Search

The authors report their experience regarding parotidectomy performed under a three-dimensional-high-definition (3D-HD) exoscope, with the aim of evaluating its effectiveness in parotid surgery. This is a prospective study on nine patients treated by the same surgeon. All patients underwent parotidectomy for extrafacial primary tumours without preoperative involvement of the skin or of the facial nerve from March 2019 to June 2019 with the use of a 3D-HD exoscope. Magnification was variable from 8x to 30x with direct vision supplied by a 3D monitor. Six men and three women, mean (range) age 47.8 (19-74) years underwent parotidectomy. No patient experienced postoperative complications or definitive facial palsy. The mean (range) time of surgery was 149.4 (115 - 210) minutes. The 3D exoscope represents a valid alternative to the operative microscope or surgical loupe for parotid surgery. It is a light instrument allowing for precise surgical dissection of the parotid region by reducing the risks for iatrogenic lesions of the facial nerve using a real 3D magnification of the anatomical structures in HD. Furthermore, its use does not prolong the operative time and shows high potential for training and educational purposes since the operating room staff can better perceive the procedure and the surgeon's fine gestures. Although the preliminary applications show promising results, there is still a need for wider scientific validation.

The aim of this study is to report our experience with double-stage laryngotracheal reconstruction with anterior or antero-posterior cartilage grafting in the management of acquired laryngotracheal stenosis in children. Patients were treated by the same surgeon at the UMC National Research Center for Maternal and Child Health of Astana (Kazakhstan), and Sfendiyarov Kazakh National Medical University, Almaty (Kazakhstan).From November 2011 to September 2019, 9 children underwent surgery for grade III and IV laryngotracheal stenosis according to the European Laryngological Society classification (mean age of 6 years, range of 2-12 years).Six patients underwent double-stage laryngotracheal reconstruction with anterior and posterior cartilage graft, and 3 patients underwent double-stage laryngotracheal reconstruction with single anterior cartilage graft. In all patients, a T-tube was used to stabilize the airway (mean time of 5.8 months, range of 5-9 months). One patient required additional dilation with bougies to obtain a viable laryngotracheal diameter. No postoperative complications were observed. One patient experienced recurrence of the stenosis 5 months after double-stage laryngotracheal reconstruction with double anterior and posterior cartilage grafts and is waiting for revision surgery. After a mean follow-up of 14 months (range of 4-36 months), 8 patients are tracheostomy-free, and all patients are feeding tube-free.Double-stage laryngotracheal reconstruction with a single or double cartilage grafting represents a safe and effective option in the management of complete or severe laryngotracheal stenosis.