DOCSLIB.ORG

Sialoendoscopy-A New Scope & Sphere for Diagnosis of Salivary

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sialoendoscopy-A New Scope & Sphere for Diagnosis of Salivary Sialoendoscopy-A New Scope & Sphere for Diagnosis of Salivary Gland Disorders Dr. S. Bhavana Dr. V. Nagalaxmi Sr. Lecturer, Professor & HOD Dept. of Oral Medicine & Radiology, Dept. of Oral Medicine & Radiology Drs. Sudha & Nageswara Rao Siddhartha Dental College, Vijayawada, Andhra Pradesh. Sri Sai College of Dental Surgery, Vikarabad. Abstract compact and modular endoscopes were when sialolith is >5mm4. (Fig. C) ialolithiasis and sialadenitis are the compact is used for therapeutic purpose and Methods of Retrieving The Sialolith most common salivary gland modular for diagnostic, irrigation and Endoscopic techniques which are used to Sdisorders. Many conventional surgical purposes. (Figure A,B) Semirigid remove the sialolith include: modalities have been tried yet unsatisfactory. endoscopes are most commonly used as it 1. Basket Technique: This is the oldest New endoscopic techniques have been incorporates both flexible and rigid technique. Basket is introduced in close pioneered with sialoendoscopy a novel endoscope, with peculiar features like clear position to bypass the calculus and open therapy for optical exploration of salivary view, small diameter, stiffness which allows the prongs, basket is then pulled out in ductal system which incorporates diagnostic modification of salivary gland anatomy open position with the stone entrapped.4,3,6 and therapeutic procedures. It can be used hence endoscope can be easily introduced.1 It (Fig. E). effectively for salivary gland infections, consists of working and rinsing channel with 2. Grasper : In grasper there are three strictures and kinks. It is a simple procedure external diameter of 1.3mm.5 prongs which are used to hold the which can be performed under local Types of sialoendoscopes include: calculus. It need not be bypassed as in anesthesia. Hence forth, diagnostic and Diagnostic Sialoendoscope: 0.8 mm basket system.4,3,6 (Fig. D). interventional sialoendoscopy will be soon diameter/120-mm length/6000-pixel port for 3. Minigrasping Forceps: It is newly emerged into clinical practice. Thus this irrigation. designed with two prongs namely a) article reviews and focuses the importance of Multi functional Sialoendoscope: 1.1- Flexible b) Rigid.4 (Fig. E). endoscopy in salivary gland pathologies. mm diameter / 120-mm length / 6,000 pixels. 4. Balloon Technique: It uses 2 techniques Key Words : Sialoendoscopy, Sialolith, Surgical Sialoendoscope: 1.6mm a. Irrigate thoroughly and wash out the Endoscope. diameter/ 120mm length 6000 pixels 4. stone. Introduction Indications b. Pull the balloon in inflated position and Sialolith is one of the major cause for 1. When calculus removal by conventional retrieve the stone. salivary gland disorders and symptoms method is difficult to perform as in C. Calculus is crushed with minigrasp preclude pain, swelling, tenderness of posterior portion of Wharton's duct with forceps and removed piece by piece. involved salivary glands and altered salivary proximity to lingual nerve or in stenson's 5. Mechanical Fragmentation: can be 1 flow . Over the last few years, many duct posterior to sigmoid area.1 done by intracorpeal laser fragmentation techniques have been introduced but still 2. For screening of ductal system to rule out or combined intracorpeal laser there is a increasing demand for minimally any residual calculi after surgical lithotriptor, basket and minigrasp invasive surgery and sialoendoscopy is one sialolithotomy.2 forceps.6,8 such technology with new promising method 3. When there is positive evidence of ductal Ductal catheterization is carried out with for treatment of non neoplastic obstructive dilatation or stenosis on sialography.1 a polymeric sialostent into the duct for two to disease of salivary