{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T00:02:38Z","timestamp":1648512158744},"reference-count":4,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T00:00:00Z","timestamp":1529280000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215118000798_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Juvenile nasopharyngeal angiofibroma often attaches firmly to the adjoining bony region around the sphenopalatine foramina\u2013sphenopalatine fossa\u2013pterygomaxillary fissure. This can result in hourglass-shaped constriction and predispose to incomplete resection (residual disease) with a transpalatal approach. This paper describes attempts to address this \u2018inaccessible\u2019 area with a novel instrument, used since 2012.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215118000798_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>Measurements of the sphenopalatine foramen, nasal septum, posterior nasopharyngeal wall and hard palate were undertaken in 20 skulls and 10 computed tomography scans (lateral extension). A device was designed (in terms of angulation and length) following several trials with malleable wire. A search of patents was also undertaken. Recurrence rates were compared in cases of device use and non-use.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215118000798_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>The novelty of the sphenopalatine fossa dissector was established and the device was patented. This device has significantly improved our 17.59 per cent recurrence rate of the past 4 decades; of 63 cases over 3 years, there were only 3 recurrences and 2 residual disease cases. Findings of our previous studies with or without the device are compared.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215118000798_sec_a4\" sec-type=\"conclusion\"><jats:title>Conclusion<\/jats:title><jats:p>Existing evidence supports the incorporation of this inexpensive instrument in the armamentarium for resecting lateral extension of juvenile nasopharyngeal angiofibroma during a transpalatal approach.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215118000798","type":"journal-article","created":{"date-parts":[[2018,6,18]],"date-time":"2018-06-18T06:48:17Z","timestamp":1529304497000},"page":"657-660","source":"Crossref","is-referenced-by-count":0,"title":["Assisted resection of lateral extension of juvenile nasopharyngeal angiofibroma using a sphenopalatine fossa dissector"],"prefix":"10.1017","volume":"132","author":[{"given":"A","family":"Mishra","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2018,6,18]]},"reference":[{"key":"S0022215118000798_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2016.01.006"},{"key":"S0022215118000798_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000268"},{"key":"S0022215118000798_ref2","volume-title":"Scott-Brown's Otolaryngology, Volume IV: Rhinology","author":"Chew","year":"1987"},{"key":"S0022215118000798_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215116000773"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215118000798","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,14]],"date-time":"2019-04-14T18:54:00Z","timestamp":1555268040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215118000798\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,18]]},"references-count":4,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["S0022215118000798"],"URL":"https:\/\/doi.org\/10.1017\/s0022215118000798","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,18]]}}}