Quantifying Lateral Frontal Sinus Access: The Upper Blepharoplasty Approach

2018 ◽  
Vol 127 (3) ◽  
pp. 155-161 ◽  
Author(s):  
Toby O. Steele ◽  
Oliver Y. Chin ◽  
Michael R. Kinzinger ◽  
E. Bradley Strong
Keyword(s):  
Frontal Sinus ◽  
Neurovascular Bundle ◽  
Combined Approach ◽  
Frontal Sinuses ◽  
Upper Blepharoplasty

Objective: Despite advances in technology and instrumentation, access to the lateral frontal sinus remains a challenge for surgeons. We sought to quantify the reach and applicability of the upper blepharoplasty approach (UBA) to the frontal sinus. Methods: Twelve cadaveric specimens were obtained for anatomic research and frontal sinuses divided into 3 zones. Zone 1 was defined as medial to the supraorbital neurovascular bundle (SON). The remaining orbit was then bisected to define zone 2 (centrally) and zone 3 (laterally). Twenty-four UBAs were performed followed by 12 modified endoscopic Lothrop procedures (MELP). The ability to instrument each wall of the frontal sinus was recorded for the MELP, UBA, and combined approach. Results: The UBA provided excellent access to the lateral frontal sinus in zones 2 and 3 (89% and 100%). The MELP provided poorer access in zone 3 (67%) but improved access in zone 1 (83%-100%). Access for zone 1 through the UBA was limited. The combined approach yielded 100% access to each frontal sinus boundary. Conclusion: The MELP in combination with the UBA/lateral trephination provides excellent access to each frontal sinus boundary. The UBA provides excellent access to the lateral frontal sinus but is limited medially by the SON.

Malignant melanoma arising in the frontal sinuses

1997 ◽  
Vol 111 (4) ◽  
pp. 376-378 ◽  
Author(s):  
Samuel M. Jayaraj ◽  
Jonathan D. Hern ◽  
George Mochloulis ◽  
Graham C. Porter
Keyword(s):  
Malignant Melanoma ◽  
Natural History ◽  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Poor Prognosis ◽  
Review Of The Literature ◽  
History Of ◽  
Frontal Sinuses ◽  
Sinonasal Malignant Melanoma

AbstractSinonasal malignant melanoma is rare and usually occurs in the nasal cavity. Presentation is often varied and occurs late in the natural history of the disease, resulting in a poor prognosis. A case is reported of a patient with malignant melanoma arising from the frontal sinus who presented with a forehead swelling and progressive confusion. A review of the literature on malignant melanoma in the nasal cavity and paranasal sinuses regarding its presentation, site of origin and principles of management is discussed.

Intrusion of an incisor tooth into the contralateral frontal sinus following trauma

1993 ◽  
Vol 107 (3) ◽  
pp. 240-241 ◽  
Author(s):  
Akira Hara ◽  
Jun Kusakari ◽  
Akira Shinohara ◽  
Yuzo Yamada ◽  
Naoaki Sato
Keyword(s):  
Ct Scan ◽  
Frontal Sinus ◽  
Traffic Accidents ◽  
Facial Trauma ◽  
Skin Damage ◽  
Incisor Tooth ◽  
Upper Face ◽  
Frontal Sinuses ◽  
Missing Tooth

Although intrusions of glass fragments into the frontal sinuses are not uncommon in traffic accidents, a case with a tooth in the frontal sinus has never been reported. We report a patient with traumatic inclusion of an incisor tooth in the contralateral frontal sinus. Radiographic investigations demonstrated the tooth in the frontal sinus though no skin damage was recognized on the upper face. The usefulness of CT scan in localizing the missing tooth after facial trauma and its route of entry into the contralateral frontal sinus is discussed.

