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We found 10 results for Texas Children\'s Hospital in video

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Choanal Atresia Repair
video

Contributor: Tyler McElwee Choanal atresia describes the congenital narrowing of the back of the nasal cavity that causes difficulty breathing in neonate. Choanal atresia is often associated with CHARGE, Treacher Collins and Tessier Syndrome. It is a rare condition that occurs in 1:7000 live births, seen in females twice as often as males, and affects bilaterally in roughly 50% of cases. Bilateral choanal atresia is usually repaired in the newborn period. Unilateral CA repair is often deferred until age 2-3 years. Stent placement has become optional as stentless repair is gaining popularity because this technique decreases foreign body reaction in the nasopharynx which in term decreases granulation formation. Transnasal endoscopic choanal atresia repair is performed by opening the atresia bilaterally, drilling out pterygoid bone as needed, and removal of the posterior septum and vomer. Normal mucosa is preserved as much as possible by elevating a lateral based mucosal flap to prevent scarring and restenosis. Postoperatively, these patients are treated with antibiotic, reflux medications and steroid nasal drops; a second look procedure is planned 4-6 weeks postop for debridement and possible removal of granulation tissue & scar. DOI: http://dx.doi.org/10.17797/9s5ty2f7yv Editor Recruited By: Sanjay Parikh, MD, FACS

Bilateral Dacryocystoceles Resection
video

Contributor: Tyler McElwee Congenital dacryocystocele describe the distended lacrimal sac in neonates with or without associated intranasal cyst. The prevalence is about 0.1% of infants with congenital nasolacrimal duct obstruction and a slight prevalence in female infants. It refers to cystic distention of the lacrimal sac as a consequence of the nasolacrimal drainage system obstruction. It typically presents as a bluish swelling inferomedial to the medial canthus in the neonates. Unilateral congenital dacryocystocele is more common but 12-25% of patients affected have bilateral lesions. Ultrasound, CT scan or MRI can be used for diagnosis. About half of the patient with acute dacryocystitis can be management with conservative management such as digital massage of lacrimal sac or in-office lacrimal duct probing. The other half of patients will require surgery under general anesthesia for removal of the dacryocystocele. Endoscopic excision of the intranasal cysts has been used successfully as a treatment option with Crawford stent placement. Post-operatively patients are treated empirically with antibiotics and nasal saline. No second look is usually planned unless patients develop significant nasal obstrctuion. Editor Recruited By: Sanjay Parikh, MD, FACS DOI: http://dx.doi.org/10.17797/16rnuq8n0y

Endoscopic Tracheoesophageal Fistula Repair
video

Contributors: Noemie Rouillard-Bazinet, MD and Deepak Mehta, MD Endoscopic repair of tracheoesophageal fistula using electrocautery and fibrin glue. DOI: http://dx.doi.org/10.17797/uq9ifhudgd Editor Recruited By: Sanjay Parikh, MD, FACS

Posterior Cricoid Split and Costal Cartilage Grafting for Bilateral Vocal Fold Paralysis
video

Contributors: Noemie Rouillard-Bazinet and Julina Ongkasuwan Bilateral vocal fold paralysis causes airway obstruction and, in some patients, tracheostomy dependence. Posterior cricoid split with costal cartilage grafting can open the posterior glottis and improving the airway. DOI: http://dx.doi.org/10.17797/hyp0b3mzd5 Editor Recruited By: Michael M. Johns III, MD

Management of subglottic stenosis with endoscopic stent placement
video

History of airway stenosis, s/p laryngotracheal reconstruction. Developed restenosis, and balloon dilated three times.

In this video we describe our technique for airway stent insertion and its securing to the neck skin.

Balloon dilation of the airway expanded the airway to its appropriate size. After sizing, an 8mm modified Mehta laryngeal stent with rings (Hood Laboratories, Pembroke, Mass., USA)is inserted in the airway with laryngeal forceps. The scope is inserted into the stent to verify its position. Then a 2.0 prolene stitch is taken through the neck, trachea, stent, and taken out through the contralateral skin. This is performed under visualization with a 2.3mm endoscope through the stent. The needle is then re-inserted through the exit puncture and again taken out next to the entry puncture after passing through a subcutaneous tunnel, without re-entering the stent. A small skin incision is performed between the two prolene threads. Multiple knots are taken over an angiocath, which is then buried under the skin.

The stent is taken out 2-6 weeks after the procedure. A neck incision is performed, the angiocath is identified, the knot is cut and the stent is removed under the vision of the endoscope.

Treatment of Chronic Atelectatic Middle Ear with Endoscopic Placement of Cartilage Shield T-tube
video

Chronic tympanic membrane (TM) atelectasis is a difficult condition with many management challenges and currently has no acceptable gold standard treatment. TM atelectasis is the loss of the normal elasticity of the TM as a result of chronic negative pressure in the middle ear and can be associated with retraction pockets. The under-ventilation of the middle ear and TM retraction can cause ossicular erosion, hearing loss, or cholesteatoma formation. Atelectasis can be halted or reversed with placement of pressure equalization tube (PET). Cartilage tympanoplasty with or without PET has been reported as the preferred material likely due to its higher mechanical stability under negative pressure changes within the middle ear, in addition to its resistance to resorption. This video demonstrates the feasibility of a minimally invasive endoscopic approach of cartilage shield T-tube tympanoplasty as a treatment of chronic TM atelectasis.

Closure of H-type tracheoesophageal fistula
video

We present the case of a 20 months old boy with developmental delay and chromosomal abnormality, who presented with a history of chronic aspiration. He was found to have a laryngeal cleft, which was injected with Prolaryn, then formally repaired, twice. Despite an initial a negative swallow study, the patient had persistent aspiration. A repeat direct laryngoscopy and bronchoscopy finally revealed the presence of an H-type tracheoesophageal fistula (TEF). We describe here the steps of the surgical repair of an H-type tracheoesophageal fistula.

Base of Tongue Reduction: Endoscopic Approach vs. Transoral Robotic Surgical Approach
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The video demonstrates successful endoscopic coblation of lingual tonsils and residual palatine tonsils as well as successful TORS reduction of obstructive base of tongue tissue.

Successful Placement of Transcutaneous Bone Anchored Hearing Aid in a Pediatric Patient
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The Osia System is a transcutaneous bone anchored hearing aid which can be used for the correction of both conductive and sensorineural hearing loss. This video depicts the implantation of the Osia in a pediatric patient with a history of right-sided microtia.

Endoscopic Assisted Aural Atresia Repair
video

Congenital aural atresia (CAA) is a birth defect that describes both aplasia and hypoplasia or stenosis of the external auditory canal (EAC). CAA can be associated with microtia (malformation of the pinna), middle ear and occasionally inner ear malformations. Surgical correction of CAA is a very challenging operation and requires a thorough knowledge of the surgical anatomy of the facial nerve, middle and inner ears. Traditional post-auricular approach or transcanal approach with the help of a microscope usually provides adequate images needed for the procedure. Endosocpic ear surgery provides the advantage of visualization beyond the view provided by the microscope, further refinement of the surgical approach, precise assessment of the ossicular chain mobility and placement of ossicular chain prosthesis if necessary.

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