BOOK
Hemostasis in Head and Neck Surgery, An Issue of Otolaryngologic Clinics of North America, E-Book
Carl H. Snyderman | Harshita Pant
(2016)
Additional Information
Book Details
Abstract
Bleeding is a major factor that hinders visualization in head and neck surgery and is a risk factor for intraoperative complications and perioperative morbidity. Endoscopic approaches also pose significant technical challenges to managing expected intraoperative bleeding and vascular injury. The approach for this publication in Otolaryngologic Clinics is to provide clinically relevant information in a problem-based manner that encompasses assessment to identify patients with a high risk for vascular complications, pre-operative, intra-operative and post-operative strategies to manage expected bleeding and major vessel injury during endoscopic sinus and skull base surgery for inflammatory and neoplastic diseases. Clinically relevant anatomy, physiology, pharmacology, and surgical and interventional radiology techniques to manage bleeding are outlined and an algorithm for management of major vessel injury such as internal carotid artery injury is presented. Because skull base surgery is generally undertaken as a team approach, this information is relevant to the subspecialized ENT surgeon from rhinology or head and neck specializations, to neurosurgeons, to interventional radiologists, and to neurophysiologists who monitors intraoperative cerebral and cranial nerve activity for these operations. Carl Snyderman leads this issue with Harshita Pant and has composed topics and assembled an expert group of practitioners to provide information. The reader will find this a novel, focused, and indispensable resource on all issues of hemostatis in head and neck surgery.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Hemostasis in Head\rand Neck Surgery | i | ||
| Copyright | ii | ||
| CME Accreditation Page | iii | ||
| PROGRAM OBJECTIVE | iii | ||
| LEARNING OBJECTIVES | iii | ||
| ACCREDITATION | iii | ||
| DISCLOSURE OF CONFLICTS OF INTEREST | iii | ||
| UNAPPROVED/OFF-LABEL USE DISCLOSURE | iv | ||
| TO ENROLL | iv | ||
| METHOD OF PARTICIPATION | iv | ||
| CME INQUIRIES/SPECIAL NEEDS | iv | ||
| Contributors | v | ||
| EDITORS | v | ||
| AUTHORS | v | ||
| Contents | xi | ||
| Preface: Hemostasis in Otolaryngology—Head and Neck Surgery | xi | ||
| Preoperative Assessment of Risk Factors | xi | ||
| Anesthetic Techniques in Endoscopic Sinus and Skull Base Surgery | xi | ||
| Blood-Sparing Techniques in Head and Neck Surgery | xi | ||
| Quality Control Approach to Anticoagulants and Transfusion | xi | ||
| Hemostatic Materials and Devices | xii | ||
| Surgical Adhesives in Facial Plastic Surgery | xii | ||
| Hemostasis in Pediatric Surgery | xii | ||
| Hemostasis in Tonsillectomy | xii | ||
