Endoscopic Approaches to the Paranasal Sinuses and Skull Base

2017 ◽  
Keyword(s):  
Skull Base ◽  
Paranasal Sinuses

scholarly journals The orbitopterygoid corridor as a deep keyhole for endoscopic access to the paranasal sinuses and clivus

2020 ◽  
pp. 1-10
Author(s):  
Kenichi Oyama ◽  
Kentaro Watanabe ◽  
Shunya Hanakita ◽  
Pierre-Olivier Champagne ◽  
Thibault Passeri ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Skull Base ◽  
Paranasal Sinuses ◽  
Middle Cranial Fossa ◽  
The Body ◽  
Middle Fossa Approach ◽  
Alternative Approach ◽  
Endoscopic Assistance ◽  
Skull Base Lesions ◽  
Cranial Fossa

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.

scholarly journals FOSSA NAVICULARIS MAGNA AT THE SKULL BASE: EMBRYOGENESIS AND ITS DETECTION BY COMPUTED TOMOGRAPHY

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
Keyword(s):  
Computed Tomography ◽  
Congenital Anomaly ◽  
Skull Base ◽  
Paranasal Sinuses ◽  
Ventral Surface ◽  
The Body ◽  
Spiral Computed ◽  
Edge Defect ◽  
Medical Centers ◽  
Fossa Navicularis

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.

scholarly journals PARANASAL SINUS MUCOCELE AND ITS COMPLICATIONS: RETROSPECTIVE ANALYSIS AND LITERATURE REVIEW

2021 ◽  
pp. 1-3
Author(s):  
Sudhagar Eswaran ◽  
Namrataa S ◽  
Prasanna Kumar S
Keyword(s):  
Skull Base ◽  
Retrospective Analysis ◽  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Vision Loss ◽  
Delay In Diagnosis ◽  
Diagnosis And Management ◽  
Audit Data ◽  
Tertiary Center ◽  
Skull Base Defect

BACKGROUND: Mucocele is a true cystic expansile mass filled with mucus resulting from obstruction of the sinus ostia. Prompt diagnosis and management are needed to avoid complications due to the intracranial or intra-orbital extension. OBJECTIVES: To audit data of mucocele of the paranasal sinuses in a tertiary center, to review the literature regarding the clinical features and the management of mucocele in the paranasal sinus and to emphasize the iatrogenic causes of mucocele after the development of Endoscopic Skull Base Surgeries. MATERIALS AND METHODS: A retrospective analysis of etiology, clinical presentation, sinuses involved, operative technique, complication, recurrence were interpreted. RESULTS: The mean age of 16 patients managed is 49. Location:37% frontal,19% ethmoidal,19% frontoethmoidal,19% sphenoidal,6% maxillary. The iatrogenic cause was 44%. Symptoms included proptosis, external swelling, nasal block, and discharge, and vision loss. Complications were orbital abscess and skull base defect. 14 patients underwent endoscopic procedures-excision or marsupialization. One patient underwent craniotomy; one patient combined approach was performed. One patient had a recurrence. CONCLUSION: Mucocele of the paranasal sinuses is still a rare clinical scenario and it is imperative to note that any delay in diagnosis and management can lead to expansion and erosion of the bony wall of the sinuses and causing complications.

Mucoceles of the Paranasal Sinuses with Intracranial Extension-Postoperative Course

2001 ◽  
Vol 15 (4) ◽  
pp. 243-247 ◽  
Author(s):  
Keiichi Ichimura ◽  
Yasushi Ohta ◽  
Yoh-Ichiro Maeda ◽  
Hiroyoshi Sugimura
Keyword(s):  
Skull Base ◽  
Paranasal Sinuses ◽  
Original Position ◽  
Intracranial Extension ◽  
Transnasal Approach ◽  
Postoperative Course ◽  
Transnasal Surgery ◽  
Long Term Follow Up ◽  
Magnetic Resonance Imaging Mri

Mucoceles of the paranasal sinuses cause progressive distension of the bony walls and induce compressive symptoms. Although rare, cases of massive intracranial extension have occurred. We believe that an endoscopic transnasal approach is the best choice for such huge mucoceles because it is the least invasive and can provide an adequate surgical field of view for wide marsupialization. However, the results of long-term follow-up after endoscopic transnasal surgery have not been reported. This study was designed to evaluate prospectively the postoperative course of patients with intracranially extended mucocele. In the last 5 years, we have operated on four patients with intracranially extended mucocele. Although postoperative scanning is not recommended routinely after surgery for inflammatory disease, we followed up two patients who consented by using magnetic resonance imaging (MRI) along with endoscopy. Dural descent to the original skull base plane necessitated long periods of follow-up, lasting 18 and 5 months, respectively. On the mucocele wall mucosa, which had been smooth during surgery, polyps and granulations developed after surgical drainage and lasted for a considerable time. Although endoscopic transnasal opening of mucocele is a method of choice, we recommend follow-up of such patients for long periods, at least until the frontal skull base dura returns to its original position.

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