glands. It is an efficient yet 4. Cases of recurrent major salivary gland four weeks to prevent post operative oedema, simple mode of treatment for major salivary 1,2 and allow crushed particles of calculus to be 1,2 swellings without obvious cause. gland obstructions and strictures. It can be 5. When the calculus diameter does not washed out by saliva. A total of 100mg of easily performed under local anesthesia .Thus exceed 7 mm in Wharton's duct and 5mm hydrocortisone solution should be injected the advancements have resulted with major in stenson’s duct. 6 intraductally after the procedure. progress in this field. 6. When there are strictures, bends within Postoperative antibiotics, analgesics are History of Salivary Gland Endoscopy ductal system or presence of intraductal given with follow up.6,2 Koingsberger and colleagues introduced adenoids or foreign bodies .1,2 Complications their first successful application of Contraindications Complications of sialoendoscopy while endoscopically controlled intracorporeal retrieving a sialolith may result in temporary 3 1. Absolute contraindication include acute lithotripsy of salivary gland stones in 1990. inflammatory conditions like acute lingual nerve parasthesia, Post operative Later in 1993 he introduced the use of sialedinitis and non-functioning gland. 4 infection, bleeding, development of combined flexible miniendoscopes and 2. Relative contraindication include traumatic ranula, ductal strictures, tears and intracorporeal lithotriptor for sialolith perforations.6,9,4 intraparenchymal stones and when the fragmentation. In 2004, Zenk and colleagues ductal lumen cannot be enlarged more Advantages reported their experiences with a new highly than 1.3mm.2,6 1. It is a minimally invasive technique flexible, semirigid Sialoendoscope with which enhances removal of sialolith 4 Procedure of sialoendoscopy high-quality imaging (6,000 pixels) . In 2006 Preoperative assessment is done using from the deeper portions of ducts, within Nahlieli and Nazarian reported the results of conventional, digital radiographs or the glands, and openings of strictures, preliminary study of endoscopic treatment of ultrasound. The average time of kinks and duct strictures through 4 1 radioactive iodine sialedinitis . sialoendoscopy is 60min .Before introducing endoscopic guided visualization. Instrumentation the endoscope into the gland it should be 2. It is the only endoscopic technique that The use of miniature endoscopic imaging dilated either by using papillotomy or ensures complete removal of stones.2,6 tools makes the procedure uncomplicated. sialolothomy procedure7,then lubrication is 3. Surrounding tissues are minimally Miniendoscopes are traditionally divided into done using isotonic saline, and anesthetized damaged. three types namely rigid, flexible, and 4. The status of glandular tissues from 4 with 2 percent lidocaine. Intra ductal semirigid endoscopes. The semirigid approach is used when the sialolith diameter appearance of ductal lining can be endoscopes can be further divided into <5mm while extra ductal approach is used observed. In healthy gland, shiny Heal Talk | January-February 2013 | Volume 05 | Issue 03 41 Bhavana, et al. : Sialoendoscopy-A New Scope & Sphere for Diagnosis of Salivary Gland Disorders appearance of duct and proliferating sialolith is easy. It is an outpatient procedure 5. Paul S.Sialoendoscope Journal of Oral Maxillofacial Surgery 2001; 59(5): 484-490. blood vessels can be appreciated .In performed under local anesthesia without 6. Nahlieli O, Shacham R ,BarT, Eliav.E Endoscopic chronic sialedinitis, matted lining, major complications, and a solution for mechanical retrieval of Sialoliths. journal of oralsurg echymosis and small blood vessels can be managing intricated and perplexing oral med oralpathol oral radol 2003; 95: 396-402. percieved.10 inflammatory salivary gland pathology. As 7. Baptista PM, GimenoVC, Reymartinez JA, Casale FM. A new alternative for treatment of Salivary 5. It can identify radiolucent stones, polyps, the technique advances with endoscopy, more gland pathology Our Experience. Acta stenosis, mucous plugs and foreign findings, innovations and uniqueness will be Otorrinolaringol Esp200; 59(3):120-123. bodies.2 forthcoming, adding to its effectiveness. 