Bilateral Choanal Atresia Associated with Malformation of the Anterior Skull Base: Embryogenesis and Clinical Implications

1992 ◽  
Vol 101 (11) ◽  
pp. 916-919 ◽  
Author(s):  
Michael E. Dunham ◽  
Robert P. Miller
Keyword(s):  
Skull Base ◽  
Choanal Atresia ◽  
Three Dimensional ◽  
Anterior Skull Base ◽  
Preoperative Imaging ◽  
Clinical Implications ◽  
High Resolution Computed Tomography ◽  
Ethmoid Bone ◽  
Intracranial Complications ◽  
Skull Base Defect

A number of craniofacial and systemic malformations have been described in association with choanal atresia. We report a case of bilateral choanal atresia associated with congenital absence of the cribriform plate, crista galli, and perpendicular plate of the ethmoid bone. The anterior skull base defect was detected by using high-resolution computed tomography with three-dimensional reconstructions. The findings support the mesodermal flow theory of choanal atresia, in which there is excess migration of neural crest cells into the developing nasal septum and posterior choanae. This occurs at the expense of cells that would otherwise form the rest of the ethmoid complex. Clinical implications include the need for adequate preoperative imaging of the anterior skull base and consideration of potential intracranial complications during surgical repair.

scholarly journals Postoperative Cerebrospinal Fluid Leak after Septoplasty: A Potential Complication of Occult Anterior Skull Base Encephalocele

2013 ◽  
Vol 4 (1) ◽  
pp. ar.2013.4.0043 ◽  
Author(s):  
Resha S. Soni ◽  
Osamah J. Choudhry ◽  
James K. Liu ◽  
Jean Anderson Eloy
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Cerebrospinal Fluid Leak ◽  
Anterior Skull Base ◽  
Intracranial Abscess ◽  
Ethmoid Bone ◽  
Csf Rhinorrhea ◽  
Csf Leakage ◽  
Skull Base Defect ◽  
Fluid Leak

Postoperative cerebrospinal fluid (CSF) rhinorrhea after septoplasty is a known entity resulting from errors in surgical technique and improper handling of the perpendicular plate of the ethmoid bone. When these occur, urgent management is necessary to prevent deleterious sequelae such as meningitis, intracranial abscess, and pneumocephalus. Encephaloceles are rare occurrences characterized by herniation of intracranial contents through a skull base defect that can predispose patients to CSF rhinorrhea. In this report, we present a case of CSF rhinorrhea occurring 2 weeks after septoplasty likely from manipulation of an occult anterior skull base encephalocele. To our knowledge, no previous similar case has been reported in the literature. Otolaryngologists should be aware of the possibility of occult encephaloceles while performing septoplasties because minimal manipulation of these entities may potentially result in postoperative CSF leakage.

Reconstruction of a large anterior skull base defect with a multilayer graft augmented by a vascularized flap: A technical note

2021 ◽  
Vol 7 (3) ◽  
pp. 1-8
Author(s):  
Ahmed Monib ◽  
Ahmed Ibrahim ◽  
Aly Abd el-Hakeem ◽  
Ahmed Sholkamy Diab ◽  
Mohammed Ragaae
Keyword(s):  
Skull Base ◽  
Technical Note ◽  
Anterior Skull Base ◽  
Skull Base Defect

Huge Anterior Skull Base Defect Reconstruction on Communicating Between Cranium and Nasal Cavity

2020 ◽  
Vol 31 (2) ◽  
pp. 436-439
Author(s):  
Dongwoo Shin ◽  
Chae Eun Yang ◽  
Yong Ook Kim ◽  
Jong Won Hong ◽  
Won Jai Lee ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Skull Base ◽  
Anterior Skull Base ◽  
Defect Reconstruction ◽  
Skull Base Defect

A safer transnasal technique for the management of bilateral choanal atresia

1991 ◽  
Vol 105 (12) ◽  
pp. 1004-1005 ◽  
Author(s):  
Bharath Singh
Keyword(s):  
Skull Base ◽  
Choanal Atresia ◽  
The Other ◽  
Csf Leak ◽  
Anatomical Site ◽  
Base Damage ◽  
Entire Field ◽  
Field Of Vision ◽  
Intracranial Complications ◽  
The Right

