{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T14:28:02Z","timestamp":1766068082108,"version":"3.44.0"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg B Skull Base"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Rigid endoscopes have allowed surgeons to safely perform endoscopic sinus surgery. However, their rigid nature creates inherent visualization limitations. The study herein looks to assess the visualization potential of a novel articulating rigid-flexible endoscope when compared with traditional rigid and flexible nasal endoscopes.<\/jats:p><jats:p>A new articulating endoscope capable of bending its distal tip and extending beyond the point of angulation was compared with 0- and 30-degree 4.0-mm rigid endoscopes, and a 3.7-mm flexible nasopharyngoscope in their ability to visualize predefined anatomic landmarks within the maxillary, sphenoid, and frontal sinuses. Visible markers were placed at applicable landmarks using image guidance in a total of five cadaveric heads. The ability to visualize these intrasinus anatomic landmarks was recorded for each scope.<\/jats:p><jats:p>When inspecting the surgically naive anatomy of all sinus ostia and predefined anatomic landmarks, the articulating endoscope had superior visualization (p\u2009&lt;\u20090.01) compared with the 0-degree, 30-degree, and flexible endoscopes throughout all sinuses (maxillary sinus: 62.5, 0, 5, and 0%, respectively; sphenoidal sinus: 92.5, 27.5, 37.5, and 40%, respectively; frontal sinus: 51.4, 5.7, 20, and 37.1%, respectively). After performing a Draf IIa, the articulating endoscope was able to visualize 100% of the predefined frontal sinus landmarks compared with 22.9, 45.7, and 65.7% for the 0-degree, 30-degree, and flexible endoscopes, respectively (p\u2009&lt;\u20090.001).<\/jats:p><jats:p>The articulating rigid-flexible endoscope is superior in reaching and visualizing anatomic landmarks within the paranasal sinuses, compared with standard endoscopes.<\/jats:p>","DOI":"10.1055\/s-0044-1791575","type":"journal-article","created":{"date-parts":[[2024,10,3]],"date-time":"2024-10-03T18:55:05Z","timestamp":1727981705000},"page":"529-537","source":"Crossref","is-referenced-by-count":1,"title":["Paranasal Sinus Visualization Capabilities of a Novel Articulating Rigid-Flexible Endoscope: A Cadaveric Study"],"prefix":"10.1055","volume":"86","author":[{"given":"Allen L.","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3355-4651","authenticated-orcid":false,"given":"Barak","family":"Ringel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric H.","family":"Holbrook","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, United States"},{"name":"Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,10,3]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.wjorl.2016.12.001","article-title":"Thirty years of endoscopic sinus surgery: what have we learned?","volume":"3","author":"B A Tajudeen","year":"2017","journal-title":"World J Otorhinolaryngol Head Neck Surg"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1002\/lary.20777","article-title":"Ambulatory sinus and nasal surgery in the United States: demographics and perioperative outcomes","volume":"120","author":"N Bhattacharyya","year":"2010","journal-title":"Laryngoscope"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1177\/0194599818768482","article-title":"Laryngeal force sensor: quantifying extralaryngeal complications after suspension 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Neck Surg"},{"issue":"04","key":"ref7","first-page":"259","article-title":"Video endoscopic oro-nasal visualisation of the anterior wall of maxillary sinus: a new technique","volume":"34","author":"M Trimarchi","year":"2014","journal-title":"Acta Otorhinolaryngol Ital"},{"issue":"07","key":"ref8","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1097\/MLG.0b013e31803330f1","article-title":"New staging system for sinonasal inverted papilloma in the endoscopic era","volume":"117","author":"S B Cannady","year":"2007","journal-title":"Laryngoscope"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"9195163","DOI":"10.1155\/2017\/9195163","article-title":"Risk factors of recurrence and malignant transformation of sinonasal inverted papilloma","volume":"2017","author":"M Gamrot-Wrzo\u0142","year":"2017","journal-title":"BioMed Res Int"},{"issue":"09","key":"ref10","doi-asserted-by":"crossref","first-page":"2499","DOI":"10.1007\/s00405-019-05535-0","article-title":"A prospective, feasibility study to evaluate the efficacy and usability of a novel drivable endoscope in patients with chronic rhinosinusitis","volume":"276","author":"T Van Zele","year":"2019","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"04","key":"ref11","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1007\/s11102-013-0508-y","article-title":"A panoramic view of the skull base: systematic review of open and endoscopic endonasal approaches to four tumors","volume":"17","author":"C S Graffeo","year":"2014","journal-title":"Pituitary"},{"issue":"09","key":"ref12","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1001\/jamaoto.2014.1321","article-title":"Endoscopic and open surgical approaches to locally advanced sinonasal melanoma: comparing the therapeutic benefits","volume":"140","author":"W Swegal","year":"2014","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"09","key":"ref13","first-page":"784","article-title":"Surgical outcomes of malignant sinonasal tumours: open versus endoscopic surgical approaches","volume":"128","author":"B Saedi","year":"2014","journal-title":"J Laryngol Rhinol Otol"},{"key":"ref14","first-page":"194599818815881","article-title":"Long-term outcome for open and endoscopically resected sinonasal tumors","author":"J Hagemann","year":"2018","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"05","key":"ref15","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1055\/s-0035-1549003","article-title":"Endoscopic versus open approach to the infratemporal fossa: a cadaver study","volume":"76","author":"A Youssef","year":"2015","journal-title":"J Neurol Surg B Skull Base"}],"container-title":["Journal of Neurological Surgery Part B: Skull 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