Frontal Sinus Outflow Anatomy

1997 ◽  
Vol 11 (4) ◽  
pp. 283-286 ◽  
Author(s):  
Dennis Lee ◽  
Robin Brody ◽  
Gady Har-El
Keyword(s):  
20Th Century ◽  
Frontal Sinus ◽  
Average Distance ◽  
Uncinate Process ◽  
Outflow Tract ◽  
Early 20Th Century ◽  
Drainage Patterns ◽  
Nasal Floor ◽  
Frontal Sinuses ◽  
Pyriform Aperture

Most of the studies of frontal sinus anatomy were completed 50 to 70 years ago. The information they provide is not necessarily relevant or helpful to the modem rhinologic surgeon who approaches the frontal sinus transnasally and endoscopically. We performed anatomical dissections of the outflow tract of 82 frontal sinuses in 41 cadaver heads to illustrate the various drainage patterns from the frontal sinus to the nose and to correlate these drainage sites with the distance and angle from the pyriform aperture. We found that the frontal sinus drained anterior to the uncinate process in 24 specimens (29.3%) with an average distance of 3.65 cm from the pyriform aperture and 58° from the nasal floor. The frontal sinus drained posterior to the uncinate process in 56 specimens (68.3%) with an average distance of 4.10 cm and 65 degrees from the nasal floor. In this latter group, most of the sinuses (51 specimens) drained into the ethmoid infundibulum. Two of the specimens had a hypoplastic frontal sinus with no outflow tract at all. These findings are different from those described in the early 20th century.

scholarly journals Bilateral Absence of Frontal Sinus and Unilateral Mandibular Hypoplasia – A Case report

2015 ◽  
Vol 5 (1) ◽  
pp. 29-32
Author(s):  
Roopika Handa ◽  
Soheyl Sheikh ◽  
P Shambulingappa ◽  
Amit Aggarwal ◽  
Ravinder Singh ◽  
...  
Keyword(s):  
Frontal Sinus ◽  
Treatment Options ◽  
East Asian ◽  
Cold Climate ◽  
Indian Woman ◽  
Warm Climate ◽  
Mandibular Hypoplasia ◽  
Bilateral Absence ◽  
Frontal Sinuses ◽  
Research And Education

Absence of frontal sinus is usually associated with various syndromes such as craniosynostosis, osteodysplasia, down syndrome etc. Geographically, absence of frontal sinus is seen usually in areas with cold climate. This paper reports a case of 18-year old Indian woman suffering from bilateral absence of frontal sinuses which was non-syndromic in conjunction with unilateral mandibular hypoplasia. The paper also highlights the clinical significance of frontal sinus which was non-syndromic absence and its rarity in warm climate such as in South East Asian regions and the treatment options of unilateral mandibular hypoplasia. DOI: http://dx.doi.org/10.3329/bjdre.v5i1.22459 Bangladesh Journal of Dental Research and Education Vol.5(1) 2015: 29-32

scholarly journals Comparison between three techniques for videosinuscopy in cattle

2016 ◽  
Vol 46 (7) ◽  
pp. 1262-1267 ◽  
Author(s):  
Fernando Zanlorenzi Basso ◽  
Eduarda Maciel Busato ◽  
Jéssica Rodrigues da Silva ◽  
Rogério Luizari Guedes ◽  
Ivan Roque de Barros Filho ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Maxillary Sinus ◽  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Surgical Approaches ◽  
Endoscopic Anatomy ◽  
Flexible Colonoscope ◽  
Frontal Sinuses ◽  
Made In

ABSTRACT: Cattle have extensive paranasal sinuses that are susceptible to disease, most commonly sinusitis. The sinuscopy can be used to evaluate these structures, although there are no descriptions of this region for endoscopic anatomy, especially regarding the trocar position and the most appropriate type of endoscope. This study aimed to standardize the surgical approaches to sinuscopy in cattle by comparing the use of three endoscopes. Four accesses by trephination (one hole for each of the maxillary and frontal sinuses) were made in eight heads of slaughtered cattle. Each hole was inspected with three endoscopes: a 10mm flexible colonoscope with up to 180º of angulation, a 10mm 0° laparoscope and a 4mm 30º arthroscope. It was observed that all regions of the maxillary sinus were better visualized with the 4mm endoscope, and the structures of this sinus were less well visualized with the 10mm laparoscope. The frontal sinus was difficult to evaluate due to the tortuosity of its bony projections, and the cranial portion was not observed by the proposed accesses. The caudal regions of the frontal sinus such as the nuchal diverticulum and the back of the orbit had the greatest number of structures visualized by the 4mm endoscope, followed by the colonoscope. The comparative analysis showed that the 4mm endoscope was most efficient and could be adapted to sinuscopy in cattle.