| Surgical Management of Severe Epistaxis | xiii | ||
| Treatment of Hereditary Hemorrhagic Telangiectasia–Related Epistaxis | xiii | ||
| Hemostasis in Endoscopic Sinus Surgery | xiii | ||
| Hemostasis in Skull Base Surgery | xiv | ||
| Hemostasis in Airway Surgery: Adult and Pediatric | xiv | ||
| Hemostasis in Laryngeal Surgery | xiv | ||
| Hemostatic Options for Transoral Robotic Surgery of the Pharynx and Base of Tongue | xiv | ||
| Thyroidectomy Hemostasis | xv | ||
| Hemostasis in Otologic and Neurotologic Surgery | xv | ||
| Hemostasis in Orbital Surgery | xv | ||
| Managing Vascular Tumors—Open Approaches | xv | ||
| Endoscopic Management of Vascular Sinonasal Tumors, Including Angiofibroma | xvi | ||
| Management of Major Vascular Injury: Open | xvi | ||
| Management of Major Vascular Injury During Endoscopic Endonasal Skull Base Surgery | xvi | ||
| Management of Carotid Blowout from Radiation Necrosis | xvi | ||
| Endovascular Management of Diseases in Relation to Otolaryngology | xvii | ||
| Education and Training in Hemostasis: Perspectives of the Early Practitioner and Expert Practitioner | xvii | ||
| Simulation Training for Vascular Emergencies in Endoscopic Sinus and Skull Base Surgery | xvii | ||
| OTOLARYNGOLOGIC CLINICS\rOF NORTH AMERICA | xviii | ||
| FORTHCOMING ISSUES | xviii | ||
| August 2016 | xviii | ||
| October 2016 | xviii | ||
| December 2016 | xviii | ||
| RECENT ISSUES | xviii | ||
| April 2016 | xviii | ||
| February 2016 | xviii | ||
| December 2015 | xviii | ||
| Preface:\rHemostasis in Otolaryngology—Head and Neck Surgery | xix | ||
| Preoperative Assessment of Risk Factors | 517 | ||
| Key learning points | 517 | ||
| INTRODUCTION | 517 | ||
| DISCUSSION | 518 | ||
| SUMMARY | 527 | ||
| SUPPLEMENTARY DATA | 528 | ||
| REFERENCES | 528 | ||
| SUGGESTED READINGS | 529 | ||
| Anesthetic Techniques in Endoscopic Sinus and Skull Base Surgery | 531 | ||
| Key learning points | 531 | ||
| INTRODUCTION | 532 | ||
| Role of the Anesthesiologist in Endoscopic Sinus and Skull Base Surgery | 532 | ||
| PREOPERATIVE EVALUATION OF PITUITARY AND SKULL BASE SURGICAL PATIENTS | 532 | ||
| ENDOSCOPIC SKULL BASE SURGERY | 533 | ||
| LOCAL VERSUS GENERAL ANESTHESIA IN SINUS AND SKULL BASE SURGERY | 533 | ||
| ENDOTRACHEAL TUBE VERSUS LARYNGEAL MASK | 537 | ||
| PREPARATION OF THE PATIENT FOR SURGERY | 538 | ||
| MAINTENANCE OF ANESTHESIA | 539 | ||
| Controlled Hypotension | 539 | ||
| TOTAL INTRAVENOUS ANESTHESIA VERSUS INHALATIONAL ANESTHESIA | 540 | ||
| SPONTANEOUS VERSUS POSITIVE PRESSURE VENTILATION | 541 | ||
| EMERGENCE OF ANESTHESIA | 541 | ||
| POSTOPERATIVE CARE | 542 | ||
| LOOKING INTO THE FUTURE | 543 | ||
| SUPPLEMENTARY DATA | 544 | ||
| REFERENCES | 545 | ||
| SUGGESTED READINGS | 546 | ||
| Blood-Sparing Techniques in Head and Neck Surgery | 549 | ||
