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Пікірлер
@toanx0082 2 күн бұрын
Great demonstration professor! As a resident, I really treasure your videos... btw regarding nasal obstruction, could you please make a full video performing endoscopic septoplasty on real case?
@christymoen9247 3 күн бұрын
Prof, are you still using 3 months of macrolide for this diffuse non type 2 types? (250mg OD clari?)
@NoseandSinus 3 күн бұрын
Yes - these patients still do well from surgery and then a corticosteroid irrigation (non-Type2 don’t response as well but corticosteroid topically is still a good blunt anti-inflammatory). However, once the pathology reveals low eosinophils on tissue and bloods then we give macrolides 250mg clarithromycin daily for 3months. The response is either amazing or not. If not then we cease, but if the mucosa normalizes then we continue 3x/week until 12mths then cease. I have only one patient that’s had to go back on treatment after 1year
@christymoen9247 3 күн бұрын
@ amazing thank you Sir!
@mafikizolo182 3 күн бұрын
Do you pack the nose after?
@NoseandSinus 3 күн бұрын
I use silicone or silastic sheets to cover the healing area for 7-21days. This allows the tissues to heal outside of the drying effects of nasal airflow (about 15,000-20.000L/day) but doesn’t occlude the nose
@kandukurirambabu9134 4 күн бұрын
Professor What is upper limit of drilling ,is axilla of middle turbinate or agger nasi cell
@kandukurirambabu9134 4 күн бұрын
Professor, lateral mucosal wall of inferior turbinate removal till tail end must required and while outward folding of medial flap any chance of closing lacrimal opening in inferior meatus
@NoseandSinus 4 күн бұрын
The lacrimal valve needs to be respected. We look for it at the beginning and then the scoring of the mucosa at the apex of the inferior meatus helps to avoid the valve and prevent stripping of mucosa into the valve area. Remembering that the valve is low down on the lateral wall of the inferior meatus
@kandukurirambabu9134 4 күн бұрын
Thank you for wonderful demonstration professor, while you performing surgery hardly no bleeding seen is there any specific preparation required
@NoseandSinus 4 күн бұрын
There’s no one factor that makes bleeding perfect but here are the steps 1. Early non-selective alpha blockage topically - 1:2000 adrenaline 2. Reverse trendelenberg 20deg bed position 3. Bradycardic anesthesia (HR 55-65) - often TIVA 4. Systemic TXA 1g iv at induction 5. Local infiltration (our mix 8ml 1% ropivicaine, 1ml of 1:10,000 adrenaline and 1ml of TXA (100mg)) 6. Be in the correct surgical plane!
@ENTChannel. 4 күн бұрын
Thanks for the video Prof. , I just wanted to know how was the middle turbinate addressed in this case.
@NoseandSinus 4 күн бұрын
OMG - that’s for another video!!
@purevdorjsukhbaatar 4 күн бұрын
And what kind of ointment do you recommend applying to the nose? By the way, I'm from Mongolia and I work as an otolaryngologist.
@NoseandSinus 4 күн бұрын
In the immediate postop period we use mupiricin ointment to prevent staph aureus colonization but in general lip balms - carmex or blistex…
@purevdorjsukhbaatar 4 күн бұрын
Thank you for sharing this video with us, Professor Richard Harvey. After you remove the selastic sheet, how long do you recommend irrigating the nose?
@NoseandSinus 4 күн бұрын
Semi regular for the first. 3 months - 3-6 weeks the silicone Important for donor site at the back to heal well
@purevdorjsukhbaatar 4 күн бұрын
@@NoseandSinus thank you for your prompt answer professor.
@kanggachandra 5 күн бұрын
do we need to remove all the bone? Thank you prof harvey
@NoseandSinus 4 күн бұрын
Is the main step to ensure a ‘lateral’ position of the new turbinate
@jameskokmd 5 күн бұрын
Prof Harvey, again thanks so much for the wonderful video. I'm just curious , if you didn't damage the turbinate vessels why would you still cauterized it ?
@NoseandSinus 4 күн бұрын
The distal branches have absolutely been cut but that’s the power of injection with adrenaline prior Those vessels are ready to bleed when it wears off ! Best to seal the vessel upstream and our secondary bleed rate approaches 1% with this strategy
@kandukurirambabu9134 5 күн бұрын
Thank you professor Richard Harvey sir good demonstration ,keep post as many as surgical videos so that we learn from you.thank you so much 🙏
@ENTChannel. 6 күн бұрын
Informative surgical demonstration Prof. Harvey. Glad to have undertaken Advanced FESS course under your guidance… Keep posting as they are very helpful . Thanks. 🙏🙏🙏
@christymoen9247 6 күн бұрын
Great to see you posting again Prof, your videos are a great educational resource. The Ghent course material is second to none!
