accuracy, and clinical effect of intraoperative navigation for resection of elongated styloid process (ESP) in Eagle's syndrome.

Patients and methods: Twelve patients with Eagle's syndrome with clinically and radiologically established diagnoses of ESP were included in this study. Preoperatively, all patients accepted three-dimensional computed tomography scan, and their skulls' digital imaging and communications in medicine data were inputed into the navigation system workstation to make a virtual surgical plan in advance. During surgery, the intraoperative navigation was performed to excise the ESP accurately for both intraoral (without tonsillectomy) and extraoral approaches following the virtual plan. Postoperatively, the amount of bleeding, duration of operation and hospitalization, and the length of resected styloid process (SP) were measured and compared with those cases that had traditional styloidectomy without the help of surgical navigation (SN). A simple visual analog scale questionnaire was also used to assess patients' satisfaction and the surgery effect after 3 months.

Results: In total, 17 SPs from 12 patients were precisely resected by intraoral parapharyngeal approach and small cervical approach with the aid of SN. No severe complications occurred in any patients. The length of resected SPs was 21.93±14.26 mm. The average amount of bleeding and duration of operation were 22.50±8.54 mL and 40.35±11.81 minutes, respectively, which were all less than with traditional styloidectomy. The visual analog scale analysis showed that the discomfort in all patients was relieved, while ten patients' symptoms were improved greatly, and two patients had some improvement.

Conclusion: The higher accuracy of surgery, lesser amount of bleeding, decreased duration of surgery and hospitalization, absence of complications, and improved subjective symptoms indicated that SN is an effective and minimally invasive surgical procedure suitable for resection of ESP for treating Eagle's syndrome.

No MeSH data available.


Related in: MedlinePlus