| Key learning points | 549 | ||
| INTRODUCTION | 549 | ||
| JEHOVAH’S WITNESSES | 550 | ||
| COMPLICATIONS OF BLOOD TRANSFUSIONS | 551 | ||
| PREOPERATIVE TECHNIQUES | 552 | ||
| INTRAOPERATIVE TECHNIQUES | 555 | ||
| SUMMARY | 559 | ||
| SUPPLEMENTARY DATA | 560 | ||
| REFERENCES | 560 | ||
| SUGGESTED READINGS | 562 | ||
| Quality Control Approach to Anticoagulants and Transfusion | 563 | ||
| Key learning points | 563 | ||
| INTRODUCTION | 563 | ||
| MANAGING ANTICOAGULANTS IN THE ACUTE AND PERIOPERATIVE SETTINGS | 564 | ||
| Older Anticoagulant Medications | 565 | ||
| Oral Antiplatelet Agents | 565 | ||
| New Oral Anticoagulants: Target Xa and Thrombin | 566 | ||
| Stopping New Oral Anticoagulants Before Elective Surgery | 568 | ||
| Nonspecific Reversal Products and Agents May Increase the Risk of Thrombosis | 568 | ||
| Developing a Care Pathway | 568 | ||
| QUALITY IN BLOOD TRANSFUSION | 569 | ||
| Indications for Transfusion | 570 | ||
| DEVELOPING A QUALITY PLAN FOR HEMOSTASIS AND TRANSFUSION | 572 | ||
| SUMMARY | 573 | ||
| SUPPLEMENTARY DATA | 574 | ||
| REFERENCES | 574 | ||
| SUGGESTED READINGS | 575 | ||
| Hemostatic Materials and Devices | 577 | ||
| Key learning points | 577 | ||
| INTRODUCTION | 577 | ||
| DISCUSSION | 578 | ||
| HOW HAVE MATERIALS AND DEVICES IN ENDOSCOPIC SINUS AND SKULL BASE SURGERY EVOLVED? | 579 | ||
| WHAT ARE THE BENEFITS AND DRAWBACKS OF TOPICAL MATERIALS IN USE TODAY? | 580 | ||
| AUTHORS’ INSIGHTS | 582 | ||
| SUMMARY | 582 | ||
| REFERENCES | 583 | ||
| SUGGESTED READINGS | 584 | ||
| Surgical Adhesives in Facial Plastic Surgery | 585 | ||
| Key learning points | 585 | ||
| INTRODUCTION | 585 | ||
| SURGICAL TISSUE ADHESIVES | 586 | ||
| SUMMARY | 597 | ||
| SUPPLEMENTARY DATA | 598 | ||
| REFERENCES | 598 | ||
| SUGGESTED READINGS | 599 | ||
| Hemostasis in Pediatric Surgery | 601 | ||
| Key learning points | 601 | ||
| PREOPERATIVE EVALUATION | 601 | ||
| PEDIATRIC BLEEDING AND BLOOD DISORDERS IN SURGERY | 602 | ||
| SICKLE CELL DISEASE | 605 | ||
| THROMBOCYTOPENIA | 605 | ||
| METHODS OF HEMOSTASIS DURING SURGERY | 606 | ||
| MECHANICAL HEMOSTASIS | 606 | ||
| CHEMICAL HEMOSTASIS | 607 | ||
| BIOMATERIALS | 607 | ||
| HEMOSTASIS IN PEDIATRIC TONSILLECTOMY AND ADENOTONSILLECTOMY | 608 | ||
| POSTOPERATIVE HEMORRHAGE | 609 | ||
| HEMOSTASIS IN PEDIATRIC MIDDLE EAR SURGERY | 610 | ||
| INDICATIONS FOR BLOOD VOLUME REPLACEMENT | 611 | ||
| SUPPLEMENTARY DATA | 613 | ||
| REFERENCES | 613 | ||
| SUGGESTED READINGS | 614 | ||
| Hemostasis in Tonsillectomy | 615 | ||
| Key learning points | 615 | ||
| WHAT IS THE INCIDENCE OF POSTTONSILLECTOMY HEMORRHAGE? | 615 | ||
| ARGON PLASMA COAGULATION | 619 | ||
| FIBRIN GLUE | 621 | ||
| TRANEXAMIC ACID | 622 | ||
| AMINOCAPROIC ACID (AMICAR) | 623 | ||
| VON WILLEBRAND DISEASE | 623 | ||
