Combined external and endoscopic transnasal approach with use of a diamond burr in the removal of a fishing harpoon hook traversing bilateral sphenoid sinuses in a 22-year-old man

2021 ◽  
Vol 14 (5) ◽  
pp. e239055
Author(s):  
Jan Alexeis Lacuata ◽  
Agnes Tirona - Remulla ◽  
Arsenio Claro Cabungcal ◽  
Romiena Mae Santos
Keyword(s):  
Visual Acuity ◽  
Sphenoid Sinus ◽  
Oral Antibiotics ◽  
Orbital Apex ◽  
Transnasal Approach ◽  
Endoscopic Transnasal Approach ◽  
Diamond Burr ◽  
The Right ◽  
Sphenoid Sinuses

A 22-year old construction worker was shot with a fishing harpoon gun on the left side of his face. He consulted at the emergency room 12 days postinjury, stable but with blurring of vision on the right. The shaft of the harpoon was protruding at the left preauricular area; the tip was neither visible nor palpable. Craniofacial CT scan and skull anteroposterolateral radiographs revealed the tip of the harpoon to be at the right orbital apex. A hook attached 1 cm from the tip was lodged in the sphenoid sinus. The hook was dismantled from the shaft via a combined external and endoscopic transnasal approach, enabling the shaft to be gently pulled. The hook, together with the tip, were removed endoscopically. The patient’s visual acuity improved. He was discharged after 2 days on oral antibiotics with no deficits on follow-up.

scholarly journals Monophasic Epithelial Synovial Sarcoma Accompanied by an Inverted Papilloma in the Sphenoid Sinus

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Xiaohua Jiang ◽  
Qi Huang ◽  
Jianguo Tang ◽  
Matthew R. Hoffman
Keyword(s):  
Synovial Sarcoma ◽  
Sphenoid Sinus ◽  
Inverted Papilloma ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Olfactory Sensation ◽  
History Of ◽  
The Right ◽  
Sphenoid Sinuses

A 58-year-old man presented with a six-month history of intermittent blood-stained posterior nasal discharge. Five years ago, he had a three-week episode of fitful light headaches. Nasal ventilation, olfactory sensation, and facial sensation were normal; there were no ophthalmological complaints. Coronal computed tomography (CT) scans revealed soft masses in the bilateral sphenoid sinuses with bone absorption. The patient underwent bilateral functional endoscopic sinus surgery and resection of right nasal papillary masses. Papillary masses and mucosa in both sphenoid sinuses were also removed. The mass in the left sphenoid sinus was diagnosed as two separate entities, one being a primary monophasic epithelial synovial sarcoma and the other an inverted papilloma, while the mass in the right sphenoid sinus was an inverted papilloma. After surgery, the patient underwent radiotherapy and chemotherapy. At the 50-month follow-up visit, there were no signs of recurrence.

scholarly journals Intravitreal moxifloxacin in acute post-phacoemulsification endophthalmitis: a case report

2021 ◽  
Vol 3 (4) ◽  
pp. 236-243
Author(s):  
Tri Winarti ◽  
Mohammad Eko Prayogo ◽  
Suhardjo Pawiroranu ◽  
Rifna Luthfiamida ◽  
Grace Sancoyo
Keyword(s):  
Visual Acuity ◽  
Intravitreal Injection ◽  
Therapeutic Dose ◽  
Hand Movement ◽  
Oral Antibiotics ◽  
Broad Spectrum Antibiotic ◽  
Blurred Vision ◽  
Vitreous Opacities ◽  
The Right

Background: Vancomycin and ceftazidime are commonly used intravitreal antibiotics to treat acute post-phacoemulsification endophthalmitis. However, they are not commercially available in appropriate therapeutic dose for intravitreal injection. Moxifloxacin is a broad-spectrum antibiotic that is commercially available in appropriate therapeutic dose for intravitreal injection, thus providing a rationale for its use in acute post-phacoemulsification endophthalmitis.Case presentation: A 46-year-old female presented with blurred vision, redness, and pain in the right eye 5 days after phacoemulsification. Visual acuity was hand movement and conjunctival and circumcorneal injection, corneal oedema, anterior chamber reaction, and vitreous opacities were observed. The patient was treated with intravitreal moxifloxacin 500 μg/0.1 ml, vitrectomy, and topical and oral antibiotics. Visual acuity improved to 6/15 and follow-up at 5 weeks did not reveal any signs of intraocular inflammation.Conclusion: Intravitreal moxifloxacin is an alternative in the treatment of acute post-phacoemulsification endophthalmitis.

