Avoiding complications of endoscopic sinus surgery: Analysis of coronal, axial, and sagittal computed tomographic images

Author(s):  
Roy A. Holliday ◽  
Barry A. Shpizner
2010 ◽  
Vol 49 (178) ◽  
Author(s):  
M Bista ◽  
M Maharjan ◽  
S Shrestha ◽  
T KC

INTRODUCTION: Endoscopic sinus surgery is an upcoming branch in rhinological practice but with some major risks since it has to play around the skull base area. Lateral lamella of cribriform plate is the thinnest area of the skull base. Thus this study is undertaken to evaluate the height of lateral lamella of cribriform plate and the depth of olfactory fossae by the help of computed tomographic images. METHODS: Computed tomographic study of 50 patients was done in Advanced Imaging and Diagnostic center, Kathmandu Medical College. Coronal sections at the centre of infra-orbital foramina were taken as reference slide. The height of cribriform plate point was subtracted from the height of medial ethmoidal roof point to measure the length of lateral lamella of cribriform plates on both sides. RESULTS: The median height of LLCP in 100 slides was 2.8 mm. LLCP height was 0 to 3.9 mm in 86 slides, 4 to 7 mm in 12 slides and greater than 7mm in 2 slides. The LLCP length was greater in right side in 28 (56%) patients and was greater in left side in 19 (38%) patients. It was equal in both sides in only three patients (6%). CONCLUSIONS: As regards the length of LLCP; 0 to 3.9 mm length was most common. The olfactory fossa depth was more in the right side compared to the left side. Thus, right side is more vulnerable to injury during surgery. Thus adequate caution has to be exercised by the rhinological surgeon during endoscopic sinus surgery. Keywords: lateral lamella of Cribriform plate, medical ethmoidal roof, olfactory fossa.  


2017 ◽  
Vol 10 (2) ◽  
pp. 78-85
Author(s):  
Anjali Prakash ◽  
Anoop Raj ◽  
Vikram Wadhwa ◽  
Swati Tandon ◽  
Praveen K Rathore

ABSTRACT Objective Chronic sinusitis affects more than 30 million people each year worldwide. Computed tomography (CT) has become a standard diagnostic tool in the evaluation of paranasal sinuses (PNS), but medical literature lacks studies correlating preoperative CT and intraoperative findings of functional endoscopic sinus surgery (FESS). The aim of our study was to evaluate ostiomeatal unit on multidetector CT (MDCT) and correlate findings of MDCT with intraoperative findings during FESS in patients with chronic sinusitis and hence check for its usefulness during surgery. Study design Prospective clinical study. Materials and methods Forty-nine patients with chronic sinusitis who visited the Lok Nayak Hospital, Delhi, India, between October 2010 and February 2012 were included in the study. All such patients underwent preoperative CT scan of PNS before surgery, i.e., FESS with or without septoplasty under general anesthesia. Results Maxillary sinus was found to be the most common sinus involved in chronic sinusitis. Preoperative CT findings correlated well with intraoperative findings for all sinuses except left maxillary sinus. Conclusion Multiplanar CT of nose and PNS helps to deli­neate the anatomy of nose and PNS, and drainage pathways of sinuses preoperatively. Therefore, the operating surgeon should be well versed with it. Progress of endoscopic sinus surgery can be partially attributed to revolution in imaging modalities. How to cite this article Tandon S, Rathore PK, Raj A, Prakash A, Wadhwa V. Correlation of Computed Tomographic Findings and Intraoperative Findings in Patients with Chronic Sinusitis. Clin Rhinol An Int J 2017;10(2):78-85.


1996 ◽  
Vol 10 (4) ◽  
pp. 217-220 ◽  
Author(s):  
Katsuhisa Ikeda ◽  
Yoshifumi Kondo ◽  
Hiroshi Sunose ◽  
Koji Hirano ◽  
Takeshi Oshima ◽  
...  

Endoscopic sinus surgery (ESS) is the first modality for the surgical treatment of chronic sinusitis. We evaluated the outcome of ESS based on subjective and objective assessment. Subjective improvement was achieved in 98% of 54 patients chosen consecutively in the present study. The extent of disease revealed by computed tomographic (CT) scans was significantly ameliorated to an 82% improvement rate by ESS. However, no correlation of improvement rate between symptoms and CT scores was obtained. Both quantitative olfaction and anterior rhinomanometry were significantly improved following ESS. The present study provides objective evidence for clinical efficacy of ESS in the treatment of chronic sinusitis.


Author(s):  
Manish Munjal ◽  
Suneet Bhatia ◽  
Porshia Rishi ◽  
Nitika Tuli ◽  
Harjinder Singh ◽  
...  

<p class="abstract"><strong>Background:</strong> The optic nerve is susceptible to injury during endoscopic surgical intervention in the sphenoethmoidal region.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective analysis of 157 axial computed tomography sections through the sphenoid sinus of randomly selected cases from the departments of Otorhinolaryngology and Neurosurgery, Dayanand Medical College and Hospital, Ludhiana was undertaken during the period 2002 to 2004.  </p><p class="abstract"><strong>Results:</strong> A computed tomographic study of the Onodi cells, of this region was carried out in 157 axial scans. The incidence of Onodi cells was 12.10% with predominance of left sided and indirect type of cells in our study.</p><p class="abstract"><strong>Conclusions:</strong> Thorough pre-operative evaluation of sphenoethmoidal region optic nerve and extent of pathology is essential to avoid the irreversible complication of optic nerve injury.</p><p class="abstract"> </p>


2002 ◽  
Vol 26 (2) ◽  
pp. 317-322 ◽  
Author(s):  
James J. Ludwick ◽  
Katherine H. Taber ◽  
Spiros Manolidis ◽  
Achal Sarna ◽  
L. Anne Hayman

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