Hans Briner - Academia.edu (original) (raw)

Papers by Hans Briner

Transnasal endoscopic skull base and brain surgery: Tips and pearls

Head & Neck, 2012

A very well-written textbook for the treatment of skull base pathology. The high-quality operativ... more A very well-written textbook for the treatment of skull base pathology. The high-quality operative, dissection, and imaging photographs make this an excellent resource for the skull base surgeon. -- Ashutosh Kacker, MBBS, MD, The Laryngoscope Ideal for both otolaryngologist-head and neck surgeons and neurosurgeons, Transnasal Endoscopic Skull Base and Brain Surgery: Tips and Pearls gathers together in one comprehensive volume invaluable advice from world-renowned authorities on state-of-the-art endoscopic technologies and techniques. Each succinct chapter begins with a summary of key takeaway points and features an easily accessible outline format. After uniquely detailed coverage of macroscopic and endoscopic anatomy, the expert authors discuss the most up-to-date surgical approaches integrated with key information on technologic advances, such as 3D reconstruction and navigation. Clearly labeled illustrations demonstrate each step of the various procedures. The book closes with practical guidance on postoperative care and guidelines for avoiding and managing the potential complications encountered in these complex surgeries. Features: * In-depth information on endoscopic surgical procedures for the paranasal sinuses, anterior skull base, and the craniocervical junction * Easy-to-reference bullet-points in each chapter distill the renowned authors&amp;amp;amp;#39; vast experience * Step-by-step surgical descriptions cover the full spectrum of skull base pathology * Stunningly detailed illustrations, including more than 500 in full-color, enhance the text throughout This landmark work will improve the accuracy and precision of every surgeon and fellow in otolaryngology-head and neck surgery and neurosurgery who deals with this delicate anatomic region.

Swiss medical forum =, Sep 26, 2018

Prevalence of antibodies toBorrelia burgdorferi in forestry workers and blood donors from the same region in Switzerland

European Journal of Clinical Microbiology & Infectious Diseases, Nov 1, 1989

ABSTRACT

CSF Rhinorrhoea and the Anterior Skull Base

Contemporary Rhinology: Science and Practice

Regarding ‘Radiological and clinical correlations of the anterior ethmoidal artery in functional endoscopic sinus surgery’

Journal of Laryngology and Otology, May 18, 2023

Tailored, Individually Adapted Transnasal Endoscopic Approaches to the Anterior and Central Skull Base

Journal of neurological surgery, Jun 17, 2014

Otorhinolaryngology-head and neck surgery, 2016

Background: The inferior turbinate, as part of the nasal valve area, plays a key role in directin... more Background: The inferior turbinate, as part of the nasal valve area, plays a key role in directing the airflow and moisturizing and heating the inspired air. Excessive resection of the inferior turbinate leads to a significant reduction in heating and humidification of inhaled air. Different types of turbinate surgery are described in the current literature. Pyriform Turbinoplasty is a new endoscopically performed procedure which includes a submucosal reduction of the bone of the frontal process of the maxilla and the lacrimal bone yet it preserves the mucosal surface. This new surgical technique is able to improve nasal airflow without hampering nasal climatization. Objective: Effects of Nasal Wall Lateralization and Pyriform Turbinoplasty on nasal climatization were analyzed using Computational Fluid Dynamics. Methods: A three dimensional model of the nasal cavity and paranasal sinuses was created basing on the CT-scans of a patient with nasal obstruction and hypertrophy of the inferior turbinates. The simulation was performed using transient boundary conditions and a breathing cycle with a length of 4.2 seconds. Results: Nasal resistance was reduced after performing Nasal Wall Lateralization and Pyriform Turbinoplasty. The main area of airflow and humidification increased and was elevated from the inferior to the medial turbinate. A homogeneous distribution of airflow around all nasal turbinates was observed. In contrast to many other techniques that include partial resection of the inferior turbinate, heating and humidifying of respiratory air during inspiration takes place in the entire nasal cavity postoperatively. Conclusion: Pyriform Turbinoplasty and Nasal Wall Lateralization are endoscopic procedures that widen the nasal valve area without mucosal resection. Computational Fluid Dynamics prove that these procedures produce a homogeneous distribution of airflow along the inferior and middle turbinate. The Pyriform Turbinoplasty and the nasal wall lateralization substantially improve nasal breathing without altering nasal climatization essentially.