8. Jacob D, Niels W, HelgeA, Preben H. Sialoendoscopy for diagnosis and treatment of non- Success Rate References neoplastic obstruction in Salivary glands. Danish • Success rate of parotid endoscopic 1. Suma GN, RaoD. Sialoendoscopy Review and medical Bulletin 2011; 58(2):A4232. sialolithotomy is 86% update. Journal of oral sign 2010; 2(1). 9. Capaccio P, Torretta S, OttavianiF,SambataroG, 2. Nallan CSK, Shashikanth MC, Ali IM. Pignataro L. Moderen management of Obstructive • Success rate of submandibular Sialoendoscopy a new diagnostic and treatment 1, 4 Salivary diseases. Acta Otorhinolaryngol Ital 2007; sialolithotomy is 89%. modality. JIAOMR 2007;19: 341-344. 27(4) 161-172. 3. Zenk J, Koch M, Bozzato A, Iro H. Sialoscopy Initial 10. Nahlieli O, Baruchin AM Sialoendoscopy a 3year Conclusion experience with new Endoscope. British Journal of Sialoendoscopy is a promising and experience as a diagnostic and treatment modality. Oral and Maxillofacial Surgery 2004; 2(4):293-298. Journal of Oral maxillofacial surgery1997; 66: 954- proficient method in diagnosing and treating 4. Nahlieli O, Nakar LH ,Nazarian Y,Michael.DT. 962. inflammatory conditions of major salivary Sialoendoscopy a new approach to Salivary gland Obstructive pathology. JADA 2006; 137(10): 1394- glands. The post operative management of 1400. Fig. C: Introduction of a Sialoendoscope through the orifice of the Whartonís duct (after dilatation) into the gland. Note the transilluminating effect. (courtesy Nahlieli O ; JADA 2006). Fig. A:
Load more

Recommended publications
  • View Our Annual Report
    2015 Surgery Report Inova Fairfax Medical Campus 2015 Surgery Report Table of Contents Inova Fairfax Medical Campus 1 Welcome 3 Education 5 Quality and Patient Safety 6 ASTEC 8 Research 9 Midlevel Clinical Practice Providers 10 Surgery Department Administration 11 Surgical Department Organizational Chart 13 Surgical Specialty Areas 24 Surgery by the Numbers 26 Selected Honors, Presentations, Publications and Research Mission Statement John J. Moynihan, MD, FACS Chairman, Department of Surgery To work collaboratively with the entire Associate Professor, VCU School of Medicine - Inova Campus healthcare team to provide the highest quality, most innovative and effective patient-centered surgical care to the diverse population we serve In 2015, the Inova Fairfax Medical Campus Department of Surgery had another Inova “Vision 2020” is to exciting and successful year. Build the Future of Health: The dedication and determination of our surgeons resulted in significant progress in the department’s mission to deliver world-class patient care, conduct 1 We will reinvent hospital-based care to cutting edge research in a multidisciplinary fashion and provide state-of-the-art increase value for our patients undergraduate and graduate medical education. 2 We will look outside our hospitals to build an integrated network of facilities, In addition to advancing surgical care through adoption of new technologies, the providers and programs to support our members of the department continue to be strong advocates for improvements community in the quality of care and the experience of patients who receive their care at our 3 We will gain national and international institution. recognition and funding – as well as an Recognition of the accomplishments of our department’s surgeons at regional, expanded patient base – through world- national and international levels further promotes the widespread value of the work renowned specialty care and leading-edge our surgeons are doing.
