scholarly journals The Whole Lateral Type of the Sphenoethmoidal Cell and Its Relevance to Endoscopic Sinus Surgery

2020 ◽  
pp. 014556132092211
Author(s):  
Jinfeng Liu ◽  
Jingjing Yuan ◽  
Jinsheng Dai ◽  
Ningyu Wang
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Sphenoid Sinus ◽  
Sinus Surgery ◽  
Great Similarity ◽  
Maxillary Nerve ◽  
Imaging Characteristics ◽  
Anatomical Imaging ◽  
Onodi Cell ◽  
Paranasal Sinus Computed Tomography

Background: The sphenoethmoidal cell and the sphenoid sinus (SS) show great similarity in endoscopy and imaging. Hence, it is important to accurately identify the sphenoethmoidal cell preoperatively to prevent injury of the nerve and artery during endoscopic surgery. The aim of the present study was to investigate a special type of sphenoethmoidal cell. Methods: A total of 365 inpatients whose paranasal sinus computed tomography (CT) was collected and reviewed from May 2018 to September 2019 were included. The anatomical imaging characteristics of the sphenoethmoidal cell were observed. Results: A special type of the sphenoethmoidal cell was found on 9 sides in 730 sides (1.3%), according to its extension to the SS. Unlike Onodi cell (49.6%) and Jinfeng cell (1.3%), this cell simultaneously extends toward the superolateral, lateral, and inferolateral regions of the SS and is simultaneously closely attached to the optic canal and the maxillary nerve. Presently, this cell is named as the whole lateral type of the sphenoethmoidal cell, and the SS is located at the medial or inferomedial of it. Conclusions: When evaluating the paranasal sinus CT preoperatively, attention must be paid to the possibility of the whole lateral type of sphenoethmoidal cell appearing, not just Onodi cell, extending into the SS.

Paranasal sinus computed tomography anatomy: a surgeon's perspective

2011 ◽  
Vol 125 (11) ◽  
pp. 1141-1147 ◽  
Author(s):  
Y Ramakrishnan ◽  
I Zammit-Maempel ◽  
N S Jones ◽  
S Carrie
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Operative Management ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Systematic Evaluation ◽  
Assessment Technique ◽  
Radiological Features ◽  
Computed Tomography Scans ◽  
Paranasal Sinus Computed Tomography

AbstractComputed tomography scans serve as a critical ‘roadmap’ for functional endoscopic sinus surgery. A systematic evaluation of such scans, and an awareness of any anatomical variants that may modify one's surgical approach, allow one to pre-empt complications. This article describes, from a novice's perspective, two methods of evaluating paranasal sinus computed tomography scans: a quick assessment technique; and a step-wise, operative approach covering radiological features relevant to pre- and peri-operative management.

scholarly journals Anatomical variations of sphenoid sinus among patients undergoing computed tomography of paranasal sinus

2019 ◽  
Vol 5 (4) ◽  
pp. 888 ◽  
Author(s):  
Bhanu Pratap Singh ◽  
Rajendra Basayya Metgudmath ◽  
Divya Singh ◽  
Udit Saxena
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Paranasal Sinus ◽  
Sphenoid Sinus ◽  
Internal Carotid ◽  
Three Dimensional ◽  
Maxillary Nerve ◽  
Vidian Nerve

<p class="abstract"><strong>Background:</strong> The approach to sphenoid sinus still remains a clinical challenge, despite the arrival of endoscopy, computed tomography (CT) and functional endoscopic sinus surgery (FESS). The complex and variable anatomy of the sphenoid sinus can be difficult to appreciate with standard axial or coronal CT images of the sinus. The study was done with the objective to study the anatomy of the sphenoid sinus and its variations, and to compare the prevalence of variants obtained in our study with the reported cases in the literature.</p><p class="abstract"><strong>Methods:</strong> The CT scans of 168 normal slides obtained from 84 patients with paranasal sinus were analysed using triplanar imaging provided by 64-slice spiral CT. The prevalence of each of the sphenoid sinus variation was also analysed.  </p><p class="abstract"><strong>Results:</strong> Results showed that the prevalence of pneumatization of the anterior clinoid process, greater wing of the sphenoid, and the pterygoid process was 17.85%, 22.61% and 32.14%, respectively. Protrusion of the internal carotid artery, optic nerve, maxillary nerve, and the vidian nerve was 47.61%, 36.90%, 25% and 26.19%, respectively. Dehiscence of internal carotid artery, optic nerve, maxillary nerve, and the vidian nerve was 30.95%, 29.76%, 14.28% and 22.61%, respectively. The prevalence of pneumatization in the Onodi cells was seen in 17.85% of the cases. Association of septa with an internal carotid artery was seen in 29.7% of the cases. Septa attachment to the optic nerve was also observed in 27.3% of the cases.</p><p class="abstract"><strong>Conclusions:</strong> The triplanar imaging (section thickness of 1 mm) is a better three-dimensional image of the sphenoid sinus, compared to coronal imaging. Triplanar imaging guides the surgical approach of the sphenoid sinus with mentally reconstructed three-dimensional images.</p><p class="abstract"> </p>

Indolent mucormycosis of the paranasal sinus in immunocompetent patients: are antifungal drugs needed?