Laryngo-rhino-otologie, Mar 1, 1999

Die zunehmende Bedeutung des Geruchssinns im taglichen Leben fUhrt dazu, da Patienten verrnehrt S... more Die zunehmende Bedeutung des Geruchssinns im taglichen Leben fUhrt dazu, da Patienten verrnehrt Storungen ihres Riechvermogens wahrnehmen und abklären lassen. Die Erfassung der Funktion des Geruchssinnes ist allerdings nicht emfach. Die wachsenden physiologischen und molekularbiologischen Erkeiintnisse zeigen, da es sicli urn em kornplexes Sinnesorgan handelt, dessen Funktion mit einfachen Testmethoden our unvollstandig erfat werden kann. So ist die Konzentrationsschwelle zur Wahrnehmung eines Riechstoffes von vielerlei Faktoren abhangig. Es 1st beispielsweisebekannt, da Frauen grundsätzlich einen besseren Geruchssinn haben als Manner, und da das Riechvermogen irn Alter abninimt. Auch ist das Riechvermogen einer Person nicht imrner konstant, die Riechschwelle eines bestimmten Stoffes kann von Tag zu Tag unterschiedlich sein, und auch emotionelle Faktoren können das Riechvermogen beeinflussen. All diese Faktoren erschweren die Normierung vonTestmethoden zur PrUfung des Geruchssinnes. Neben der objektiven Testrnethode der olfaktorisch evozierten Potentiale wurde eineVielzahl von subjekti-Dieses Dokument wurde zum persönlichen Gebrauch heruntergeladen. Vervielfältigung nur mit Zustimmung des Verlages.

European Archives of Oto-rhino-laryngology, Oct 22, 2020

Objectives An increasing proportion of patients who are candidates for endoscopic sinus surgery c... more Objectives An increasing proportion of patients who are candidates for endoscopic sinus surgery can be treated as an outpatient. A preoperative risk assessment is needed to evaluate eligibility for day surgery. This study analyses the effectiveness of a risk assessment scoring system which examines medical, procedure-related, and socioeconomic factors. Design Prospective multicenter study. Setting Three center study including Klinik Hirslanden,

Endoscopic sinus surgery training courses: benefit and problems - a multicentre evaluation to systematically improve surgical training

PubMed, Sep 1, 2012

Background: The aim of this multicentre study was to systematically analyse the strengths and wea... more Background: The aim of this multicentre study was to systematically analyse the strengths and weaknesses in the surgical training for endoscopic sinus surgery (ESS) and identify measures that may improve training. Methodology: Using a structured questionnaire, 133 participants of ESS courses in seven centres in Germany, Switzerland and Australia were asked about their experiences during their dissection courses and how they perceived their course could be improved. Results: Gaining confidence in handling of instruments and endoscopes was only a problem for participants with little experience in ESS. The majority of the participants, independent from their level of training, considered infundibulotomy and anterior ethmoidectomy as the easiest dissection steps, whilst surgery of the frontal sinus posed a considerable challenge for many surgeons even those with a higher level of training. Participants with and without ESS experience thought that emphasis on anatomy was the most important improvement that could be made during their surgical training. Virtually all participants stated that the course improved their anatomical knowledge, their surgical skills and their confidence when performing ESS. Conclusions: ESS dissection courses are considered beneficial by surgical trainees. Participants felt that more emphasis on sinus anatomy in conjunction with private study is essential to maximize their skills in surgical dissection. For beginners with ESS, an infundibulotomy and anterior ethmoidectomy were thought to be the best initial procedures to help develop endoscopic surgical skills.

Olfaction in rhinology--methods of assessing the sense of smell

PubMed, Jun 1, 2006

Olfactory disorders frequently occur in rhinological disease. Different subjective and objective ... more Olfactory disorders frequently occur in rhinological disease. Different subjective and objective test methods are available to assess the sense of olfaction. Among the subjective methods, screening tests and threshold measurements are commonly used to quantify hyposmia or anosmia. Qualitative methods are available using discrimination and identification tests. Objective methods are used in research and in some medicolegal situations. Objective tests include olfactory evoked potentials, functional Magnetic Resonance Imaging and functional Positron Emission Tomography. The measurement of the sense of smell helps to assess the whole spectrum of the effects of nasal disease. This is especially important before rhinological surgery, because a non-detected smell disorder in patients with rhinological disease is common. The assessment of a pre-existing hyposmia or anosmia helps to avoid a postoperative claim that this was caused by surgery. A variety of validated screening tests for olfaction is available and they are a useful tool to document whether a patient is able to smell.