    [Show full text]
  • 2014 Final Program
    INTERNATIONAL FEDERATION OF HEAD AND NECK ONCOLOGIC SOCIETIES 5th World Congress of IFHNOS & Annual Meeting of the AHNS AMERICAN HEAD AND NECK SOCIETY Celebrating the 100th Anniversary of the Head and Neck Program at Memorial Sloan-Kettering Cancer Center July 26-30, 2014 Marriott Marquis, New York City, NY The Largest Head and Neck Cancer Congress in History A Century of Progress in Head and Neck Cancer HOSTED BY: ORGANIZED & SPONSORED BY: SUPPORTED BY: FINAL PROGRAM WORLD CONGRESS ON LARYNX CANCER 2015 SAVE THE DATE! To view the provisional program visit www.wclc2015.org KEyNoTE ToPiCS: • Larynx cancer and its place in history • Non-open laryngeal surgery including robots • The patient as a variable in defining outcome • Voice restoration/preservation • Clinical trials and larynx cancer • Reconstruction • Pre-malignant lesions • Radiotherapy-where to for the future • Staging and surgical anatomy • Poor prognostic factors for survival • Voice assessment methods and function • Molecular biology and translational • Chemotherapy-good to use alone? research • Swallowing assessment/ • Public health issues around the rehabilitation world including the status of anti-smoking campaigns in China • Transplant • Patient support structures • Survivorship • Databases • Larynx cancer in the developing world Further information: T: +61 3 9249 1273 E: [email protected] VISIBILITY DONORS Thank you to our 2014 Visibility Donors! The following companies have provided generous support for non-CME meeting activities. DIAMOND DONORS Ethicon US, LLC IBM Watson Medtronic Surgical Technologies PLATINUM DONORS Bayer Healthcare Pharmaceuticals and Onyx Pharmaceuticals IRX Therapeutics, Inc. Merck KGaA GOLD DONORS Bristol-Myers Squibb Exelixis SILVER DONORS Covidien Medrobotics Veracyte BRONZE DONOR Olympus America Inc.
    [Show full text]
  • Surgery Notes IIIII a PPROACH to ABDOMINAL MASSES 1111 IV IV OESOPHAGEAL DISEASES 1212
    CONTENTS Page I TRAUMA (MULTI-SPECIALTY APPROACH) 22 IIII APPROACH TO ABDOMINAL PAIN 1100 Surgery Notes IIIII A PPROACH TO ABDOMINAL MASSES 1111 IIVV OESOPHAGEAL DISEASES 1122 For the M.B.B.S. VV UPPER BLEEDING GIT AND ITS CAUSES 2211 VVII COLORECTAL DISEASES 1199 By Andre Tan VII LIVER DISEASES 3399 VIII PANCREA TIC DISEASES 4455 IIXX BILIARY TRACT DISEASES 5511 XX BREAST DISEASES 6600 XXII HEAD AND NECK MASSES 6699 XII SALIVARY GLAND SWELLINGS 7744 XIII THYROID DISEASES 7788 XIV PERIPHERAL ARTERIAL DISEASE 8855 XV ABDOMINAL AORTIC ANEURYSM 9933 XVI PERIPHERAL VENOUS DISEASE 9955 XVII UROLOGICAL DISEASES 9999 XVIII SURGICAL INSTRUMENTS 111100 TRAUMA (MULTI-SPECIALTY APPROACH) Management o f breathing -- Supplemental oxygen -- Ventilate as required if patient requires assistance with breathing AADVANCED TTRAUMA LLIFEIFE SSUPPORT ALGORITHM -- Needle thoracotomy for tension pneumothorax, followed by chest tube MAIN PRINCIPLES: -- Occlusive dressing for open pneumothorax -- Treat greatest threat to life first -- Definitive diagnosis is less important 3.3. CIRCULATION -- Time is important – – the “golden hour” after trauma is when 30% of trauma deaths Assessment of organ perfusion occur, and are preventable by ATLS -- Level of consciousness -- Skin colour and temperature, capillary refill -- Pulse rate and character – – all major pulses APPROACH -- Blood pressure 1.1. Primary survey and Resuscitation with adjuncts 2.2. Re-evaluation of the patient Classes of haemorrhagic shock 3.3. Secondary survey with adjuncts I II III IVIV 4.4. Post-resuscitation monitoring and re-evaluation Bld loss 5.5. Optimise for transfer and definitive care Amt (ml) <750 750-1500 1500-2000 >2000 Percentage <15<15 15-30 30-40 >40>40 Ht rate <100 >100 >120 >140 PRIMARY SURVEY – – ABCDE BPBP Normal Normal Decreased Decreased Cap refill Normal Prolonged Prolonged Prolonged 1.1.