@tiagomartinelli8532 7 күн бұрын
Great educational video! Thanks for posting! What is this gel used in the end of the surgery?
@NoseandSinus 7 күн бұрын
Puraregen - a hyaluronic gel. www.endotx.com.au/product/pureregen-gel-sinus-dressing/#
@Otolaryngologyvideosjk 7 күн бұрын
Richard sir i am big fan of yours
@wirachc 7 күн бұрын
Great video and narration. Thank you prof.Richard.
@NoseandSinus 7 күн бұрын
You are very welcome - will try to post more!
@juliadoherty83 23 күн бұрын
Christ on a bike! This looks like a form of torture. 😱😷😱
@andrewreed1329 Ай бұрын
this has helped me, chronic sinus patient, i use prenidsoline every 4 weeks for 3 days, and inbetween use a nebuluser of budesonide… every now and then mix it with a decongestant. i irrigate everyday with distilled water, i always seem to be blowing out polyps everyday..
@DrJahinTareqBhuiyan Ай бұрын
Excellent demonstration. Thank you Sir from here in Bangladesh.
@NoseandSinus Ай бұрын
You are most welcome Jahin
@jessicalewis5185 Ай бұрын
@Prof Harvey I have a question. I have been suffering from sinus pressure and pain for 3 years. The ENT did a scope and told me I had a mild deviated septum, chronic tonsilitis but did not have any recommendations. I have tried sprays and other treatments without success. I recently found a treatment called Bilateral Nasal Release. It is done by chiropractic. They place a balloon in the turbinates and with a pound of pressure open the turbinates up. They often talk about cracking. Would the cracking be the tiny nasal bones of the turbinates? Could they be damaged? I have searched and searched to find this answer and I can't seem to get one. Everyone who has the treatment talks about feeling more clear in sinuses and the cracking seems to be fine. Any ideas on this?
@anuarjun3516 Ай бұрын
Fantastic...just wanted to know..1)what is the approximate surgical duration with Carolyn's window?...Is it longer than the regular FESS with type 2 draf..? 2) how is the postop recovery phase?...is it longer than or same as full house fess?.any special precautions...wats the implications of this procedure on recovery period?.. Thank you
@Yeezynight Ай бұрын
Hi sickos, Yes you! Dont worry even i am not even a doctor.
@vestitealamoda 2 ай бұрын
Hello Dr, in my case they performed a septal perforation repair, and when tissue from the meatus and turbinate was used, part of the turbinate detached from the lateral wall. The end of the duct was left open and air enters the duct, causing discomfort. Is it possible to shrink the outlet valve where the duct is draining so that air does not enter?
@juliejulie1702 2 ай бұрын
Can nasorex mometasone nasal spary cause ENS?
@thihoatienle1915 2 ай бұрын
❤
@itsParzivaI 2 ай бұрын
I’m 28 years old living in Switzerland and had been struggling with addiction in the past and as a result I ended up with a pierced septum 😔, sadly I can’t afford the surgery to fix this tiny 0.6cm hole and insurance won’t help with this issue 😢 Is there a way to do a payment plan for a surgery with you or your team, doctor ? It’s torture to live day by day with a whistling on your nose every time you breathe 😩 I pray for nobody to have to go through this ❤ God bless you all and if you are struggling with addiction, please consider bringing god to your life ❤ I’m 30 days sober from cocaine and alcohol, and won’t stop ever to stay clean 🪽
@eoghanhennessy443 Ай бұрын
My friend I'm in the same boat . Look up some one who is a craniosacral Therapist. People who suffer with addiction often have trauma a craniosacral Therapist would be extremely help full its changed my life absolutely brilliant
@Marshmalo-wallow 2 ай бұрын
Hi I have a bump on my forehead for years now due to an incident a rock hit my forehead(right side) it left a small bump and my right forehead is a bit higher that the left. Its not that noticeable, people don't notice it until i tell them. It became one of my insecurities so i want to remove it and if its possible to get my right forehead equal to my left? It doesn't cost any pain whatsoever. Also want to ask is this the procedure to get for my case? Or is there something else for my situation?
@creativesource3514 2 ай бұрын
What are your landmarks in finding the lamina and orbitL fat. I see you do an MMA and anterior ethmoidectomy.