The Horizon Sign and Frontal Bar: Two Topographic Landmarks to Confirm Endoscopic Frontal Sinusotomy

2019 ◽  
Vol 160 (4) ◽  
pp. 740-743
Author(s):  
Evan S. Walgama ◽  
Andrew Thamboo ◽  
Navarat Tangbumrungtham ◽  
Noel Ayoub ◽  
Zara M. Patel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Case Series ◽  
Acute Angle ◽  
Sinus Surgery ◽  
Consecutive Case ◽  
Landmark Identification ◽  
Frontal Sinuses ◽  
Anterior Posterior

Confirming a thorough dissection of the frontal sinus during endoscopic sinus surgery can be challenging, and some surgeons would benefit from reliable topographic landmark identification to ensure completion of this sinus dissection. We defined (1) the “horizon sign” as the curvilinear shadow of the posterior table cast superiorly upon the anterior table of the frontal sinus at the acute angle of their meeting point and (2) the “frontal bar” as a sagittal septation at the union of the anterior/posterior tables. A cadaveric study, followed by an intraoperative consecutive case series, was performed to evaluate these 2 landmarks as indicators of complete dissection. The horizon sign was extremely reliable, identified in 100% of cadaveric frontal sinuses and intraoperative frontal sinuses. The frontal bar was present in only 67% of frontal sinuses by computed tomography. In live patients, the sensitivity and specificity of the frontal bar were 62% and 95%, respectively.

scholarly journals Overview of the frontal sinus anteroposterior size based on against lateral cephalometric radiographs chronological age as forensic identification

2017 ◽  
Vol 29 (2) ◽  
Author(s):  
Georgiana Marsya ◽  
Inne Suherna Sasmita ◽  
Fahmi Oscandar
Keyword(s):  
Frontal Sinus ◽  
Secondary Data ◽  
Forensic Identification ◽  
Individual Identification ◽  
Chronological Age ◽  
Identification Procedure ◽  
Identification Methods ◽  
Male Patients ◽  
Frontal Sinuses ◽  
Average Size

Introduction: One part of the most important individual identification procedure is approximate age can be done on an individual living or dead. Judging from some of the methods that have been there, have not found a method forecasts age through the frontal sinuses, particularly research conducted in Indonesia. The frontal sinus can be used for identification because the frontal sinuses began to evolve and look at radiographs at the age of 7 years and did not change after the age of 20 years, it reveals the existence of differences in the size of the frontal sinuses with age. Objective: To asses of the frontal sinus anteroposterior size based on against lateral cephalometric radiographs chronological age as forensic identification. Methods: A number of samples are 502 lateral cephalometric patient data from secondary data of patients aged 7-20 years, 335 pieces of lateral cephalometric. Purpose of of the study was to asses the frontal sinus anteroposterior size chronological age as forensic identification. Radiograph female patients and 167 pieces in male patients. Data anteroposterior size of the frontal sinus is obtained by pulling the longest line perpendicular to the line of Sh-Sl. Results: The results showed that at the age of 7 years the average size of the frontal sinus anteroposterior 4.20 mm and 5.05 mm which is the smallest size, while the average size of the biggest, by 8.46 mm in women and men at the age of 11.37 mm 20 years. Conclusions: In women, the fastest increase occurred at the age of 7-8 years, males at the age of 16-18 years. The frontal sinuses anteroposterior size increases with age, both men and women.