scholarly journals Retrospective Case Analysis of Transnasal Endoscopic Resection of Benign Orbital Apex Tumors: Some Thoughts on Transnasal Endoscopic Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Cheng Li ◽  
Yang Gao ◽  
Rongxin Chen ◽  
Chao Cheng ◽  
Pan Yin ◽  
...  
Keyword(s):  
Endoscopic Surgery ◽  
Surgical Techniques ◽  
Field Testing ◽  
Benign Tumors ◽  
Orbital Apex ◽  
Retrospective Case ◽  
Transnasal Approach ◽  
Transnasal Surgery ◽  
Endoscopic Transnasal Approach ◽  
The Right

Purpose. To deeply discuss the patient selection, surgical planning, surgical techniques, and the therapeutic challenge for endoscopic transnasal resection of benign orbital apex tumors (OATs). Methods. We retrospectively analyzed the cases of 18 patients (18 eyes) with orbital apex cavernous hemangioma (OACH) who underwent endoscopic transnasal approach for resection of the tumor in Zhongshan Ophthalmic Center from March 2016 to May 2020. At each follow-up visit, the patients underwent measurement of their best-corrected visual acuity (BCVA), slit-lamp examination, indirect ophthalmoscopy, and visual field testing. Results. There were 18 patients, 7 males and 11 females, with a mean age of 49.9 ± 12.6 years (range: 26 to 70 years). All 18 patients had unilateral tumors. Among the 18 cases, 13 were located in the right orbit and 5 were located in the left orbit. Sixteen patients underwent purely endoscopic transnasal surgery, and the other 2 patients underwent an endoscopic transnasal approach combined with a transcutaneous or transconjunctival surgical approach. Fourteen patients’ OACHs were removed completely, 1 patient’s OACH was partly removed, and 3 patients underwent pure decompression of the optic nerve. Fourteen patients gained improved or stable BCVA after surgery. Three patients showed postoperative vision decline, and 1 patient had no light perception after surgery. Conclusions. Endoscopic surgery is an effective surgical technique for the treatment of benign tumors in the orbital apex. It is necessary to strictly select patients and fully evaluate the benefits and risks of tumor completely or partly removed.

Ossifying fibromyxoid tumour of the sphenoid sinus

2009 ◽  
Vol 124 (4) ◽  
pp. 437-440
Author(s):  
S D Shetty ◽  
R J Salib ◽  
S B Nair ◽  
N Mathad ◽  
J Theaker
Keyword(s):  
Skull Base ◽  
Sphenoid Sinus ◽  
Neoplastic Disease ◽  
Clinical Effects ◽  
Soft Tissue Neoplasm ◽  
Transnasal Approach ◽  
Fibrous Stroma ◽  
Neuroectodermal Origin ◽  
Endoscopic Transnasal Approach

AbstractIntroduction:Ossifying fibromyxoid tumour is a recently described, rare but morphologically distinctive soft tissue neoplasm characterised by a combination of myxoid and/or fibrous stroma with areas of ossification. Although most authors postulate a neuroectodermal origin for this peculiar tumour, there is no agreement in the literature regarding its histopathogenesis. To our knowledge, this is the first reported case of ossifying fibromyxoid tumour involving the sphenoid sinus.Histological findings:Tumour of low cell density, composed of small, spindle-shaped or stellate cells with small, irregular nuclei set in a fibromyxoid stroma.Management:Following discussion at the skull base multidisciplinary team meeting, a combined surgical team including an otorhinolaryngologist and a neurosurgeon carried out resection of the lesion, using an endoscopic transnasal approach, followed by reconstruction of the defect.Conclusions:An awareness of the distinctive histopathological features of ossifying fibromyxoid tumour, and of its clinical effects, is crucial to establishing a definitive diagnosis and thereby instituting appropriate management. This case report also reinforces the evolving role of the endoscopic transnasal approach in the management of inflammatory and neoplastic disease involving the skull base. This is increasingly being made possible by close collaboration between multiple surgical specialties, including otorhinolaryngology and neurosurgery.