| SUPPLEMENTARY DATA | 624 | ||
| REFERENCES | 624 | ||
| SUGGESTED READINGS | 626 | ||
| Surgical Management of Severe Epistaxis | 627 | ||
| Key learning points | 627 | ||
| INTRODUCTION | 627 | ||
| PATIENT OPTIMIZATION | 627 | ||
| ANATOMY | 629 | ||
| SURGICAL APPROACH FOR ENDOSCOPIC SPHENOPALATINE ARTERY LIGATION | 630 | ||
| EFFICACY OF SPHENOPALATINE ARTERY LIGATION | 630 | ||
| ANTERIOR ETHMOID ARTERY LIGATION | 631 | ||
| Surgical Anatomy | 631 | ||
| Approaches | 631 | ||
| External approach: the Lynch incision | 632 | ||
| Transcaruncular approach | 632 | ||
| Endoscopic anterior ethmoid artery ligation | 632 | ||
| Efficacy of Anterior Ethmoid Artery Ligation | 633 | ||
| POSTERIOR ETHMOID ARTERY LIGATION | 633 | ||
| VIDIAN AND PHARYNGEAL ARTERY CAUTERY | 633 | ||
| CAROTID ARTERY BLEEDING | 634 | ||
| MANAGEMENT OF VENOUS BLEEDING | 634 | ||
| SUMMARY | 635 | ||
| SUPPLEMENTARY DATA | 636 | ||
| REFERENCES | 636 | ||
| SUGGESTED READINGS | 637 | ||
| Treatment of Hereditary Hemorrhagic Telangiectasia–Related Epistaxis | 639 | ||
| Key learning points | 639 | ||
| INTRODUCTION | 639 | ||
| ETIOLOGY | 640 | ||
| DIAGNOSIS | 641 | ||
| EVALUATION | 641 | ||
| MANAGEMENT | 644 | ||
| SUMMARY | 651 | ||
| SUPPLEMENTARY DATA | 652 | ||
| REFERENCES | 652 | ||
| SUGGESTED READINGS | 654 | ||
| Hemostasis in Endoscopic Sinus Surgery | 655 | ||
| Key learning points | 655 | ||
| INTRODUCTION | 655 | ||
| APPROACH TO HEMOSTASIS IN SINUS SURGERY | 657 | ||
| BLEEDING PREVENTION: PREOPERATIVE | 657 | ||
| BLEEDING PREVENTION: INTRAOPERATIVE | 660 | ||
| Patient Position | 660 | ||
| Local Vasoconstrictors | 660 | ||
| General Anesthesia | 664 | ||
| Does Hypotensive Anesthesia Achieve the Best Surgical Field in Endoscopic Sinus Surgery? | 664 | ||
| Is Total Intravenous Anesthesia Necessary to Achieve the Best Surgical Field? | 664 | ||
| Tranexamic Acid | 665 | ||
| Surgical Technique | 665 | ||
| MANAGEMENT OF INTRAOPERATIVE BLEEDING | 666 | ||
| What are Some Strategies to Control Bone Bleeding? | 668 | ||
| What are Some Strategies to Control Named Vessel Bleeding? | 668 | ||
| MANAGEMENT OF POSTOPERATIVE BLEEDING COMPLICATIONS | 669 | ||
| Scenario | 670 | ||
| SUMMARY | 671 | ||
| SUPPLEMENTARY DATA | 673 | ||
| REFERENCES | 673 | ||
| Hemostasis in Skull Base Surgery | 677 | ||
| Key learning points | 677 | ||
| INTRODUCTION | 677 | ||
| PREOPERATIVE WORK-UP AND INTERVENTIONS | 678 | ||
| MECHANICAL COMPRESSION | 680 | ||
| BIPOLAR CAUTERY | 680 | ||
| Monopolar Cautery | 680 | ||
| Warm Saline Irrigation | 680 | ||
| Bone Wax | 680 | ||
| Conventional Local Hemostatic Adjuncts | 681 | ||
| Fibrin Sealants | 681 | ||
| Gelatin-Thrombin Matrix Sealant | 681 | ||
| Systemic Hemostatic Agents | 682 | ||
| INCISION AND FLAP | 682 | ||
| BONY EXPOSURE | 682 | ||