scholarly journals ANATOMICAL PREDICTIONS OF DEVELOPMENT OF RHINOSINUSITIS AND ITS COMPLICATIONS

2020 ◽  
Vol 7 (3) ◽  
pp. 125-130
Author(s):  
Victoriia Alekseeva
Keyword(s):  
Surgical Treatment ◽  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Posterior Wall ◽  
Maximum Density ◽  
Anatomical Structure ◽  
Lower Wall ◽  
Physiological Conditions ◽  
Orbital Wall ◽  
Frontal Sinuses

Background. The anatomical structure of the paranasal sinuses of a person predetermines the risk of development, diversity of presentation, possibility of complications and features of surgical treatment of rhinosinusitis. Objective: of our study was to determine the thickness and density of the walls of the maxillary and frontal sinuses, which are potentially dangerous in terms of the development of complications. Materials and methods: Our study involved 121 subjects without any ENT diseases, who underwent SCT examination due to the reasons that were not related to abnormalities of ENT organs. Thickness  and density in the region of the lower (orbital) wall and posterior (cerebral) wall of the frontal sinus were calculated. Results and Discussion: The  maximum density was characteristic of the lower wall of the frontal sinus under physiological conditions and appeared 107.96 ± 201.64 Hu, the minimum for the lower wall was -29.98 ± 208.54 Hu. The thickness of the bone tissue in the frontal sinus was 4.05 ± 2.04 mm. Conclusion: The minimum density and thickness of the lower and posterior walls of the frontal sinus and upper and lower walls of the maxillary sinus was established under physiological conditions. The density of the posterior wall was found to be 25.4% lower than the density of the lower wall, and the thickness 22.2% lower.

Combined Endoscopic Trephination and Endoscopic Frontal Sinusotomy for Management of Complex Frontal Sinus Pathology

2005 ◽  
Vol 19 (5) ◽  
pp. 435-441 ◽  
Author(s):  
Pete S. Batra ◽  
Martin J. Citardi ◽  
Donald C. Lanza
Keyword(s):  
Frontal Sinus ◽  
Demographic Data ◽  
Symptom Relief ◽  
Subjective Symptom ◽  
Sinus Surgery ◽  
Combined Approach ◽  
Sinus Disease ◽  
Endoscopic Techniques ◽  
Difficult Cases

Background The advances in endoscopic sinus surgery have revolutionized the management of frontal sinus disease. Despite the successes, the purely endoscopic approach has its limitations, especially in patients with alterations in anatomy caused by previous surgical intervention or complex frontal sinus pneumatization patterns. The purpose of this study was to evaluate the efficacy of combined endoscopic trephination and endoscopic frontal sinusotomy (the above and below approach) in the management of these difficult cases. Methods Chart review was performed on patients undergoing the combined approach from October 1999 to June 2004. Demographic data, symptomatology, comorbidity, previous surgery, and primary pathology were determined. Outcome was assessed based on subjective symptom relief and objective endoscopic patency. Results Twenty-two patients with a mean age of 49.2 years underwent the combined approach. The primary pathology included mucoceles (15 patients), frontal sinusitis (2 patients), inverted papilloma (2 patients), osteoma (1 patient), fibrous dysplasia (1 patient), and pneumocephalus (1 patient). A total of 25 above and below procedures (22 primary and 3 revision procedures) were performed to manage the pathology. Postoperatively, headaches resolved in 47%, improved in 35%, and remained unchanged in 18% of the patients. Orbital symptoms resolved in 63%, improved in 25%, and remained unchanged in 12% of the patients. Endoscopic patency of the frontal sinusotomy was confirmed in 19 of 22 cases (86%) at a mean follow-up of 16.2 months. Conclusion Management of complex frontal sinus pathology may require adjunct approaches in conjunction to the standard endoscopic techniques. In this series, the above and below approach was used successfully in 22 patients. The combined approach may serve as an important adjunct for management of complex frontal sinus disease.

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