Hemangiopericytoma of the Sphenoid Sinus

1981 ◽  
Vol 89 (5) ◽  
pp. 713-716 ◽  
Author(s):  
Charles P. Kimmelman
Keyword(s):  
Radiation Therapy ◽  
Sphenoid Sinus ◽  
Vascular Tumor ◽  
External Beam Radiation ◽  
Orbital Apex ◽  
Tumor Nodule ◽  
Beam Radiation ◽  
The Right ◽  
Sinus Ostium ◽  
Ethmoid Labyrinth

A 51-year-old woman complained of intermittent nasal obstruction and rhinorrhea. Sinus roentgenograms and polytomograms revealed a small mucocele of the right sphenoid sinus. There was no encroachment of the orbital apex or intracranial contents. The mucocele was marsupialized via an external ethmoidectomy, and the scant tissue present inside the sinus was examined histologically. The pathologic diagnosis was hemangiopericytoma. The small tumor had apparently originated at the sinus ostium, thus creating the mucocele. Several months postoperatively, a small, vascular tumor nodule was noted in the incision. No recurrence was evident intranasally. A course of 5,040 rads of external beam radiation therapy was given to the right ethmoid labyrinth and right sphenoid. Since completing her radiation therapy, there has been no recurrence. This case is of interest because the tumor occurred as a mucocele of the sphenoid sinus.

Removal of a Cavernous Hemangioma in the Orbital Apex via the Endoscopic Transnasal Approach: A Case Report

2010 ◽  
Vol 53 (02) ◽  
pp. 77-79 ◽  
Author(s):  
K. Yoshimura ◽  
S. Kubo ◽  
H. Yoneda ◽  
H. Hasegawa ◽  
S. Tominaga ◽  
...  
Keyword(s):  
Case Report ◽  
Cavernous Hemangioma ◽  
Orbital Apex ◽  
Transnasal Approach ◽  
Endoscopic Transnasal Approach

Unilateral Ectasia characterized by Advanced Diagnostic Tests

2016 ◽  
Vol 5 (1) ◽  
pp. 40-51 ◽  
Author(s):  
Bernardo Lopes ◽  
Marcella Q Salomão ◽  
Isaac C Ramos ◽  
Fernando Faria-Correia
Keyword(s):  
Visual Acuity ◽  
Femtosecond Laser ◽  
Diagnostic Tests ◽  
Diagnostic Methods ◽  
Distance Visual Acuity ◽  
Epithelial Thickness ◽  
Ring Segment ◽  
Intracorneal Ring Segment ◽  
The Right

ABSTRACT To describe a case of very asymmetric ectasia successfully treated by femtosecond laser-assisted intracorneal ring segment implantation, in which the diagnosis of unilateral ectasia in the right eye was based on the clinical findings including history, follow-up, and advanced diagnostic data. The patient's history was positive for ocular allergy with moderate- to-intense eye rubbing only in the right eye. The uncorrected distance visual acuity was 20/63 in the right eye and 20/32 in the left eye. The corrected distance visual acuity (CDVA) was 20/40 in the right eye (-1.75-4.00 × 35°) and 20/16 in the left eye (-0.50-0.25 × 115°). After femtosecond laser-assisted intracorneal ring segment implantation, the right eye improved CDVA to 20/20-1. Concerning ectasia/keratoconus diagnosis, the left eye remained stable over 1 year of follow-up with unremarkable topometric, tomographic, and biomechanical findings. Epithelial thickness mapping by spectral domain optical coherence tomography and very-high-frequency digital ultrasound demonstrated epithelial thickness within normal limits in the left eye. Advanced diagnostic methods along with clinical data enable the distinction from unilateral ectasia cases and subclinical (fruste) keratoconus. Literature review is also performed along with case presentation and discussion. How to cite this article Ramos IC, Reinstein DZ, Archer TJ, Gobbe M, Salomão MQ, Lopes B, Luz A, Faria-Correia F, Gatinel D, Belin MW, Ambrósio R Jr. Unilateral Ectasia characterized by Advanced Diagnostic Tests. Int J Kerat Ect Cor Dis 2016;5(1):40-51.