    [Show full text]
  • Sialoendoscopy-Assisted Sialolithectomy for Submandibular
    J Oral Maxillofac Surg 71:295-301, 2013 Sialoendoscopy-Assisted Sialolithectomy for Submandibular Hilar Calculi Deng-Gao Liu, SMD,* Lan Jiang, SMD,† Xiao-Yan Xie, SMD,‡ Zu-Yan Zhang, DDS, PhD,§ Lei Zhang, SMD,ʈ and Guang-Yan Yu, PhD, DDS¶ Purpose: To assess the clinical effects of endoscopy-assisted sialolithectomy for submandibular hilar calculi. Materials and Methods: The present study was undertaken in 70 patients with symptomatic stones in the hilum of submandibular glands who underwent endoscopy-assisted sialolithectomy from Decem- ber 2005 through March 2011 in the Peking University School and Hospital of Stomatology. The operative data were analyzed retrospectively. All patients were followed periodically postoperatively. Submandib- ular gland function was investigated by postoperative symptoms, clinical examinations, sialography, and scintigraphy. Results: Submandibular stones were successfully removed in 65 patients, with a success rate of 92.9%. Temporary lingual nerve injury occurred in 1 patient. Two patients developed ranulae and underwent an uneventful sublingual gland excision. During a mean follow-up of 23 months (range, 6 to 55 mo), 52 of 65 patients were symptom free, whereas 11 patients complained of occasional swelling of the affected gland at mealtimes and 2 patients developed a recurrent stone. Thirty patients underwent postoperative sialography. The sialographic appearances included 4 types: 1) approximately normal; 2) the main duct was significantly dilated at the hilum, but no persistent contrast was seen on the functional film; 3) the main duct was significantly dilated in the hilar region, and persistent contrast was seen at the dilated hilum of the functional film; 4) the main duct was dilated or strictured, and persistent contrast was seen on the functional film.
    [Show full text]
  • Classic Approaches to Sialoendoscopy for Treatment of Sialolithiasis ODED NAHLIELI
    7 Classic Approaches to Sialoendoscopy for Treatment of Sialolithiasis ODED NAHLIELI Obstructive sialadenitis, with or without sialolithiasis, sialoadenitis. These data do not include patients who represents the main inflammatory disorder of the major were treated as ambulatory (outpatient) cases. salivary glands. The diagnosis and treatment of obstruc- There is a male preponderance,5 and the peak tions and inflammations of these glands can be proble- incidence is between the ages of 30 and 60.5 Sialoliths matic due to the limitations of standard imaging grow by deposition and range in size from 0.1 to techniques. Satisfactory treatment depends on our 30 mm.6 Presentation is typically with a painful swelling ability to reach a precise diagnosis and, in the case of of the gland at meal times, when the obstruction caused sialoliths, to accurately locate the obstruction. Until by the calculus becomes most acute.7 recently many of these glands required complete During the past decade, with the introduction of removal under general anesthesia. salivary gland endoscopy there has been a major step Sialolithiasis is a common finding, accounting for forward, not only in providing an accurate means of 50% of major salivary gland disease.1,2 The subman- diagnosing and locating intraductal obstructions, but dibular gland is the most prone to sialolithiasis. In also in permitting minimally invasive surgical treatment various studies it was found that Â/80% of all sialo- that can successfully manage those blockages that are lithiasis cases are in the submandibular glands, 19% not accessible intraorally.8 Á20 occur in the parotid gland, and Â/1% are found in the sublingual gland.