Smell diskettes as screening test of olfaction

PubMed, Dec 1, 1999

A screening test of olfaction was developed with reusable diskettes as applicators of 8 different... more A screening test of olfaction was developed with reusable diskettes as applicators of 8 different odorants. Using a questionnaire with illustrations, the test was designed as a triple forced multiple choice test resulting in a score of 0 to 8 correct answers. To validate the test, 102 volunteers with normal olfaction, as well as 22 patients with subjective hyposmia or anosmia, were tested. To compare the developed test with an already validated method, the same persons also performed the sniffin' sticks screening test. The results indicate that the screening test with smell diskettes recognizes patients with normal olfaction and consistently distinguishes them from patients with hyposmia or anosmia.

Hypophysenadenome und Tumore der zentralen Schädelbasis: Die rhino-neurochirurgische transnasale endoskopische Operation

Swiss medical forum =, Feb 24, 2015

Die konventionell-mikrochirurgische Technik in der transnasalen Chirurgie von Hypophysenadenomen ... more Die konventionell-mikrochirurgische Technik in der transnasalen Chirurgie von Hypophysenadenomen und Tumoren der zentralen Schadelbasis geniesst in der neurochirurgischen Fachwelt einen grossen Ruckhalt. Aktuelle Studien demonstrieren bei Anwendung von endoskopischen Techniken jedoch eine deutlich verbesserte Kontrolle der Tumorresektion sowie gunstigere endokrinologische und ophthalmologische Ergebnisse.

Acta neurochirurgica, Jan 18, 2017

Background The use of endoscopes in transnasal surgery offers increased visualization. To minimiz... more Background The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, we introduced the mononostril transethmoidal-paraseptal approach. Methods The aim of the transethmoidal-paraseptal approach is to create sufficient space within the nasal cavity, without removal of nasal turbinates and septum. Therefore, as a first step, a partial ethmoidectomy is performed. The middle and superior turbinates are then lateralized into the ethmoidal space, allowing a wide sphenoidotomy with exposure of the central skull base. Conclusions This minimally invasive transethmoidal-paraseptal approach is a feasible alternative to traumatic transnasal concepts with middle turbinate and extended septal resection.

„Aerosound“ – ein realitätsnaher Test für die Sprachverständigung der Piloten?

Flugmedizin, Tropenmedizin, Reisemedizin, Aug 1, 2018

ZUSAMMENFASSUNGDie Kommunikation über Funk ist in der Luftfahrtbranche äußerst wichtig. Deshalb g... more ZUSAMMENFASSUNGDie Kommunikation über Funk ist in der Luftfahrtbranche äußerst wichtig. Deshalb gehört die Überprüfung der Hörfähigkeit zur regulären medizinischen Tauglichkeitsuntersuchung. Bisher werden diese Tests nur in Form von Audiometrien in ruhiger Umgebung durchgeführt, was nicht der Realität im Cockpit entspricht. Vor einiger Zeit wurde deshalb das realitätsnahe Testprogramm „Aerosound“ entwickelt: Originalfunkdurchsagen werden abgespielt, während im Hintergrund Cockpitgeräusche zu hören sind. Die Funksprüche müssen anschließend korrekt beantwortet werden, wobei ein wiederholtes Abspielen der Funkdurchsage erlaubt ist. Um die Durchführbarkeit und die Validität von „Aerosound“ zu überprüfen, wurden in einer Pilotstudie Militärpiloten und Piloten mit einer zivilen Fluglizenz (Private Pilote License, PPL) getestet und miteinander verglichen.

