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The region of the skull base was long considered a surgical barrier
because of its complex anatomy. With few exceptions, the region
immediately beyond the dura or bony skull base constituted a "no
man's land" for the surgeon working from the other direction. A
major reason for this was the high morbidity associated with
operative procedures in that area using traditional dissection
techniques. This situation changed with the advent of the operating
microscope. Used initially by ear, nose and throat specialists for
resective and reconstructive surgery of the petrous bone and parana
sal sinuses, the operating microscope was later introduced in other
areas, and neurosurgeons began using it in the mid-1960s. With
technical equality thus established, the groundwork was laid for
taking a new, systematic, and interdisciplinary approach to
surgical problems of the skull base. Intensive and systematic
cooperation between ear, nose and throat surgeons and neurologic
surgeons had its origins in the departments of the University of
Mainz bindly supported by our chairmen Prof. Dr. Dr. hc Kurt
Schiirmann (Department of Neurosurgery) and Prof. Dr. W. Kley
(Depart ment of Ear, Nose and Throat Diseases, Head and Neck
Surgery). The experience gained from this cooperation was taught in
workshops held in Hannover from 1979 to 1986, acquiring a broader
interdisciplinary base through the participation of specialists
from the fields of anatomy, patholo gy, neuroradiology,
ophthalmology, and maxillofacial surgery.
The exponential explosion of diagnostic techniques that is the
hallmark of Twentieth Century medicine often makes us forget that
the human perceptual senses are still the simplest, most reliable,
and most readily available means of recognizing disease and
detecting abnormalities in the human body. Improvements in optical
telescopes and in glass rod light transmission have enables us to
look directly into the human body, and they are indispensable to
modern endoscopy. The present monograph is a product of many years
of diligent search and tireless work by Professor WOLFGANG DRAF in
the field of endoscopy of the parana sal sinuses. Scholastic
curiosity, pursuit of academic excellence, and a fervent desire to
give patients prompt and lasting relief of symptoms caused by
paranasal sinus disease were the author's initial motivations. As
time went on and the methodology became more refined, he ventured
from the field of endoscopic diagnostic and photographic
documentation into the area of endoscopic therapy for selective
diseases of maxillary, frontal, and sphenoid sinuses. Many of the
instruments and most of the optical and photo graphic equipment and
accessories have been developed and improved in parallel with the
author's professional career; indeed, many of these technical
innovations were a product of Professor DRAF'S keen and methodical
research.
Addressing disease of the frontal sinus successfully remains,
perhaps, one of the most technically challenging issues encountered
by otolaryngologists. The intricate anatomy, combined with a narrow
aperture and relatively acute angle of approach, leads to
complexity not encountered elsewhere in surgery of the sinuses.
This comprehensive volume with contributions by over 30 of the
world's leading rhinologists will help to shed light on this
difficult topic. Thorough discussions of anatomy and
pathophysiology of a variety of frontal sinus diseases provide a
background for in-depth chapters on aspects of both medical and
surgical management. A variety of surgical approaches are
discussed, including the latest endoscopic techniques, as well as
more traditional open and microscopic approaches. Heavily
illustrated, this volume will be a "must have" for the rhinologist
managing disease in the frontal sinus.
Contents: The Neck and Thorax.- The Larynx and the Thyroid Gland.-
The Face.- The Oral Cavity and the Oropharynx.- The Nose.- The
Paranasal Sinus and the Retromaxillary Space.- The Eye and its
Orbital Adnexa.- The Ear.- The Middle and Posterior Cranial
Fossae.- The Skull and the Gross Anatomy of the Central Nervous
System.- The Topography and Variations of the Extra- and
Intracranial Vessels.- The Paraganglia.- References.- Index of
Operations and Surgically Important Anatomic Relationships.-
Subject Index.
This is the only book dedicated solely to frontal sinus disorders.
It is a richly illustrated and comprehensive mine of information on
the anatomy and management of these disorders. This updated second
edition offers much new information. Additional topics include
balloon dilation, frontal surgery as part of skull base surgery,
and advances in endoscopic techniques and tools that have occurred
since 2004 and have made open osteoplastic procedures almost
obsolete. The anatomy and surgery of the supraorbital ethmoid cell
and its significance in the pathology of frontal sinus disease are
also covered. Throughout the book, particularly important areas of
text are highlighted and core messages, emphasized. Videos of
described procedures are available online.
Georg von Bekesey was awarded the Nobel Prize for his seminal
everyone all over the world. In other words it is directed toward
work on hearing. It was, however, 43 years later in 2004 that
evolving a common scientifc language that is spoken uniformly Linda
Buck and Richard Axel were awarded the Nobel Prize for and
consistently all over the world. Universality, so that norms, their
work on olfaction. Tis is indicative of how the science of staging
systems, etc., can be applied anywhere in the world with rhinology
is only now coming into its own. For quite some time, equal
validity. Tis can only be achieved through consensus. rhinology was
thought to be limited in scope. It is now appreci- Tis book
contains not only the genesis and pathogenesis of ated that the
nose is not only an organ of aesthetic appeal, but rhinologic
disease, but also what all surgeons want and that is one that
carries out several important, complex functions. Te operative
steps to bring about successful resolution of disease, tremendous
surge in medical literature in recent times bears with the return
of normal function.
This is the only book dedicated solely to frontal sinus disorders.
