Endoscopic Study of the Distribution of Olfactory Filaments: A Cadaveric Study

2020 ◽  
pp. 194589242094878
Author(s):  
Roberto M. Soriano ◽  
C. Arturo Solares ◽  
Gustavo Pradilla ◽  
John M. DelGaudio
Keyword(s):  
Skull Base ◽  
Anatomical Study ◽  
Sinus Surgery ◽  
Endoscopic Endonasal ◽  
Superior Turbinate ◽  
Endoscopic Observation ◽  
Defect Repair ◽  
Skull Base Defect ◽  
Student’S T ◽  
Student’S T Test

Objective Provide a detailed anatomical description of the olfactory filaments (OF) and their distribution in the nasal cavity through endoscopic endonasal dissection. Methods Four cadaveric specimens (8 sides) were used in this study. Nasoseptal (NSM), middle (MTM) and superior turbinate (STM) mucosa dissection was performed to identify the OF and follow them superiorly to the cribriform plate (CP). Measurements of the OF were taken on the NSM, MTM, STM under direct endoscopic visualization. A Student’s T-Test was performed to compare means. Results The NSM contained a mean of 11 OF, distributed over surface area (SA) of 173 ± 31 mm2 with the highest density of OF being found at the posterior NSM. The MTM contained a mean 6 OF, covering a mean SA of 77 mm2, with the first OF found 5 mm from the anterior border of the MTM, on average. The STM had a mean 9 OF, with the OF covering a mean SA of 96 mm2. Overall mean OF length was 6 mm. The STM OF were significantly greater in number, with a greater distance from the first OF to last OF (p < 0.05) than the MTM OF. Summary The STM and MTM combined were found to have a greater density of OF than the NSM. The STM contains a significantly greater number of OF covering a greater area than the MTM OF. Preservation of the STM and MTM in skull base defect repair, and in routine sinus surgery, can be as beneficial for olfactory function as preservation of the NSM; particularly in CP defect repair. Moreover, our findings indicate that nasoseptal flap harvest performed at least 6 mm from the skull base preserves OF in the NSM. To our knowledge, this is the first anatomical study of the OF through direct endoscopic observation and measurements.

Endoscopic sinus surgery the art of new era

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Wasam A Albusalih
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Chronic Infection ◽  
Malignant Tumour ◽  
Sinus Surgery ◽  
Skull Base Tumor ◽  
Short Hospital Stay ◽  
Gland Tumor ◽  
New Era ◽  
Skull Base Defect

Endoscopic sinus surgery is one of the fastest technique for treatment of sinonasal diseases which includes acute and chronic infection and resection of benign and malignant tumour; soon it extend for management of more deep area and deal with lesions in the pterygopalatine and infratemporal fossae then extended for management of skull base tumor which include pituitary gland tumor clival tumor and skull base defect leading to csf rhinorrea and its complications…in this lecture i cited the success which achieved in Diwanyia teaching hospital in this growing branch of medicine and illustrate some of my procedures pre and postoperatively with brief discussion for each.Endoscopic sinus surgery and its extended applications now play a major role in management of sinonasal And Skull base diseases with minimum complications and short hospital stay without the need for external devastating approach.

Extended endoscopic endonasal approach to the pterygopalatine fossa: anatomical study and clinical considerations

2005 ◽  
Vol 19 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Luigi M. Cavallo ◽  
Andrea Messina ◽  
Paul Gardner ◽  
Felice Esposito ◽  
Amin B. Kassam ◽  
...  
Keyword(s):  
Skull Base ◽  
Anatomical Study ◽  
Pterygopalatine Fossa ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Anatomical Dissection ◽  
Clinical Considerations ◽  
Functional Surgery ◽  
Safe Approach

Object The pterygopalatine fossa is an area located deep in the skull base. The microsurgical transmaxillary–transantral route is usually chosen to remove lesions in this region. The increasing use of the endoscope in sinonasal functional surgery has more recently led to the advent of the endoscope for the treatment of tumors located in the pterygopalatine fossa as well. Methods An anatomical dissection of three fresh cadaveric heads (six pterygopalatine fossas) and three dried skull base specimens was performed to evaluate the feasibility of the approach and to illustrate the surgical landmarks that are useful for operations in this complex region. The endoscopic endonasal approach allows a wide exposure of the pterygopalatine fossa. Furthermore, with the same access (that is, through the nostril) it is possible to expose regions contiguous with the pterygopalatine fossa, either to visualize more surgical landmarks or to accomplish a better lesion removal. Conclusions In this anatomical study the endoscopic endonasal approach to the pterygopalatine fossa has been found to be a safe approach for the removal of lesions in this region. The approach could be proposed as an alternative to the standard microsurgical transmaxillary–transantral route.

Squamous Metaplasia and Chronic Rhinosinusitis: A Clinicopathological Study

2008 ◽  
Vol 22 (6) ◽  
pp. 602-605 ◽  
Author(s):  
Robert G. Mynatt ◽  
Jennifer Do ◽  
Christine Janney ◽  
Raj Sindwani
Keyword(s):  
Chronic Rhinosinusitis ◽  
Clinical Features ◽  
Chronic Sinusitis ◽  
Squamous Metaplasia ◽  
Sinus Surgery ◽  
Preoperative Ct ◽  
Student’S T ◽  
Pathology Reports ◽  
Clinical Records ◽  
Student’S T Test

