scholarly journals Penetrating Orbital Sphenoid Sinus Trauma with a Wooden Stick: A Challenging Case Report

2020 ◽  
Vol 11 (3) ◽  
pp. 540-545
Author(s):  
Marie-Louise Uhre Hansen ◽  
Mads Thorsberger ◽  
Jesper Skovlund Jørgensen ◽  
Christian von Buchwald
Keyword(s):  
Sphenoid Sinus ◽  
Fatal Outcome ◽  
Posterior Wall ◽  
Foreign Object ◽  
Orbital Trauma ◽  
Surgical Expertise ◽  
Close Relationship ◽  
Wooden Stick ◽  
Expertise Level ◽  
Level 1 Trauma Center

Transorbital and intra-sphenoidal traumas are relatively uncommon, can be challenging to manage, and are associated with a high risk of complications and potentially fatal outcome. Transorbital and intra-sphenoidal trauma pose a medical challenge due to close relationship to delicate and critical anatomical structures, such as the globe, optic nerve, the ophthalmic internal carotid arteries, and central nervous system. Rapid admission to a level 1 trauma center with a high surgical expertise level is essential to ensure the best possible treatment and outcome. We present a case of a 75-year-old man who had a severe orbital trauma, where a wooden foreign object penetrated the orbit into the sphenoid sinus without penetrating its posterior wall. This case is important because of the rare trauma presentation with a wooden foreign object, which can easily be missed on computed tomography. The case also illustrates the importance of close collaboration between ophthalmologists and rhinologists when challenged with severe orbital sphenoid sinus trauma.

Cystic Lesions of the Petrous Apex: Transsphenoid Approach

1977 ◽  
Vol 86 (4) ◽  
pp. 429-435 ◽  
Author(s):  
William W. Montgomery
Keyword(s):  
Sphenoid Sinus ◽  
Cystic Lesion ◽  
Surgical Techniques ◽  
Posterior Wall ◽  
Petrous Apex ◽  
Surgical Approaches ◽  
Cystic Lesions ◽  
Ct Brain ◽  
Exact Relationship ◽  
Wide Access

The transsphenoid approach to cystic lesions of the petrous tip has been made possible by the advances in techniques for diagnosis. These include polytomography, improved angiography, and computer tomographic (CT) brain scanning. The results of these studies can determine the size, shape, and thickness of the cystic lesion, as well as its exact relationship to the sphenoid sinus. A number of surgical approaches have been used to reach the cystic lesion of the petrous apex. Most notably, these include the middle fossa extradural craniotomy and posterior fossa craniotomy. These surgical techniques allow the cyst to be biopsied but do not establish permanent drainage. The translabyrinthine approach accomplishes wide access to the petrous apex, but cochlear and vestibular functions are sacrificed. The transsphenoid approach to cystic lesions of the petrous apex should be the ideal operation provided that the anterior aspect of the cyst abuts against the posterior wall of the sphenoid sinus. The cyst can be completely evacuated and permanent fistulization established into the sphenoid sinus using a septal mucosal flap and a silicone drainage device. The operation is accomplished without destruction to the inner ear.

Endoscopic trans-sphenoidal removal of cholesterol granuloma of the petrous apex: case report and literature review

2010 ◽  
Vol 125 (2) ◽  
pp. 169-172 ◽  
Author(s):  
G Dhanasekar ◽  
N S Jones
Keyword(s):  
Case Report ◽  
Sphenoid Sinus ◽  
Vestibular Function ◽  
Posterior Wall ◽  
Uneventful Recovery ◽  
Petrous Apex ◽  
Cholesterol Granuloma ◽  
Alternative Route ◽  
Review Of The Literature

AbstractObjective:We report a case of cholesterol granuloma of the petrous apex which was surgically treated via an endoscopic trans-sphenoidal approach.Methods:Case report and review of the literature concerning cholesterol granulomas of the petrous apex and their management.Results:The lesion was approached endoscopically via a bilateral sphenoidotomy with removal of the vomer. A large cholesterol granuloma was evacuated and marsupialised. The patient made an uneventful recovery.Conclusion:Trans-sphenoidal access to the petrous apex represents an alternative route for the drainage and ventilation of cholesterol granulomas. This approach is the technique of choice when the cholesterol granuloma abuts the posterior wall of the sphenoid sinus. The trans-sphenoid approach, unlike other lateral approaches to the petrous apex, spares cochlear and vestibular function and allows post-operative endoscopic follow up.

Posterior Maxillary Sinus Wall: A Landmark for Identifying the Sphenoid Sinus Ostium

2018 ◽  
Vol 128 (3) ◽  
pp. 215-219 ◽  
Author(s):  
Raj D. Dedhia ◽  
Tsung-yen Hsieh ◽  
Yecenia Rubalcava ◽  
Paul Lee ◽  
Peter Shen ◽  
...  
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Average Distance ◽  
Posterior Wall ◽  
Sinus Surgery ◽  
Endoscopic Endonasal ◽  
Sinus Wall ◽  
Significant Difference ◽  
Sinus Ostium