Chronische Mykosen der Nasennebenhöhlen - Stellenwert der endonasalen Nasennebenhöhlenchirurgie

Laryngo-rhino-otologie, Aug 1, 1998

BACKGROUND: Many host factors even in immunocompetent patients may have an influence on developme... more BACKGROUND: Many host factors even in immunocompetent patients may have an influence on development of a fungal diseases within the paranasal sinuses. Fungal sinusitis can occur in an acute form or more often to a chronic type of the disease. These mainly relatively asymptomatic chronic forms and further divided into a chronic noninvasive, chronic allergic, and chronic invasive disease. Endonasal microsurgery has significantly changed the management of chronic fungal sinusitis and allows adequate removal of pathologic tissue even in advanced situations. The aim of this study was to analyze the efficacy of endonasal surgery in chronic fungal sinusitis. MATERIAL AND METHODS: In a retrospective study we assessed a group of 40 patients who had endonasal surgery for chronic fungal sinusitis. Patient records, CT and MRI scans, microbiology and histology as well as the postoperative clinical follow-up including endoscopic photo documentation were evaluated over a period of 5 years. All patients underwent endonasal surgery using endoscopic techniques. The microscopic was of additional help in a few cases with extended disease and multiple dehiscences of the skull base. RESULTS: Twenty-four patients had a chronic noninvasive of fungal sinusitis and 16 patients had a chronic invasive form. All these patients underwent endonasal surgery without external incision. The fungal disease was erradicated in 39 cases, and revision surgery was required in only one case in which involvement of the contralateral side was not initially detected. in two cases scar tissue in the middle meatus was later excised but without evidence of residual fungal disease. Only in 6 cases was antifungal chemotherapy required, where the disease had spread into surrounding tissue or the patient had severe symptoms. CONCLUSIONS: Endonasal microsurgical techniques are today the appropriate approach for managing chronic fungal sinus disease even in severe cases with radiologic evidence of expansion or invasion of surrounding tissue. Additional antifungal chemotherapy is only rarely indicated, specifically when the fungal disease invades surrounding tissue.

Rhinology, Jun 1, 2012

Loss of olfactory function is one of the main symptoms in patients with chronic rhinosinusitis. T... more Loss of olfactory function is one of the main symptoms in patients with chronic rhinosinusitis. This prospective, non-randomized interventional study reports five years results of olfaction of patients with chronic rhinosinusitis who underwent endoscopic sinus surgery in conjunction with topical medical treatment. Forty-five patients with chronic rhinosinusitis who underwent endoscopic sinus surgery were evaluated preoperatively, after three months and 34 (76%) of them after five years. Olfactory function was assessed by a subjective visual analogue scale, by a screening test of olfaction with Smell Diskettes and by measuring the N-Butanol threshold. Patient's subjective sense of olfaction using a visual analogue scale was improved in 79% at 5 years. Objective measurements by Smell Diskettes improved in 53% at 5 years whilst the quantitative measurement by the N-Butanol threshold improved in 85% at 5 years. The high percentage of patients with improvement of olfaction five years after surgery indicates that endoscopic sinus surgery in conjunction with continued topical treatment leads to a long term improvement of the sense of smell. However, it was found that-measured by the sensitive N-Butanol thresholdup to 9% had no improvement and 6% had deterioration in their olfaction at 5 years after endoscopic sinus surgery. This fact has to be considered in the preoperative counselling of patients.

Breathing straws

Journal of Laryngology and Otology, Sep 18, 2009

Following nasal, septal or endoscopic surgery, it is common practice to insert nasal packs in bot... more Following nasal, septal or endoscopic surgery, it is common practice to insert nasal packs in both nasal cavities to achieve haemostasis, if there has been any bleeding at the end of the procedure. However, such packs make it difficult for patients to breathe, mainly in the first post-operative night which leads to discomfort and poor sleep. To enable patients to breathe better with nasal packs in situ, we describe a simple technique using trimmed straws and wrapped Netcell® packs for post-operative care following septal surgery, rhinoplasty and endoscopic sinus surgery. These packs also assist suction of any blood or mucous from the post-nasal space.

Archives of Facial Plastic Surgery, Sep 1, 2004

To provide an objective method to measure the extent of nasal tip projection and the nasolabial a... more To provide an objective method to measure the extent of nasal tip projection and the nasolabial angle. Design: We retrospectively studied preoperative and postoperative images using a novel approach. The constant position of the cornea in lateral views and the diameter of the iris in frontal views were used to standardize and compare digitalized images of patients before and after surgery. We tested this objective assessment technique using the digitized slides of patients with saddle nose deformities and measured changes in their nasal tip projection and nasolabial angle. We included 63 patients who had undergone an open rhinoplasty with the I-beam technique by the same surgeon over a 7-year period. We tested the reproducibility of these measurements with 10 independent investigators. We also determined whether the measurements using this objective technique correlated with the surgeon's or patients' subjective assessments of the outcome.