@DrArchanaShah 2 ай бұрын
Thanks for simplifying the most critical step of the procedure. Any specific tips for a paediatric septoplasty with gross DNS abutting the lateral wall of nose? The cartilage to me was too delicate and fragile for the dust sign.The knife literally sliced through while looking for the dust.
@rkpb1484 2 ай бұрын
Excellent demonstration 👍🏻👍🏻 just practised this in the cadaver today 👍🏻👍🏻
@JakeStenton 2 ай бұрын
I got my septum destroyed 3 years ago. I breath funny sometime ehistle but I ve no problems I dont understand why surgery....
@GhidoraKidora 2 ай бұрын
what are we looking at; the inside of the nose, the brain????
@GhidoraKidora 2 ай бұрын
boiii i thought it was going to be maggots under that tissue. For some reason this reminds me of tagging a wall with under ground street art...
@GhidoraKidora 2 ай бұрын
is this inside the brain???
@viniz.b5433 3 ай бұрын
24:09 - Radiology View 30:19 - Septoplasty 43:38 - Lamela relaxing incision 45:26: - Uncinectomy + Maxilar antrostomy 51:33 - Anterior Ethmoidectomy 54:26 - Posterior Ethmoidectomy 57:58 - Trans-Ethmoidectomy Sphenoid opening 1:06:59 - SPA ligation 1:15:08 - Vidian Neurectomy 1:23:50 - Prelacrimal approach 1:39:31 - Frontal sinus surgery 2:04:50 - Dacryocystorhinostomy 2:20:04 - Ethmoidal Artery 2:25:42 - Endoscopic medium maxilectomy 2:39:48 - Draf III
@NoseandSinus 3 ай бұрын
perfect! thank you and much appreciated
@viniz.b5433 3 ай бұрын
@@NoseandSinus Thank you for the great lesson Professor Harvey!!
@rkpb1484 2 ай бұрын
Thanks a lot 👍🏻👍🏻
@arunsrinivaasan307 3 ай бұрын
Prof Saunders sdp for owr syndrome . Sir what are the differences from the classical one sir. Thank you
@vestitealamoda 3 ай бұрын
I had a septoplasty and was left with a septum perforation. He had a bone spur and the entire osteocartilaginous structure of his septum was resected. Is it possible to obtain an anterior or posterior ethmoidal artery flap if there is no osteocartilaginous support? I have read about doctors who take the flap in the same way, finding a fibrous plane between both mucous membranes that are glued to the part of the posterior septum but I don't know how feasible it is, given that sometimes that part can be perforated as well.
@NoseandSinus 3 ай бұрын
@@vestitealamoda sorry to hear of that, but we will often repair perforations in patients with HHT. Closing the perforation often reduces crusting and bleeding I think anterior ethmoid artery flap work well here and although the success rate is probably not as high as those patients unaffected by HHT - it’s still a robust choice in my opinion
@vestitealamoda 3 ай бұрын
@@NoseandSinus thanks for your response. In my case I do not have HHT disease, but due to the septoplasty I had I do not have bone or cartilage between the mucous membranes of the posterior septal portion. My main question is whether it is feasible and safe to take a flap from here, even though there is no cartilage or bone and only mucosa from both sides of the posterior septum.
@eoghanhennessy443 24 күн бұрын
Doctor what country are you in
@eoghanhennessy443 24 күн бұрын
Australia sorry I have a constantly dry nose driving me in same septum is damaged
@nurislamakhmet6527 3 ай бұрын
Beautiful post op view
@mohammed-l7r1b 3 ай бұрын
Prof richard Great mentor spread knowledge all over the world
@aliomran32 3 ай бұрын
Thank you prof. Amazing , great job❤
@caioviniciussaettini2707 3 ай бұрын
Excelent, professor.
@cityboy6314 3 ай бұрын
Brilliant
@trankhoa9282 4 ай бұрын
Thank you sir!
@authenticentcentre 4 ай бұрын
Superb sir ,leading guru
@sundara-xo6zm 4 ай бұрын
Great demonstration sir...plz do demonstrate optic nerve decompression in your next video...eagerly waiting for your video...please explain landmarks with respect to move locr avoiding carotid where to drill details please...
@janevvchannel1969 4 ай бұрын
Great demonstation professor!!! Thank you
@AhmedSalah-hs2fk 4 ай бұрын
Impressive and excelent demonstration , Thank you alot sir
@thuanlehoangminh6406 4 ай бұрын
What if I do a transnasal sphenoidotomy? Should I bite down or laterally?
@tushar11113 4 ай бұрын
Brilliant insights as usual from the Master.