Preoperative CT Scan for Nasal Surgery

2021 ◽  
pp. 109-139
Author(s):  
Fabio Meneghini
2003 ◽  
Vol 17 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Robert D. Thomas ◽  
Scott M. Graham ◽  
Keith D. Carter ◽  
Jeffrey A. Nerad

Background Enophthalmos in a patient with an opacified hypoplastic maxillary sinus, without sinus symptomatology, describes the silent sinus syndrome. A current trend is to perform endoscopic maxillary antrostomy and orbital floor reconstruction as a single-staged operation. A two-staged approach is performed at our institution to avoid placement of an orbital floor implant in the midst of potential infection and allow for the possibility that enophthalmos and global ptosis may resolve with endoscopic antrostomy alone, obviating the need for orbital floor reconstruction. Methods A retrospective review identified four patients with silent sinus syndrome evaluated between June 1999 and August 2001. Patients presented to our ophthalmology department with ocular asymmetry, and computerized tomography (CT) scanning confirmed the diagnosis in each case. Results There were three men and one woman, with ages ranging from 27 to 40 years. All patients underwent endoscopic maxillary antrostomy. Preoperative enophthalmos determined by Hertel's measurements ranged from 3 to 4 mm. After endoscopic maxillary antrostomy, the range of reduction in enophthalmos was 1–2 mm. Case 2 had a preoperative CT scan and a CT scan 9 months after left endoscopic maxillary antrostomy. Volumetric analysis of the left maxillary sinus revealed a preoperative volume of 16.85 ± 0.06 cm3 and a postoperative volume of 19.56 ± 0.07 cm3. This represented a 16% increase in maxillary sinus volume postoperatively. Orbital floor augmentation was avoided in two patients because of satisfactory improvement in enophthalmos. In the other two patients, orbital reconstruction was performed as a second-stage procedure. There were no complications. Conclusion Orbital floor augmentation can be offered as a second-stage procedure for patients with silent sinus syndrome. Some patients’ enophthalmos may improve with endoscopic antrostomy alone.


2017 ◽  
Vol 123 ◽  
pp. S635
Author(s):  
T. Saxena ◽  
V. Goel ◽  
G. Kadyaprath ◽  
D. Arora ◽  
A.K. Verma ◽  
...  

Author(s):  
Jorge Hernández ◽  
Laureano Molins ◽  
Juan J. Fibla ◽  
Ángela Guirao ◽  
Juan J. Rivas ◽  
...  

Hernia ◽  
2022 ◽  
Author(s):  
S. T. Adams ◽  
D. Slade ◽  
P. Shuttleworth ◽  
C. West ◽  
M. Scott ◽  
...  

2020 ◽  
Vol 17 (02) ◽  
pp. 110-120
Author(s):  
Ramesh Chandra Vemula ◽  
B. C.M. Prasad ◽  
Venkat Koyalmantham ◽  
Kunal Kumar

Abstract Introduction Some neurosurgeons believe that doing a trephine craniotomy (TC) decreases the chance of recurrence in chronic subdural hematoma (cSDH). But this is not supported by any evidence. Methods A retrospective analysis of patients who were operated for cSDH from 2014 to 2019 at our institute was done. Factors causing recurrence were studied. Results A total of 156 patients were operated in the given period, among which 88 underwent TC and 68 patients underwent burr hole drainage (BHD) for evacuation of cSDH. All patients underwent two trephines or two burr holes placed according to the maximum thickness of the hematoma. Rate of recurrence in trephine group was 12.5% and in burr-hole group was 11.76% and was not statistically significant. Significant factors for recurrence included nontraumatic cSDH, anticoagulant use, presence of membranes, preoperative computed tomography (CT) showing iso- or mixed-density subdural collection and SDH volume > 60 mL. There was selection bias for the procedure. Patients with subdural membranes were preferentially taken for TC as the percentage of subdural membrane found intraoperatively was significantly greater in trephine group (51.1%) than burr-hole group (17.6%) (p value < 0.001).When all the patients who showed membranes in CT scan were excluded, there was no statistical difference in the base line characteristics of both the groups. After excluding the patients with membranes in preoperative CT scan, there was no significant difference in recurrence rate between the two groups.In TC group with membranes, 8 out of 45 had recurrence, whereas in burr-hole group with membranes, 8 out of 12 had recurrence. This difference was statistically significant. (p value < 0.001). Conclusion Surgical intervention in both modalities improves patient outcome with an overall recurrence rate of 12.17%. In the absence of any identifiable membranes in preoperative CT scan, BHD is the preferred surgical intervention. We prefer TC as first choice for patients with membranes in CT scan.


2012 ◽  
Vol 256 (1) ◽  
pp. 139-145 ◽  
Author(s):  
Hadrien Tranchart ◽  
Sébastien Gaujoux ◽  
Vinciane Rebours ◽  
Marie-Pierre Vullierme ◽  
Safi Dokmak ◽  
...  

Neurosurgery ◽  
1983 ◽  
Vol 12 (2) ◽  
pp. 169-174 ◽  
Author(s):  
Isao Yamamoto ◽  
Makoto Hara ◽  
Koichiro Ogura ◽  
Yoshio Suzuki ◽  
Toshichi Nakane ◽  
...  

Abstract The relationship between the results of early operation for ruptured intracranial aneurysms (72 cases) and the preoperative computed tomographic (CT) findings was studied. There was a correlation among the surgical results, the development of symptomatic vasospasm, and high density on the preoperative CT scan, particularly the presence of a localized, thick layer in the subarachnoid space. However, no relationship was found between the occurrence of ventricular enlargement and the preoperative CT findings. Cisternal or ventricular drainage might contribute to an uncomplicated postoperative course for patients with severe subarachnoid clot shown on the preoperative CT scan.


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