| TUMOR REMOVAL | 683 | ||
| INCISION AND FLAP | 684 | ||
| BONE EXPOSURE | 684 | ||
| TUMOR REMOVAL | 685 | ||
| HEMOSTASIS TECHNIQUES FOR ENDOSCOPIC SKULL BASE SURGERY | 685 | ||
| PREOPERATIVE PREPARATION | 686 | ||
| SURGERY: NASAL STAGE | 686 | ||
| SPHENOIDAL STAGE | 687 | ||
| SELLAR STAGE | 687 | ||
| RECONSTRUCTIVE STAGE | 687 | ||
| SPECIAL SURGICAL TECHNIQUES FOR EXPANDED ENDONASAL APPROACH | 687 | ||
| CAROTID ARTERY INJURY | 688 | ||
| SUMMARY | 688 | ||
| SUPPLEMENTARY DATA | 689 | ||
| REFERENCES | 689 | ||
| SUGGESTED READINGS | 689 | ||
| Hemostasis in Airway Surgery | 691 | ||
| Key learning points | 691 | ||
| INTRODUCTION | 691 | ||
| SURGICAL MANAGEMENT OF ADULT AND PEDIATRIC LARYNGOTRACHEAL PATHOLOGIES | 693 | ||
| DEFINITION AND CLASSIFICATION | 694 | ||
| EVALUATION | 694 | ||
| SURGICAL MANAGEMENT OF LARYNGOTRACHEAL STENOSIS | 694 | ||
| Endoscopic Treatment | 695 | ||
| Anterior Cricoid Split | 696 | ||
| Laryngotracheoplasty with Cartilage Grafting | 697 | ||
| Cricotracheal Resection | 697 | ||
| Slide Tracheoplasty | 698 | ||
| Tracheoinnominate Fistula Complication | 699 | ||
| HEMANGIOMAS, PAPILLOMAS, AND OTHER AIRWAY NEOPLASMS | 699 | ||
| Infantile Hemangiomas | 699 | ||
| Subglottic Cysts | 700 | ||
| Recurrent Respiratory Papillomas | 700 | ||
| SUMMARY | 701 | ||
| SUPPLEMENTARY DATA | 702 | ||
| REFERENCES | 702 | ||
| SUGGESTED READINGS | 703 | ||
| Hemostasis in Laryngeal Surgery | 705 | ||
| Key learning points | 705 | ||
| INTRODUCTION | 705 | ||
| VASCULAR SUPPLY OF LARYNX | 706 | ||
| LARYNGEAL PROCEDURES | 707 | ||
| SURGICAL INSTRUMENTATION | 709 | ||
| LASER | 710 | ||
| EMBOLIZATION | 712 | ||
| ANESTHETIC CONSIDERATIONS | 712 | ||
| ANTICOAGULATION | 712 | ||
| SUMMARY | 713 | ||
| SUPPLEMENTARY DATA | 714 | ||
| REFERENCES | 714 | ||
| SUGGESTED READINGS | 714 | ||
| Hemostatic Options for Transoral Robotic Surgery of the Pharynx and Base of Tongue | 715 | ||
| Key learning points | 715 | ||
| INTRODUCTION | 715 | ||
| RELEVANT ANATOMY | 716 | ||
| Vascular Supply of the Tonsillar Fossa | 717 | ||
| Vascular Supply of the Base of Tongue | 718 | ||
| PREVENTION OF SIGNIFICANT INTRAOPERATIVE AND POSTOPERATIVE BLEEDING | 719 | ||
| MANAGEMENT OF SIGNIFICANT BLEEDING | 720 | ||
| Intraoperative Prevention and Management of Bleeding | 720 | ||
| Delayed Bleeding | 722 | ||
| Risk factors | 722 | ||
| Management | 723 | ||
| SUMMARY | 723 | ||
| SUPPLEMENTARY DATA | 724 | ||
| REFERENCES | 724 | ||
| SUGGESTED READINGS | 724 | ||
| Thyroidectomy Hemostasis | 727 | ||
| Key learning points | 727 | ||
| INTRODUCTION | 727 | ||
| VASCULAR ANATOMY: ARTERIES | 728 | ||
| Superior Thyroid Artery | 728 | ||
| Inferior Thyroid Artery | 728 | ||
| Thyroidea Ima Artery | 729 | ||
| Perforating Tracheal Blood Vessels | 729 | ||