Macular Telangiectasia Type 2 With Spontaneous Resolution of Intraretinal/Sub-Internal Limiting Membrane Hemorrhage in the Absence of Neovascularization

2017 ◽  
Vol 1 (6) ◽  
pp. 415-419 ◽  
Author(s):  
Varun Chandra ◽  
Rohan Merani ◽  
Alex P. Hunyor ◽  
I-Van Ho ◽  
Mark Gillies
Keyword(s):  
Visual Acuity ◽  
Multimodal Imaging ◽  
Internal Limiting Membrane ◽  
Macular Telangiectasia ◽  
Corrected Visual Acuity ◽  
Visual Improvement ◽  
Macular Telangiectasia Type 2 ◽  
The Right

Purpose: To describe a case of macular telangiectasia type 2 (MacTel) presenting with decreased vision due to intraretinal/sub-internal limiting membrane (ILM) hemorrhage in the absence of neovascularization. Method: Clinical examination and multimodal imaging were performed. Results: A 65-year-old female presented with blurred left vision, recording 20/160 in that eye. There was intraretinal hemorrhage at the left macula centrally, with sub-ILM hemorrhage superiorly and inferiorly. Optical coherence tomography (OCT) showed no evidence of subretinal neovascularization. Imaging of the right macula was consistent with MacTel. The blood spontaneously cleared and the left visual acuity gradually improved to 20/25 by 4 months. Fluorescein angiography confirmed MacTel, and once the hemorrhage resolved, both inner and outer retinal cavitation was identified on OCT of the left macula. The left best-corrected visual acuity remained at 20/25 at 2-year follow-up. Conclusion: Spontaneous resorption of hemorrhage was accompanied by visual improvement.

scholarly journals Endoscopic transnasal resection of the CP angle schwannoma

2020 ◽  
Vol 2 (2) ◽  
pp. V13
Author(s):  
Satoshi Kiyofuji ◽  
Masahiro Shin ◽  
Kenji Kondo ◽  
Tsukasa Koike ◽  
Taichi Kin ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Surgical Instruments ◽  
Neurological Deficits ◽  
Cystic Tumor ◽  
Subtotal Resection ◽  
Transnasal Approach ◽  
Fusion Images ◽  
Endoscopic Transnasal Approach ◽  
The Right ◽  
Peeling Off

Cerebellopontine (CP) angle tumors are often resected via retrosigmoid craniotomy; however, sometimes cranial nerves (CNs) make their resection more complex. In such cases, the endoscopic transnasal approach can avoid such manipulations as delivering surgical instruments over CNs or peeling off CNs from the tumor, minimizing the risk of postoperative deficits. A 35-year-old man presented with a 37-mm cystic tumor in the right CP angle, and preoperative 3D fusion images revealed that multiple CNs (VII, VIII, and lower CNs) were running on the tumor posteriorly. The endoscopic transnasal approach enabled safe subtotal resection without causing neurological deficits, and the patient underwent stereotactic radiosurgery for the residual schwannoma.The video can be found here: https://youtu.be/xKLwdDsLpWA.

scholarly journals Case Report: Phototherapeutic Keratectomy for Band Keratopathy Secondary to Chemo-Laser-Cryotherapy for Retinoblastoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Ruoyan Wei ◽  
Meiyan Li ◽  
Weiming Yang ◽  
Haipeng Xu ◽  
Joanne Choi ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Phototherapeutic Keratectomy ◽  
White Band ◽  
Corrected Distance Visual Acuity ◽  
Band Keratopathy ◽  
History Of ◽  
Distant Visual Acuity ◽  
The Right

Purpose: To report the clinical outcomes of phototherapeutic keratectomy (PTK) for pediatric band keratopathy after treatment for retinoblastoma.Methods: A 5-year-old boy presented with a 2-year history of poor visual acuity and a horizontal gray-white band across the central cornea in the right eye. He was diagnosed with band keratopathy after chemo-laser-cryotherapy for retinoblastoma. The band keratopathy was treated via PTK using the Mel-90 excimer laser with an optical treatment zone of 7.0 mm and ablation depth of 120 μm. The patient was followed at 1 week and 3 months postoperatively.Results: Surgery and postoperative follow-up were uneventful. At the 3-month follow-up, the uncorrected distant visual acuity of the right eye improved to 20/125, and the corrected distance visual acuity improved to 20/70 with a refraction of +10.00 D/−2.50 DC × 15. The clarity of the ablated area was evidently improved. The central corneal thickness decreases from 612 to 584 μm. The optical coherence tomography showed the thin band of hyperreflectivity in the ablated area disappeared, corneal transparency improved and the corneal surface smoothened.Conclusions: PTK is a safe and effective procedure to treat band keratopathy following treatment of retinoblastoma in children. Early intervention can reduce the risk of developing deprivation amblyopia.

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