Importance: Safe entry into sphenoid sinus is critical in endoscopic sinus and skull base surgery. A number of surgical landmarks have been used to identify the sphenoid sinus ostium during endoscopic endonasal surgery with variable reliability and intraoperative feasibility. Objective: To determine if the posterior wall of the maxillary sinus is a reliable landmark to determine the depth of the sphenoid sinus ostium during anterior to posterior dissection. Design, Setting, and Participants: Prospective study of adult patients undergoing endoscopic sinus surgery between August 2016 and September 2017. Measurements were made intraoperatively between the depth of the posterior maxillary sinus wall and sphenoid sinus ostium. Main Outcomes and Measures: The primary measurement is the distance between the depth of the posterior maxillary sinus wall and sphenoid sinus ostium. Additional data points included age, gender, surgical indication, and primary versus revision endoscopic sinus surgery. Results: Forty-five patients (38% male, 62% female) with an average age of 56 were enrolled, resulting in 88 operated sides. The average distance between the depth of the posterior wall of the maxillary sinus and the sphenoid ostium was 1.5 mm ± 1.4 mm. The most common position of the sphenoid sinus ostium was posterior to the level of the posterior maxillary sinus wall (54%), followed by same level (23%) and anterior (23%). There was no significant difference between different disease states ( P = .75) and between primary and revision cases ( P = .13). Conclusions and Relevance: The posterior wall of the maxillary sinus serves as an adjunctive intraoperative landmark to determine the depth of the sphenoid sinus ostium. While the posterior wall of the maxillary sinus approximates the depth of the sphenoid sinus ostium, the relative position is variable and can be anterior or posterior.

scholarly journals Reception of law as a form of cultural interaction

2021 ◽  
Vol 118 ◽  
pp. 02018
Author(s):  
Yulia Evgenievna Voronina
Keyword(s):  
Fatal Outcome ◽  
Donor Country ◽  
Recipient Country ◽  
Roman Law ◽  
Negative Consequences ◽  
Intercultural Interaction ◽  
Close Relationship ◽  
Legal Space ◽  
Relationship Of ◽  
Main Factor

The study’s objective is to identify factors contributing to the positive results of legal reception and generalize the concept of legal reception, revealing the close relationship of law with the culture. During the research, various scientific approaches and methods of knowledge contributed to the achievement of the intended objective. The research is based on dialectical, systemic methods and the comparative legal approach. The result of the study was the conclusion that the result of intercultural interaction is not always favorable and can have both positive and negative consequences: when the national legal system becomes inconsistent, illogical, loses the character of self-execution, up to the fatal outcome – the destruction of the legal culture of society. As the most important condition for the successful reception of law, the authors highlight the compatibility of the cultures of the donor country and the recipient country (interacting cultures). It is argued that the formation of a single global cultural, legal space does not reflect the objectively existing patterns of development of societies, and the incompatibility of different types of legal cultures is the main factor preventing the creation of global legal order in general and hindering the success of the reception of law in particular. The novelty of the research is determined by the fact that the reception of law is one of the forms of intercultural interaction and plays a significant role in the mutual penetration of legal cultures. Although the topic is one of the most popular for domestic and foreign legal science, as a rule, its study is reduced to the description of the facts of reception, in most cases of Roman law, and the number of general theoretical studies of this issue is insufficient.

Applied Anatomy of the Posterior Sinuses in Relation to the Optic Nerve, Trigeminal Nerve, and Carotid Artery

1995 ◽  
Vol 9 (6) ◽  
pp. 321-334 ◽  
Author(s):  
David R. Edelstein ◽  
Lisa Liberatore ◽  
Sheila Bushkin ◽  
Jin C. Han
Keyword(s):  
Optic Nerve ◽  
Carotid Artery ◽  
Trigeminal Nerve ◽  
Sphenoid Sinus ◽  
Posterior Wall ◽  
Sinus Surgery ◽  
Endoscopic Techniques ◽  
Mri Studies ◽  
Radiographic Measurements ◽  
Ethmoidal Artery

Retrobulbar hemorrhage and visual loss are among the most serious complications of endoscopic sinus surgery. To minimize the occurrence of these risks, the surgeon's knowledge of the specific locations of the neurovascular structures is of paramount importance. In this study, the location of the internal carotid artery (ICA), optic nerve, trigeminal nerve, and anterior and posterior ethmoidal arteries were evaluated by cadaver dissection and anatomic and radiographic measurements. Fifty cadavers were studied using endoscopic techniques, calibrated instruments, and photographic documentation. The average distances from the columella to the optic nerve and ICA were 8.31 cm and 8.57 cm respectively. Mean distances to the anterior ethmoidal artery, posterior ethmoidal artery, ostium of the sphenoid, and posterior wall of the sphenoid sinus were also determined. Measurements derived from 50 normal cranial MRI studies yielded similar results. The ICA was clearly identified in 95%, and the optic nerve in 72% of sagittal MRI studies. The interrelationship of the maxillary division of the trigeminal nerve with the lateral sphenoid wall, optic nerve, and carotid artery was also studied. Sagittal section MRI scans were very useful in determining the critical relationships between the optic nerve, carotid artery, and sphenoid sinus. Comparisons and contrasts are made between the usage of CT scans and MRI in the delineation of these structures.

Visual loss in patients with sphenoethmoidal cells

2015 ◽  
Vol 129 (2) ◽  
pp. 198-201 ◽  
Author(s):  
J Rimmer ◽  
T Beale ◽  
V J Lund
Keyword(s):  
Optic Nerve ◽  
Chronic Rhinosinusitis ◽  
Optic Neuropathy ◽  
Sphenoid Sinus ◽  
Visual Loss ◽  
Case Reports ◽  
Sinus Disease ◽  
Close Relationship ◽  
A Cell ◽  
Relationship Of

AbstractBackground:A sphenoethmoidal cell is a posterior ethmoid cell that pneumatises superiorly and/or laterally to the sphenoid sinus. Disease within such a cell may cause visual symptoms because of the close relationship of the optic nerve.Case reports:This paper reports four cases of chronic rhinosinusitis involving a sphenoethmoidal cell, two with visual loss. The management of such cases is discussed and the current literature is reviewed.Conclusion:Pathology within a sphenoethmoidal cell must be considered in cases of optic neuropathy. The presence of these cells may be relevant even in cases of seemingly uncomplicated rhinosinusitis as they are associated with a higher rate of optic nerve protrusion and dehiscence.

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