    [Show full text]
  • Sialendoscopy-Approaches to Parotid Duct and Gland-Lecture-10
    11/6/2014 Sialoendoscopic Approaches to the Parotid Duct and Gland For Sialadentis / Sialolithiasis Disclosures William Ryan, MD Assistant Professor Head and Neck Oncologic/Endocrine/Salivary Surgery Consultant for Medtronic Department of Otolaryngology-Head and Neck Surgery Transoral Open Sialodochotomy / Sialodochoplasty Transoral Open Sialodochotomy / Sialodochoplasty Distal Stones / Stenosis Transoral Sialendoscopy Transoral Sialendoscopy Middle Duct - Hilar Stones / Stenosis Transfacial Open Duct Surgery (+/- Sialendoscopy) Transfacial Open Duct Surgery (+/- Sialendoscopy) Impacted Stones / > 5-7mm Stones / Parenchymal stones Failed Sialendoscopy Parotidectomy Parotidectomy Parenchymal Stones / Multiple Stones / Generalized fibrosis / Fistula Failed Sialoendoscopy Intraoperative Ultrasound Guidance Intraoperative Ultrasound Guidance Confirmation, Localization, Stone Fragmentation, Stenosis Guidance 1 11/6/2014 Preparation / Exposure 2 11/6/2014 Instrumentation 3 11/6/2014 Identification of Stensen’s Duct Papilla 4 11/6/2014 Punctal Dilation / Ductal Dilation 5 11/6/2014 Transoral Open Sialodochotomy / Sialodochoplasty Distal Stones / Stenosis Transoral Sialendoscopy Middle Duct - Hilar Stones / Stenosis Transfacial Open Duct Surgery (+/- Sialendoscopy) Impacted Stones / > 4-7mm Stones / Parenchymal stones Failed Sialendoscopy Parotidectomy Parenchymal Stones / Multiple Stones / Generalized fibrosis / Fistula Failed Sialoendoscopy Intraoperative Ultrasound Guidance Confirmation, Localization, Stone Fragmentation, Stenosis Guidance
    [Show full text]
  • Guide for Answering Theory Questions in MS Surgery
    WBUHS (2011-2015) MS- PAPER – I -IV Guide for Answering theory questions in MS Surgery Dr. Arkaprovo Roy ASSOCIATE PROFESSOR DEPARTMENT OF GENERAL SURGERY Dr. Arkaprovo Roy ASSOCIATE PROFESSOR DEPARTMENT OF GENERAL SURGERY MEDICAL COLLEGE AND HOSPITAL, KOLKATA THE WEST BENGAL UNIVERSITY OF HEALTH SCIENCES MS (General Surgery) Examination, 2015 PAPER I Time Allowed: 3 Hours Full Marks: 100 Attempt all questions 1. How will you assess the nutritional status of a surgical patient? Define and classify artificial nutritional support (ANS). Give an account of enteral nutrition and its advantages and drawbacks. 4+4+8+4 2. Describe the lymph node status in relation to spread of carcinoma stomach. Discuss in detail the different types of gastric carcinoma and prognosis in respect to lymph node harvest. 5+10+5 3. Write short notes of the following: 5x6 a) Pharmacological therapy in patients awaiting surgery for pheochromocytoma. b) Retroperitoneal fibrosis. c) Ethics and law in surgical practice. d) Pathophysiology of short bowel syndrome. e) Metabolic response to trauma. 4. Answer briefly on the following. 4x71/2 a) Laparoscopic versus conventional surgery in pregnancy. b) Component separation and role of blood components in surgery. c) Graft rejection in transplants. d) Immunohistochemistry. THE WEST BENGAL UNIVERSITY OF HEALTH SCIENCES MS (General Surgery) Examination, 2015 April 2015 PAPER I Time Allowed: 3 Hours Full Marks: 100 Attempt all questions 1. How will you assess the nutritional status of a surgical patient? Define and classify artificial nutritional support (ANS). Give an account of enteral nutrition and its advantages and drawbacks. 4+4+8+4 Answer.
    [Show full text]
  • 2015 Final Program
    AHNS 2015 Translational Research Meeting on Transforming Patient Care Through Innovative Research April 21-22, 2015 Sheraton Boston Hotel, 39 Dalton Street, Boston, MA 02199 FINAL PROGRAM www.ahns.info THE RESEARCH AND EDUCATION FOUNDATION OF THE AMERICAN HEAD AND NECK SOCIETY Dear Colleagues, As we all know, head and neck cancer is not one of the more “publicized” cancers and often overlooked by both the general public and research funding sources. However, we believe that this is slowly starting to change. With increased attention on head and neck cancer, the Research and Education Foundation believes this is an opportunity to strengthen and expand our impact. With your commitment to the Foundation, we can reverse the trend of declining funding for head and neck cancer research! Presently the Research and Education Foundation supports two research awards each year. We are proud to fund these grants but there are more to cover. We would like to create more opportunities for young clinicians and researchers to explore unique and innovative treatments which may one day lead to a cure. To do as much, the Foundation needs to increase its asset base. There are three targeted ways for you to support the Foundation which are designed to provide immediate revenue as well as to increase the capital base for the long term with the goal of generating increased annual income perpetually to support more research. The support opportunities include: 1. Legacy gifts, such as estate planning, single premium life insurance and charitable lead annuity trusts (CLATs), are meaningful ways to create continuous and sustainable growth for the Foundation in the years and decades to come.