| VASCULAR ANATOMY: VEINS | 730 | ||
| Anterior Jugular Veins | 730 | ||
| Superior Thyroid Veins | 730 | ||
| Inferior Thyroid Veins | 730 | ||
| Middle Thyroid Veins | 730 | ||
| Intrathyroidal Capsular Veins | 731 | ||
| WHY IS HEMOSTASIS IMPORTANT? | 731 | ||
| Postoperative Hematoma | 732 | ||
| SURGICAL HEMOSTASIS | 733 | ||
| Clamp, Tie, and Cut | 733 | ||
| Electrocautery | 733 | ||
| Harmonic Scalpel | 734 | ||
| LigaSure | 734 | ||
| Harmonic Scalpel | 735 | ||
| LigaSure | 735 | ||
| Standard Ligation and Coagulation Versus Harmonic Scalpel | 735 | ||
| Standard Ligation and Coagulation Versus LigaSure | 736 | ||
| Standard Ligation and Coagulation Versus LigaSure Versus Harmonic Scalpel | 736 | ||
| Harmonic Scalpel Versus LigaSure | 738 | ||
| Harmonic Scalpel Versus LigaSure in Papillary Thyroid Cancer | 738 | ||
| SURGICAL TECHNIQUE SUMMARY | 739 | ||
| HEMOSTATIC AGENTS | 739 | ||
| Ankaferd Blood Stopper | 740 | ||
| Surgicel | 741 | ||
| FloSeal | 741 | ||
| Harmonic Scalpel Plus FloSeal | 742 | ||
| POSTSURGICAL DRAINS | 743 | ||
| Cochrane Review Database | 743 | ||
| Meta-Analysis | 744 | ||
| WHAT ARE THE COST SAVINGS? | 745 | ||
| SUMMARY | 745 | ||
| SUPPLEMENTARY DATA | 746 | ||
| REFERENCES | 746 | ||
| SUGGESTED READINGS | 747 | ||
| Hemostasis in Otologic and Neurotologic Surgery | 749 | ||
| Key learning points | 749 | ||
| INTRODUCTION | 749 | ||
| SURGICAL STRATEGIES | 750 | ||
| OPTIONS FOR HEMOSTASIS | 751 | ||
| INJECTION OF VASOCONSTRICTING MEDICATIONS | 751 | ||
| CAUTERY | 752 | ||
| TOPICAL VASOCONSTRICTING AGENTS | 753 | ||
| BONE WAX | 753 | ||
| ABSORBABLE GELATIN (GELATIN MATRIX) | 753 | ||
| INTENTIONAL HYPOTENSION | 754 | ||
| THROMBIN/GELATIN PREPARATIONS | 755 | ||
| TOPICALLY APPLIED HYDROGEN PEROXIDE | 755 | ||
| MICROFIBRILLAR COLLAGEN | 756 | ||
| OXIDIZED REGENERATED CELLULOSE | 756 | ||
| FIBRIN SEALANTS | 756 | ||
| OTOLOGIC AND NEUROTOLOGIC VASCULAR EMERGENCIES | 757 | ||
| INTERVENTIONAL ENDOVASCULAR TECHNIQUES | 757 | ||
| LIGATION OF BLEEDING VASCULATURE | 758 | ||
| GLOMUS TYMPANICUM AND GLOMUS JUGULARE TUMORS | 759 | ||
| SUMMARY | 759 | ||
| REFERENCES | 760 | ||
| SUGGESTED READINGS | 761 | ||
| Hemostasis in Orbital Surgery | 763 | ||
| Key Learning Points | 763 | ||
| INTRODUCTION | 763 | ||
| Major Vascular Anatomy of the Orbit | 763 | ||
| Preoperative Assessment | 765 | ||
| Overview of Endoscopic Surgery of the Orbit | 766 | ||
| Causes of Orbital Hemorrhage | 767 | ||
| Clinical Signs of Orbital Hemorrhage | 767 | ||
| Intraoperative Techniques for Hemostasis | 768 | ||
| Hemostatic Techniques | 768 | ||
| Approaches to the Orbit for Rapid Control of Ethmoidal Hemorrhage | 769 | ||
| Postoperative Care | 771 | ||
| Mechanism of Ocular Injury During Orbital Hemorrhages | 771 | ||
| Management of Serious Orbital Hemorrhage | 771 | ||