Background The significance of squamous metaplasia (SM) in chronic rhinosinusitis (CRS) is unknown. The objectives of this study were to determine the prevalence of SM in histopathological specimens from patients with CRS and to correlate these histological findings with clinical features. Methods We reviewed the clinical records and pathological slides from 87 consecutive patients who underwent endoscopic sinus surgery for CRS. Demographic and clinical data, preoperative Chronic Sinusitis Survey (CSS) scores, and sinus CT stage were evaluated. Pathological slides were graded by a pathologist to characterize the degree of inflammation and SM, when present. CRS patients with and without SM were compared using student's t-test and χ2 test. Results Evaluation of the pathology slides revealed that 18.4% of specimens had SM present, whereas only 2.2% of pathology reports noted this. Histological grading of chronic inflammation showed significantly greater severity in specimens with SM (n = 16) when compared with the cohort without SM (n = 75; 100.0% versus 77.5%, respectively; p = 0.016). There was no difference in preoperative CT stage or the presence of hyperostosis on imaging, CSS scores, duration of CRS symptoms, or other clinical features between those with SM and those without SM (p > 0.05). Immunodeficiency was the only comorbidity more prevalent in the metaplastic group (12.5% versus 0%, respectively; p = 0.003). Conclusion SM is present in ∼18% of routine CRS specimens. It has a positive correlation with the severity of inflammation noted histologically in CRS but does not correlate with disease severity or chronicity, clinically.

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 Differential Diagnosis of Pneumonia as a Complication of Nasal Liquorrhea in the Context of the COVID-19 Pandemic

2021 ◽  
Vol 11 (6) ◽  
pp. 472-480
Author(s):  
E. V. Shelesko ◽  
O. E. Sharipov ◽  
N. A. Chernikova ◽  
O. N. Ershova ◽  
P. L. Kalinin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Rna Virus ◽  
Endoscopic Endonasal ◽  
Skull Base Defect ◽  
Coronavirus Infection ◽  
Polymerase Chain ◽  
Tomography Scan ◽  
Frosted Glass

Nasal liquorrhea — the outflow of cerebrospinal fluid from the cerebrospinal fluid spaces of the cranial cavity into the nasal cavity or paranasal sinuses due to the presence of a congenital or acquired defect in the bones of the skull base and meninges of various etiologies. Nasal liquorrhea leads to potentially fatal complications: meningitis, meningoencephalitis, pneumocephalus, brain abscess. Also, with nasal liquorrhea, less dangerous complications may occur: aspiration bronchopneumonia and gastritis. The article presents a case of aspiration pneumonitis in two patients with nasal liquorrhea treated at the N.N. N.N. Burdenko during the COVID-19 pandemic. Both patients noted the profuse nature of the nasal liquorrhea, complained of coughing in a horizontal position. In both cases, no RNA virus (SARS-CoV-2) was detected during the polymerase chain reaction. Antibodies (IgG, IgM) to coronavirus were not detected. Computed tomography of the chest organs in both cases revealed areas of frosted glass darkening. Since no data was obtained for coronavirus infection (negative tests for coronavirus, lack of antibodies), changes in the lungs were interpreted as a consequence of constant aspiration of cerebrospinal fluid. The patients were admitted to a separate ward. Both patients underwent endoscopic endonasal plasty of the skull base defect. The postoperative period in both cases was uneventful. In both cases, the patients underwent computed tomography scan of the chest organs one month later. On the photographs, the signs of pneumontis completely regressed.

Recovery peculiarities and complications in the nasal cavity caused by skull base reconstruction with nasoseptal flap after transnasal removal of chiasmo-sellar mass lesions

2021 ◽  
pp. 36-44
Author(s):  
Svetlana Dmitrievna Nikonova ◽  
Maksim Aleksandrovich Kutin ◽  
Elizaveta Vladimirovna Shelesko ◽  
Pavel Lvovich Kalinin ◽  
Nadezhda Alekseevna Chernikova ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Low Frequency ◽  
Cerebrospinal Fluid Leak ◽  
Nasoseptal Flap ◽  
Endoscopic Endonasal ◽  
Skull Base Reconstruction ◽  
Pubmed Database ◽  
Skull Base Defect

Today, endoscopic endonasal approach is considered the gold standard in skull base surgery of the chiasmosellar region. Advances in transnasal endoscopic skull base surgery allow conducting more extensive interventions via wider approaches which requires more complicated plastic closure of the skull base defect. In 2006, G. Haddad et al. suggested using a vascularized nasoseptal flap to reconstruct a skull base defect. This method is generally accepted at present due to its reliability and low frequency of postoperative complications. The purpose of this article is to analyze publications on possible complications and pathological conditions of the nasal cavity when using a vascularized nasoseptal flap for skull base surgery after removal of neoplasms of the chiasmo-sellar region. The study included articles found in the Pubmed database (2006–2020) which described frequency and character of complications caused by skull base defect reconstruction by a nasoseptal flap after transnasal removal of chiasmo-sellar neoplasms. According to the literature review, the following complications are reported: cerebrospinal fluid leak, flap necrosis and infectious complications, pathological changes in the nasal cavity: prolonged crusting, synechiae, epistaxis, septum perforation, sinusitis, subatrophic changes of mucosae, nasolacrimal duct obstruction, olfactory dysfunction. The authors conclude that the nasoseptal flap is, undoubtedly, an effective material for reconstruction of dural defects by endoscopic endonasal skull base surgery, because of its good viability due to the preserved blood supply and high tightness of the plasty. However, there is a risk of complications in the nasal cavity. For these reasons, development of effective methods for prevention of nasal complications after using a vascularized flap in endoscopic endonasal surgery is an important issue today.

Sign in / Sign up

Export Citation Format

Share Document