2013 ◽  
Vol 127 (9) ◽  
pp. 872-875 ◽  
Author(s):  
H Jung ◽  
S K Park
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Endoscopic Sinus Surgery ◽  
Clinical Symptoms ◽  
Antifungal Drugs ◽  
Sinus Surgery ◽  
Bony Destruction ◽  
Immunocompetent Patients ◽  
Paranasal Sinus Computed Tomography

AbstractObjective:To report the clinical characteristics and treatment outcomes of indolent paranasal mucormycosis in immunocompetent individuals.Materials and methods:A retrospective review of four immunocompetent patients with indolent mucormycosis of the paranasal sinus managed by endoscopic sinus surgery only was performed. One year of regular follow up comprised angled endoscopy and repeated paranasal sinus computed tomography three months after surgery.Results:Clinical symptoms were non-specific. Pre-operative paranasal sinus computed tomography showed opacification of the unilateral maxillary sinus with focal calcification but without bony destruction or extension to the orbit or cranium. All patients underwent endoscopic sinus surgery without administration of antifungal agents. There was no recurrence on regular clinical and radiological follow up.Conclusion:For indolent paranasal mucormycosis in immunocompetent patients, endoscopic sinus surgery can be the treatment of choice, and the administration of antifungal drugs may not be necessary.

scholarly journals Inter-observer agreement of paranasal sinus computed tomography scans

2016 ◽  
Vol 137 (6) ◽  
pp. 611-617 ◽  
Author(s):  
Anna Julkunen ◽  
Emma Terna ◽  
Jura Numminen ◽  
Antti Markkola ◽  
Prasun Dastidar ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinus ◽  
Observer Agreement ◽  
Computed Tomography Scans ◽  
Paranasal Sinus Computed Tomography

Sphenoid sinus mucocele: 10 cases and literature review

2009 ◽  
Vol 124 (1) ◽  
pp. 44-47 ◽  
Author(s):  
S R Soon ◽  
C M Lim ◽  
H Singh ◽  
D S Sethi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Resonance Imaging ◽  
Presenting Symptoms ◽  
Singapore General Hospital

AbstractIntroduction:Sphenoid sinus mucoceles represent only 1–2 per cent of all paranasal sinus mucoceles. Patients may present with a myriad of symptoms. Pre-operative investigations include nasoendoscopy, computed tomography and/or magnetic resonance imaging. Treatment is by endoscopic sinus surgery.Methodology:A retrospective review of the archives of the Singapore General Hospital otolaryngology department (1999–2006) identified 10 cases of sphenoid sinus mucocele. Patient demographics, presenting symptoms, investigations and treatment were evaluated.Results:The 10 patients identified (three women and seven men) had a mean age of 54.5 years (range 24–70 years). Thirty per cent of patients had a history of nasopharyngeal carcinoma treated with radiotherapy. Presenting symptoms, in order of decreasing frequency, were: ocular symptoms (50 per cent), headaches (30 per cent), nasal discharge (30 per cent) and facial pain (10 per cent). All patients underwent pre-operative computed tomography or magnetic resonance imaging. Twenty per cent of patients had evidence of intracranial involvement on imaging. All patients underwent uncomplicated transnasal sphenoidotomy and drainage of the mucocele. There was no clinical or radiological evidence of recurrence at a mean follow up of 29 months (range 4–90 months).Conclusion:Sphenoid sinus mucocele is a rare condition. In this study, radiation to the head and neck appeared to be a predisposing factor, and eye symptoms were the commonest presentation. Endoscopic sinus surgery is a safe and effective treatment modality.

scholarly journals A 16-Year Study on Incidence and Progression of Diseased Sphenoethmoidal (Onodi) Cell

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ethan I. Huang ◽  
Chia-Ling Kuo ◽  
Li-Wen Lee
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
Acute Visual Loss ◽  
Computed Tomography Images ◽  
Onodi Cell

Traumatic operative injury of the optic nerve in an endoscopic sinus surgery may cause immediate or delayed blindness. It should be cautioned when operating in a sphenoethmoidal cell, or known as Onodi cell, with contact or bulge of the optic canal. It remains unclear how frequent progression to visual loss occurs and how long it progresses to visual loss because of a diseased sphenoethmoidal cell. Research to discuss these questions is expected to help decision making to treat diseased sphenoethmoidal cells. From July 2001 to June 2017, 216 patients received conservative endoscopic sinus surgery without opening a diseased sphenoethmoidal cell. We used their computed tomography images of paranasal sinuses to identify diseased sphenoethmoidal cells that could be associated with progression to visual loss. Among the 216 patients, 52.3% had at least one sphenoethmoidal cell, and 14.8% developed at least one diseased sphenoethmoidal cell. One patient developed acute visual loss 4412 days after the first computed tomography. Our results show that over half of the patients have a sphenoethmoidal cell but suggest a rare incidence of a diseased sphenoethmoidal cell progressing to visual loss during the follow-up period.

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