ENDOSCOPIC APPROACHES TO THE PARANASAL SINUSES AND SKULL BASE. A STEP-BY-STEP ANATOMIC DISSECTION GUIDE M Bernal-Sprekelsen , I Alobid Thieme, 2017 ISBN 978 3 13201 881 5 pp 409 Price €149.99 £133.50

2017 ◽  
Vol 131 (11) ◽  
pp. 1030-1031 ◽  
Author(s):  
L M Flood
2013 ◽  
Vol 10 (1) ◽  
pp. 116-120 ◽  
Author(s):  
Andrea Bolzoni Villaret ◽  
Paolo Battaglia ◽  
Manfred Tschabitscher ◽  
Davide Mattavelli ◽  
Mario Turri-Zanoni ◽  
...  

Abstract An endoscopic approach through the transnasal corridor is currently the treatment of choice in the management of benign sinonasal tumors, cerebrospinal fluid leaks, and pituitary lesions. Moreover, this approach can be considered a valid option in the management of selected sinonasal malignancies extending to the skull base, midline meningiomas, parasellar lesions such as craniopharyngioma and Rathke cleft cyst, and clival lesions such as chordoma and ecchordosis. Over the past decade, strict cooperation between otorhinolaryngologists and neurosurgeons and acquired surgical skills, together with high-definition cameras, dedicated instrumentation, and navigation systems, have made it possible to broaden the indications of endoscopic surgery. Despite these improvements, depth perception, as provided by the use of a microscope, was still lacking with this technology. The aim of the present project is to reveal new perspectives in the endoscopic perception of the sinonasal complex and skull base thanks to 3-dimensional endoscopes, which are well suited to access and explore the endonasal corridor. In the anatomic dissection herein, this innovative device came across with sophisticated and long-established fresh cadaver preparation provided by one of the most prestigious universities of Europe. The final product is a 3-dimensional journey starting from the nasal cavity, reaching the anterior, middle, and posterior cranial fossae, passing through the ethmoidal complex, paranasal sinuses, and skull base. Anatomic landmarks, critical areas, and tips and tricks to safely dissect delicate anatomic structures are addressed through audio comments, figures, and their captions.


2020 ◽  
pp. 1-10
Author(s):  
Kenichi Oyama ◽  
Kentaro Watanabe ◽  
Shunya Hanakita ◽  
Pierre-Olivier Champagne ◽  
Thibault Passeri ◽  
...  

OBJECTIVEThe anteromedial triangle (AMT) is the triangle formed by the ophthalmic (V1) and maxillary (V2) nerves. Opening of this bony space offers a limited access to the sphenoid sinus (SphS). This study aims to demonstrate the utility of the orbitopterygopalatine corridor (OPC), obtained by enlarging the AMT and transposing the contents of the pterygopalatine fossa (PPF) and V2, as an entrance to the SphS, maxillary sinus (MaxS), and nasal cavity.METHODSFive formalin-injected cadaveric specimens were used for this study (10 approaches). A classic pterional approach was performed. An OPC was created through the inferior orbital fissure, between the orbit and the PPF, by transposing the PPF inferiorly. The extent of the OPC was measured using neuronavigation and manual measurements. Two illustrative cases using the OPC to access skull base tumors are presented in the body of the article.RESULTSVia the OPC, the SphS, MaxS, ethmoid sinus (EthS), and nasal cavity could be accessed. The use of endoscopic assistance through the OPC achieved better visualization of the EthS, SphS, MaxS, clivus, and nasal cavity. A significant gain in the area of exposure could be achieved using the OPC compared to the AMT (22.4 mm2 vs 504.1 mm2).CONCLUSIONSOpening of the AMT and transposition of V2 and the contents of the PPF creates the OPC, a potentially useful deep keyhole to access the paranasal sinuses and clival region through a middle fossa approach. It is a valuable alternative approach to reach deep-seated skull base lesions infiltrating the cavernous sinus and middle cranial fossa and extending into the paranasal sinus.


2018 ◽  
Vol 99 (3) ◽  
pp. 153-157
Author(s):  
S. L. Kabak ◽  
V. V. Zatochnaya ◽  
Yu. M. Mel’nichenko ◽  
N. A. Savrasova ◽  
E. A. Dorokh

Fossa navicularis magna was detected in multislice spiral computed  tomography in two patients who turned to the medical centers with  pathology of the paranasal sinuses. Its appearance is determined during  the development of the basilar part of the occipital bone and the body of the sphenoid bone in embryogenesis. This fossa has the  appearance of an edge defect on the ventral surface of the clivus in  CBCT scans. Practical radiologist should interpret such a finding as a  congenital anomaly of development, but not as an invasive lesion.


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