AbstractA study was undertaken on a 3.2 kilogram fresh stillborn neonate, to determine ways and means of preventing damage to the skull base.Gruber and Rosen aural specula were inserted separately into the right nostril, to determine the degree of exposure of the choana with each. The position of the surgeon was varied (septoplasty versus tonsillectomy position), to determine on which anatomical site of the choana the surgeon's field of vision was focused.The Gruber aural speculum, gave a completely, uninterrupted view of the choana.In the tonsillectomy position, the entire field of vision was focused on the choana itself, whilst in the septoplasty position, one half was focused on the choana and the other half on the roof. Since the roof is part of the skill base, damage to this area can result in serious intracranial complications, such as CSF leak and meningitis.These complications can be avoided if the surgeon uses the Gruber aural speculum for exposure and operates from a tonsillectomy position.

scholarly journals Application of hybrid cranioendoscopic approaches in anterior skull base surgery

2020 ◽  
Vol 2 (2) ◽  
pp. V5
Author(s):  
Evan Joyce ◽  
Michael Karsy ◽  
Serge Makarenko ◽  
Gretchen M. Oakley ◽  
William T. Couldwell
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Surgical Techniques ◽  
Anterior Skull Base ◽  
Endoscopic Endonasal ◽  
Link Type ◽  
Skull Base Defect ◽  
Base Lesion

Anterior skull base approaches have included endoscopic or open microsurgical approaches for intracranial pathologies. However, discussion of a combined hybrid, cranioendoscopic approach, leveraging the benefits of both techniques, has been limited. Here we describe a case of a combined endoscopic, endonasal, and open microsurgical frontotemporal approach for resection of a complex anterior skull base lesion. A 62-year-old man with a large meningioma extending intradurally through the cribiform plate and sphenoethmoidal sinuses underwent a cranioendoscopic resection. Surgical techniques, including repair of the anterior skull base defect as well as complication avoidance and the coordination of multiple surgeons, are discussed.The video can be found here: https://youtu.be/Ti9tUUdWgJc.

scholarly journals USE OF THREE-DIMENSIONAL ENDOSCOPY IN ENDONASAL AND ANTERIOR SKULL BASE SURGERY

2021 ◽  
Author(s):  
Amr Kholief ◽  
Ahmed Youseef ◽  
Ahmed Ibrahim ◽  
Samy Elwany ◽  
Shahz Ahmed
Keyword(s):  
Clinical Study ◽  
Skull Base ◽  
Surgical Procedures ◽  
Skull Base Surgery ◽  
Intraoperative Complications ◽  
Three Dimensional ◽  
Anterior Skull Base ◽  
Anatomical Landmarks ◽  
Intraoperative Complication ◽  
3D Endoscope

Objectives: The three dimensional (3D) endoscope is considered as a new surgical tool which used in different approaches in intranasal and anterior skull base surgical procedures. There are many advantages of the 3D endoscopy over the two dimensional (2D) one that have been demonstrated along clinical applications, surgical training and different experimental studies. Our study aimed to show the difference between using the 3D & 2D endoscopes during endonasal and anterior skull base surgery and its importance specially when used by novice users. Design: Our study is divided into two phases (clinical & cadaveric phases).In the clinical study we have done 52 endonasal & anterior skull base surgical procedures (26 study cases and 26 control cases).We recorded accuracy, duration and intraoperative complication for each case. The cadaveric study was performed on three cadavers, difference in accuracy and dissection time were recorded using 3D & 2D endoscopy for each side chosen by randomization. Results: In the clinical study, the cases done by 3D endoscope were significantly faster and more accurate with less intraoperative complications compared to cases done using 2D endoscope. In cadaveric dissection while using 3D endoscope there was better depth of perception regarding the anatomical landmarks compared to 2D endoscope. Conclusion: 3D endoscopy is an advanced instrument that allows better training for the coming generation of ENT surgeons. Both clinical and cadaveric studies offer a promising outcomes in both endonasal and anterior skull base surgery.

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