It is a richly illustrated and comprehensive mine of information on
the anatomy and management of these disorders. This updated second
edition offers much new information. Additional topics include
balloon dilation, frontal surgery as part of skull base surgery,
and advances in endoscopic techniques and tools that have occurred
since 2004 and have made open osteoplastic procedures almost
obsolete. The anatomy and surgery of the supraorbital ethmoid cell
and its significance in the pathology of frontal sinus disease are
also covered. Throughout the book, particularly important areas of
text are highlighted and core messages, emphasized. Videos of
described procedures are available online.
Sowohl bei der konservativen als auch bei der operativen Therapie
von Nasennebenhoehlenerkrankungen erlebt man als Arzt immer wieder
Enttauschungen insofern, als sich die Beschwerden des Patienten
nicht oder nur wenig bessern, ja, dass sie sich- und dies ist
besonders nach operativen Eingriffen gar nicht so selte- sogar
verschlimmern. Diese Unsicherheit in der Prognose hangt nicht
zuletzt mit den beschrankten diagnostischen Moeglichkeiten
zusammen, die eine sichere Beurteilung der Nasennebenhoehlener
krankung, insbesondere des Schleimhautzustandes, der Abflussver
haltnisse und der Menge und Konsistenz des pathologischen Sekretes
bisher nur in begrenztem Umfang zuliessen. Seit Beginn dieses
Jahrhunderts wurde durch verschiedene Autoren versucht, mit Hilfe
optischer Systeme Einblick in die Kieferhoehle und damit groessere
Sicherheit in der Beurteilung des Krankheitsprozesses zu gewinnen.
Aber erst in den letzten Jahren gewinnt die Endoskopie der
Nasennebenhoehlen mit der Entwick lung verbesserter Optiken und mit
besserer Ausleuchtung immer mehr Anhanger und findet nach und nach
die ihr gebuhrende Verbreitung. An dieser Entwicklung ist der Autor
dieser Monographie in einem hohen Masse beteiligt, indem er sich
seit Jahren intensiv und systematisch zunachst mit der Sinuskopie
befasste und die er hobenen Befunde photographisch dokumentierte.
Unmittelbar habe ich miterlebt, wie Herr Professor Dr. DRAF an der
stark frequentierten Universitats-Hals-Nasen -0 hren-Klinik Mainz
ein reichhaltiges Bildmaterial von typischen Normalbefunden, von
Normvarianten und von pathologischen Zustanden sammeln konnte.
Erstaunt waren wir immer wieder uber die haufige Diskrepanz
zwischen Roentgenbefund einerseits und endo skopischem Befund
andererseits, eine Diskrepanz, sicher in die vielen Fallen eine
Erklarung fur die unbefriedigenden Ergebnisse der Therapie abgeben
kann.
Ein weiteres Standardwerk aus der Kirschnerschen Operationslehre In
dieser Neuauflage wird dem Bereich der Nasennebenh-hlen und der
angrenzendenSch{delbasis endlich ein eigener Band einger{umt. Die
entsprechenden Kapitelder vorliegenden Auflage sind dazu nat}rlich
komplett }berarbeitet worden. F}r alle Nasennebenh-hlen werden die
bekannten Standardoperationen - auch im Hinblick auf den Einsatz
modernster technischer Hilfsmittel - beschrieben. So wird z.B. auch
besonders auf die Mikrochirurgie der Nasennebenh-hlen mit Hilfe von
Endoskopen und Mikroskop eingegangen. Au erdem ist eine
detaillierte Darstellung der Chirurgie der angrenzenden
Sch{delbasis bei Mi bildungen, Traumen, Entz}ndungen und Tumoren
mit aufgenommen. Jedes Kapitel beginnt mit wichtigen anatomischen
Hinweisen, streift die Wahl der geeigneten An{sthesiemethode und
bespricht dann eingehend die Indikationen f}r den jeweiligen
Eingriff. Besonders eindrucksvoll wirkt die Illustration dieses
Werkes. Die zahlreichen Abbildungen sind zum gr- ten Teil neu
erstellt und mit aussagekr{ftigen Legenden versehen. Sowird schon
durch die Bilder jeder Operationsschritt anschaulich erkl{rt. Au
erdem wird auch im Text ausf}hrlich jeder Eingriff beschrieben und
auf Fehler- und Gefahrenquellen aufmerksam gemacht.
The diagnosis and treatment of the diseases of the nose, paranasal
sinuses and skull base have changed dramatically in the past few
years, transforming rhinol ogy in one of most exciting and
attractive medical fields. The increasing advance in this area has
addressed the ENT physicians to keep up with the expanding
information in the high tech area of sinus surgery and its
expansion into skull base surgery. The intention of this book is to
present in a unique way basic information on Anatomy, Endoscopy,
Rhinomanometry, Imaging, Allergy, Nasosinus Infection, and
Polyposis followed by by clinical and surgical chapters written by
some of the most experienced rhinosurgeons around the world. We
belive that this book will be of value for all levels of
Otolaryngology, from house officers to experienced surgeons and,
although principally for Otolaryngologists, Radiologists, Patholo
gists, Maxillofacial surgeons, Ophthalmologists, Neurosurgeons, and
Infectious Diseases Specialists may find the book of value because
of its overlap with their interests. We would like to show that,
both from the technical and conceptual points of view, success can
be achieved using different techniques and philosophies. Cer
tainly, both endoscopic instrumentation and the surgical microscope
have proved to be of great assistance in nasal and sinus surgery,
and now image systems are providing further progress.
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