    [Show full text]
  • Provider Type 20 Physician, MD., Osteopath Reimbursement Rates
    Provider Type 20 Physician, MD., Osteopath Reimbursement Rates Updated: July 1, 2015 The information contained in the schedule is made available to provide information and is not a guarantee by the State or the Department or its employees as to the present accuracy of the information contained herein. For example, coverage as well as an actual rate may have been revised or updated and may no longer be the same as posted on the website. Note: Procedure codes with a rate of $0.00 are reimbursed at 62% of Usual and Customary charges unless noted otherwise in Nevada Medicaid policy. CPT codes, descriptions and other data only are copyright © 2008 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. CPT is a registered trademark ® of the American Medical Association. Current Dental Terminology, fourth edition (CDT) (including procedure codes, definitions (descriptors) and other data) is copyrighted by the American Dental Association. © 2008 American Dental Association. All rights reserved. Applicable FARS/DFARS apply. Proc Code Description Mod Rate 01953 ANESTH BURN EACH 9 PERCENT 0001 21.12 01996 HOSP MANAGE CONT DRUG ADMIN 0001 63.36 10021 FNA W/O IMAGE 0001 70.92 10022 FNA W/IMAGE 0001 65.39 10030 Guide cathet fluid drainage 0001 154.73 10040 ACNE SURGERY 0001 87.47 10060 DRAINAGE OF SKIN ABSCESS 0001 95.60 10061 DRAINAGE OF SKIN ABSCESS 0001 178.04 10080 DRAINAGE OF PILONIDAL CYST 0001 103.29 10081 DRAINAGE OF PILONIDAL CYST 0001 172.45 10120 REMOVE FOREIGN BODY 0001 103.22 10121 REMOVE FOREIGN BODY 0001 185.58
    [Show full text]
  • Micro‐Endoscopy of the Human Vas Deferens: a Feasibility Study of A
    ISSN: 2047-2919 ANDROLOGY ORIGINAL ARTICLE Correspondence: Micro-endoscopy of the human vas Matthias Trottmann, Department of Urology, University Hospitals Munich – Campus deferens: a feasibility study of a Grosshadern, 81377 Munich, Germany. E-mail: [email protected]. de novel device in several ex vivo models Keywords: azoospermia, infertility, seminal vesicles 1M. Trottmann, 1,2R. Sroka, 3C. Braun, 4B. Liedl, 5H. Schaaf, 3M. Graw, Received: 17-Apr-2016 1A. J. Becker, 1C. G. Stief and 1W. Y. Khoder Revised: 17-Jul-2016 1 2 Accepted: 2-Aug-2016 Department of Urology, Klinikum Grosshadern, University of Munich, Munich, Germany, LIFE Centre, University Hospital of Munich, Munich, Germany, 3Department for Forensic Medicine, University of Munich, Munich, Germany, 4Department of Urogenital Surgery, Clinics for Surgery doi: 10.1111/andr.12282 Munich-Bogenhausen, Munich, Germany, and 5Polydiagnost GmbH, Hallbergmoos, Germany SUMMARY The aim of this study was to show limitation as well as potential of micro-endoscopy techniques as an innovative diagnostic and therapeutic approach in andrology. Two kinds of custom-made micro-endoscopes (ME) were tested in ex vivo vas deferens specimen and in post-mortem whole body. The semi-rigid ME included a micro-optic (0.9 mm outer diameter [OD], 10.000 pixels, 120° vision angle [VE], 3–20 mm field depth [FD]) and an integrated fibre-optic light source. The flexible ME was composed of a micro-optic (OD = 0.6 mm, 6.000 pixels, 120° VE, 3–20 mm FD). The ex vivo study included retrograde investigation of the vas deferens (surgical specimen n = 9, radical prostatectomy n = 3).