| SUMMARY | 773 | ||
| SUPPLEMENTARY DATA | 774 | ||
| REFERENCES | 774 | ||
| SUGGESTED READINGS | 775 | ||
| Managing Vascular Tumors—Open Approaches | 777 | ||
| Key learning points | 777 | ||
| INTRODUCTION | 777 | ||
| Embolization | 782 | ||
| BALLOON OCCLUSION TEST | 783 | ||
| SURGICAL STRATEGIES | 784 | ||
| Transcervical Approach | 784 | ||
| Transcervical-Transparotid Approach | 784 | ||
| Mandibulotomy | 784 | ||
| Infratemporal Fossa Approach | 786 | ||
| MANAGEMENT OF THE CAROTID ARTERY | 786 | ||
| STAGING SURGERY | 787 | ||
| Nonoperative Management | 787 | ||
| POSTOPERATIVE CARE | 788 | ||
| SUMMARY | 788 | ||
| SUPPLEMENTARY DATA | 789 | ||
| REFERENCES | 789 | ||
| SUGGESTED READINGS | 789 | ||
| Endoscopic Management of Vascular Sinonasal Tumors, Including Angiofibroma | 791 | ||
| Key learning points | 791 | ||
| INTRODUCTION | 792 | ||
| WHY IS BLEEDING A PROBLEM? | 792 | ||
| GOALS OF TREATMENT | 793 | ||
| STAGING OF ANGIOFIBROMAS | 793 | ||
| TREATMENT OF ANGIOFIBROMAS | 795 | ||
| SURGICAL STRATEGY | 798 | ||
| SURGICAL TOOLS | 799 | ||
| MANAGEMENT OF INTERNAL CAROTID ARTERY | 800 | ||
| INTERNAL CAROTID ARTERY | 801 | ||
| BLOOD-SPARING STRATEGIES | 802 | ||
| STAGING OF SURGERY | 804 | ||
| SUMMARY | 804 | ||
| SUPPLEMENTARY DATA | 806 | ||
| REFERENCES | 806 | ||
| SUGGESTED READINGS | 807 | ||
| Management of Major Vascular Injury: Open | 809 | ||
| Key learning points | 809 | ||
| INTRODUCTION | 809 | ||
| INITIAL RESUSCITATION FROM VASCULAR INJURY | 810 | ||
| MONITORING | 812 | ||
| DAMAGE CONTROL | 813 | ||
| SHUNTING | 813 | ||
| DEFINITIVE MANAGEMENT | 814 | ||
| INJURY TO SMALL VESSELS | 814 | ||
| INTERNAL CAROTID ARTERY INJURIES DURING ENDONASAL SURGERY | 814 | ||
| POSTOPERATIVE HEMORRHAGE | 815 | ||
| CAROTID ARTERY BLOWOUT | 815 | ||
| SUMMARY | 815 | ||
| SUPPLEMENTARY DATA | 816 | ||
| REFERENCES | 816 | ||
| SUGGESTED READINGS | 817 | ||
| Management of Major Vascular Injury During Endoscopic Endonasal Skull Base Surgery | 819 | ||
| Key learning points | 819 | ||
| INTRODUCTION | 819 | ||
| INJURY AVOIDANCE | 820 | ||
| MANAGEMENT STRATEGIES FOR CONTROLLING ARTERIAL INJURY | 822 | ||
| NEUROPHYSIOLOGIC MONITORING AND ITS ROLE DURING VASCULAR INJURY | 823 | ||
| ENDOVASCULAR EVALUATION AND MANAGEMENT OF MAJOR VASCULAR INJURY | 823 | ||
| INTERNAL CAROTID ARTERY INJURY MANAGEMENT ALGORITHM | 824 | ||
| POST-HOC ANALYSIS FOLLOWING INJURY (ROOT CAUSE ANALYSIS) | 826 | ||
| SUMMARY | 826 | ||
| SUPPLEMENTARY DATA | 827 | ||
| REFERENCES | 827 | ||
| SUGGESTED READINGS | 827 | ||
| Management of Carotid Blowout from Radiation Necrosis | 829 | ||
| Key learning points | 829 | ||
| SUMMARY | 837 | ||
| SUPPLEMENTARY DATA | 838 | ||
| REFERENCES | 838 | ||
| SUGGESTED READINGS | 839 | ||
| Endovascular Management of Diseases in Relation to Otolaryngology | 841 | ||
| Key learning points | 841 | ||
| PULSATILE TINNITUS | 841 | ||
| Sinus Venous Stenosis | 842 | ||
| Case example | 842 | ||
| Paragangliomas | 844 | ||
| Case example | 844 | ||
| Dural Arteriovenous Fistula | 845 | ||
| Case example | 847 | ||
| Case example | 848 | ||
| Juvenile Nasopharyngeal Angiofibroma | 849 | ||
| Case Example | 849 | ||
| Epistaxis | 850 | ||
| Causes of epistaxis | 852 | ||
| Case Example | 852 | ||
| Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) | 853 | ||
| Case Example | 853 | ||
| Pseudoaneurysm | 855 | ||
| Case Example | 856 | ||
| Carotid Blowout Syndrome | 858 | ||
| Case Example | 858 | ||
| Carotid Artery Stenting | 859 | ||
| Case Example | 859 | ||
| SUPPLEMENTARY DATA | 861 | ||
| REFERENCES | 861 | ||
| SUGGESTED READINGS | 862 | ||
| Education and Training in Hemostasis | 863 | ||
| Key learning points | 863 | ||
| INTRODUCTION | 864 | ||
| EPISTAXIS | 864 | ||
| A CURRICULUM IN EPISTAXIS MANAGEMENT | 864 | ||
| OUTLINE OF LEARNER CURRICULUM | 866 | ||
| RISK FACTORS AND IMPORTANT COMPONENTS OF HISTORY | 866 | ||
| EQUIPMENT AND SUPPLIES | 867 | ||
| EVALUATE HEMODYNAMIC AND AIRWAY STATUS | 867 | ||
| Initial Management | 867 | ||
| Prepare Patient for Procedure | 867 | ||
| Pretreatment | 868 | ||
| Look for a Source of Bleeding | 868 | ||
| HEMOSTASIS FOR ANTERIOR BLEEDS | 868 | ||
| POSTERIOR EPISTAXIS | 869 | ||
| POTENTIAL COMPLICATIONS OF PACKING | 869 | ||
| POSTPROCEDURE CARE AND FOLLOW-UP | 869 | ||
| CONSIDERATIONS FOR HOSPITAL ADMISSION | 870 | ||
| INDICATIONS FOR SURGERY/EMBOLIZATION | 870 | ||
| ESCALATION OF TREATMENT: LIGATION AND EMBOLIZATION | 870 | ||
| ANGIOGRAPHY AND EMBOLIZATION | 871 | ||
| NECK HEMATOMA | 871 | ||
| Curriculum Design | 872 | ||
| Goals for the Early Learner | 873 | ||
| Learner Curriculum | 873 | ||
| Pathophysiology and relevant anatomy | 873 | ||
| Presenting signs and symptoms | 873 | ||
| Principals of Successful Management | 874 | ||
| Necessary Equipment and Supplies | 874 | ||
| Stabilize the Airway | 874 | ||
| SUMMARY | 875 | ||
| SUPPLEMENTARY DATA | 875 | ||
| REFERENCES | 875 | ||
| SUGGESTED READINGS | 876 | ||
| Simulation Training for Vascular Emergencies in Endoscopic Sinus and Skull Base Surgery | 877 | ||
| Key learning points | 877 | ||
| INTRODUCTION | 878 | ||
| SIMULATION TRAINING | 878 | ||
| SIMULATION OF VASCULAR INJURY FOR ENDOSCOPIC SINUS AND SKULL BASE SURGERY | 879 | ||
| THE SHEEP MODEL OF INTERNAL CAROTID ARTERY INJURY | 880 | ||
| CONTROLLING THE SURGICAL FIELD | 882 | ||
| HEMOSTATIC TECHNIQUES IN SIMULATED VASCULAR INJURY | 884 | ||
| VASCULAR SIMULATION TRAINING IMPROVING OUTCOMES | 885 | ||
| SUMMARY | 885 | ||
| SUPPLEMENTARY DATA | 886 | ||
| REFERENCES | 886 | ||
| SUGGESTED READINGS | 887 | ||
| Index | 889 |