    [Show full text]
  • Head and Neck Surgery Report on Clinical and Scientific Innovations Newyork-Presbyterian a Top 5 Hospital in the Nation
    NewYork-Presbyterian Otolaryngology – Head and Neck Surgery Report on Clinical and Scientific Innovations NewYork-Presbyterian A Top 5 Hospital in the Nation NewYork-Presbyterian Otolaryngology – Head and Neck Surgery New York’s #1 Hospital Report on Clinical and Scientific Innovations 19 Years in a Row Welcome 1 Otolaryngology – Head and Neck Surgery Leaders in Voice Preservation and Recovery Center for Voice and Swallowing 2 Sean Parker Institute for the Voice 4 Leadership Center for the Performing Artist 5 Lawrence R. Lustig, MD Pioneering the Understanding and Otolaryngologist-in-Chief Michael G. Stewart, MD, MPH Treatment of Hearing Loss 6 Department of Otolaryngology – Otolaryngologist-in-Chief Head and Neck Surgery Department of Otolaryngology – Innovative Treatments for Allergic Rhinitis NewYork-Presbyterian/ Head and Neck Surgery and Other Nasal Disorders 9 NewYork-Presbyterian/ Columbia University Advancing Minimally Invasive and Skull Base Surgery 11 Irving Medical Center Weill Cornell Medical Center Novel Approaches to Head and Neck Surgery Howard W. Smith Professor and Chair Professor and Chairman Department of Otolaryngology – Department of Otolaryngology – Exploring Molecular Drivers of Head and Neck Cancers 12 Head and Neck Surgery Head and Neck Surgery Facial Plastic Surgery 13 Columbia University Weill Cornell Medicine Pediatric Tracheostomy Care 13 Irving Medical Center Sleep Apnea Management 15 Leading the Way in Education 16 Make an Appointment 17 NewYork-Presbyterian 18 For More Information nyp.org Welcome Dear Colleague: The Departments of Otolaryngology – Head and Neck Surgery at NewYork- Presbyterian/Columbia University Irving Medical Center and NewYork- Presbyterian/Weill Cornell Medical Center feature world-class teams who provide comprehensive ear, nose, and throat care and head and neck surgical services for patients of all ages.
    [Show full text]
  • Provider Type 20 Physician, MD., Osteopath Reimbursement Rates
    Provider Type 20 Physician, MD., Osteopath Reimbursement Rates Updated: July 1, 2015 The information contained in the schedule is made available to provide information and is not a guarantee by the State or the Department or its employees as to the present accuracy of the information contained herein. For example, coverage as well as an actual rate may have been revised or updated and may no longer be the same as posted on the website. Note: Procedure codes with a rate of $0.00 are reimbursed at 62% of Usual and Customary charges unless noted otherwise in Nevada Medicaid policy. CPT codes, descriptions and other data only are copyright © 2008 American Medical Association. All rights reserved. Applicable FARS/DFARS apply. CPT is a registered trademark ® of the American Medical Association. Current Dental Terminology, fourth edition (CDT) (including procedure codes, definitions (descriptors) and other data) is copyrighted by the American Dental Association. © 2008 American Dental Association. All rights reserved. Applicable FARS/DFARS apply. Proc Code Description Mod Rate 01953 ANESTH BURN EACH 9 PERCENT 21.12 01996 HOSP MANAGE CONT DRUG ADMIN 63.36 0359T BEHAVIORAL ID ASSESSMENT 70.19 0360T OBSERV BEHAV ASSESSMENT 70.19 0361T OBSERV BEHAV ASSESS ADDL 70.19 0362T EXPOSE BEHAV ASSESSMENT 70.19 0363T EXPOSE BEHAV ASSESS ADDL 70.19 0364T ADAPTIVE BEHAVIOR TREATMENT 60.20 0365T ADAPTIVE BEHAVIOR TX ADDL 60.20 0366T GROUP BEHAVIOR TREATMENT 42.84 0367T GROUP BEHAV TREATMENT ADDL 42.84 0368T BEHAVIOR TREATMENT MODIFIED 60.20 0369T BEHAV TREATMENT
    [Show full text]