scholarly journals Comparison between the draf IIc and standard draf IIb procedure for frontal sinus drainage: single center experience and comparison of outcomes

2020 ◽  
Vol 12 (5) ◽  
pp. 167-170
Author(s):  
Aigerim Kvarantan ◽  
Gorazd Poje ◽  
Livije Kalogjera
Keyword(s):  
Frontal Sinus ◽  
Chronic Sinusitis ◽  
Postoperative Recovery ◽  
Treatment Results ◽  
Related Data ◽  
Single Center Experience ◽  
Uneventful Postoperative Recovery ◽  
Sinus Drainage ◽  
Frontal Sinuses

Aims: Inadequate surgical frontal sinus drainage in chronic sinusitis cases refractory to conservative treatment results in a poor clinical response and is associated with recurrent frontal recess stenosis. Endonasal frontal sinus drainage procedures are classified according to Draf into three groups: DrafIIb enables unilateral orbit to septum drainage and the IIc is the extension of the IIb across the midline. The purpose of our report is to review chronic sinusitis cases treated at our Department using the standard (IIb) or modified (IIc) procedure and compare results. Methods: Patient- and surgery-related data were retrieved on patients operated between 2013 and 2016 for chronic frontal sinusitis using the standard/modified DrafIIb procedure.The modified IIb (i.e. IIc) procedure was performed so that both frontal sinus ostia were visualized by performing an intersinusseptectomy: the aim was to provide drainage to both frontal sinuses simultaneously. Results: In the observed period, 26 patients were treated: 12 using the modified DrafIIb (IIc) and 14 using the standard DrafIIb procedure. There were no significant differences between groups regarding age, sex, number of previous procedures or follow-up period. All patients had an uneventful postoperative recovery and there were no cases of re-stenosis observed in the DrafIIc group; there were seven cases of restenosis in the DrafIIb group.

scholarly journals Gracilis Myocutaneous Flap: Adding to the Armamentarium of Complex Sacrococcygeal Defect Reconstruction

2019 ◽  
Vol 52 (02) ◽  
pp. 246-249
Author(s):  
K. Preetha Rani ◽  
J. Satish Kumar ◽  
V. Singaravelu ◽  
Fernandes Deyonna
Keyword(s):  
Myocutaneous Flap ◽  
Recovery Period ◽  
Postoperative Recovery ◽  
Skin Closure ◽  
Uneventful Postoperative Recovery ◽  
Vram Flap ◽  
Reconstructive Option ◽  
Vertical Rectus Abdominis Myocutaneous ◽  
Gracilis Myocutaneous Flap

Abstract Background With increasing radicality of rectal cancer surgeries, the postoperative defects are becoming more complex. This demands an ideal reconstructive option with minimal morbidity to the patient. Although vertical rectus abdominis myocutaneous (VRAM) flap is the commonly used flap, gracilis myocutaneous flap is increasingly being performed to avoid morbidity associated with VRAM flap. Results We share our experience about two of our patients treated for rectal malignancy with pelvic exenteration who were reconstructed immediately with pedicled gracilis myocutaneous flap. Both the patients had an uneventful postoperative recovery period and were discharged on postoperative day 10. During follow-up period both patients had a healthy flap with no evidence of recurrence. No perineal hernias or gross dehiscence of skin closure occurred. Conclusion Gracilis myocutaneous flap has its own place with unique advantages adding to the armamentarium of reconstructive options for complex perineal defects, thereby avoiding the morbidity associated with VRAM flap. It stands as a reliable alternative in patients where VRAM cannot be used.

scholarly journals Rudimentary Horn Pregnancy Diagnosed after Laparotomy

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Kurabachew Mengistu ◽  
Tufa Bobe ◽  
Gashaw Tilahun ◽  
Kibru Kifle ◽  
Dereje Geleta
Keyword(s):  
New Technologies ◽  
Postoperative Recovery ◽  
Fetal Demise ◽  
Rudimentary Horn ◽  
Unicornuate Uterus ◽  
Uneventful Postoperative Recovery ◽  
Mullerian Ducts ◽  
Primary Hospital ◽  
Ultrasound Assessment

Müllerian abnormalities are present in 0.17% of fertile women and 3.5% of infertile women, and a unicornuate uterus is observed in 0.4% of women. The uterus is normally formed during embryogenesis by the fusion of the two Müllerian ducts. If one of the ducts does not develop, only one Müllerian duct contributes to the uterine development. We report a case of Gravida II, abortion I referred from a primary hospital with a referral paper and sonography stating she had IUFD. She had regular antenatal care follow-up at the primary hospital and had 8 months of amenorrhea. Our ultrasound assessment confirmed the intrauterine fetal demise, but the rudimentary horn pregnancy was missed. Repeated attempts at the induction of labor were tried but unsuccessful. The diagnosis was confirmed at laparotomy. She underwent cesarean section with right intact rudimentary horn removal. A nonviable male fetus with birth weight of 1.2 kg was delivered. Women with this abnormality are asymptomatic and unaware of having a unicornuate uterus. Abdominal pain is the most common presenting symptom with the rudimentary horn, but communicating horn pregnancy is generally asymptomatic in early pregnancy. Early awareness of this rare clinical condition is so crucial especially in developing countries where the availability of new technologies is scarce to explore uterine abnormalities. The patient had uneventful postoperative recovery and was discharged after 3 postoperative days.

scholarly journals Long terms results of Draf type III (modified endoscopic Lothrop) frontal sinus drainage procedure in 122 patients: a single centre experience

2011 ◽  
Vol 49 (2) ◽  
pp. 195-201
Author(s):  
C. Georgalas ◽  
F. Hansen ◽  
W.J.M. Videler ◽  
W.J. Fokkens
Keyword(s):  
Revision Surgery ◽  
Frontal Sinus ◽  
Symptom Burden ◽  
Drainage Procedure ◽  
Type Iii ◽  
Sinus Drainage ◽  
Sinus Obliteration ◽  
Revision Operations ◽  
Draf Iii

Objectives: To assess the effectiveness and factors associated with restenosis after Draf type III (Endoscopic Modified Lothrop) frontal sinus drainage procedure. Design: Retrospective analysis of prospectively collected data. Patients: A hundred and twenty two consecutive patients undergoing Draf III procedure for recalcitrant chronic frontal rhinosinusitis (CRS) (71%), frontal sinus mucocoele (15%), benign frontal sinus tumours (9%) and cystic fibrosis with severe CRS (5%) were followed up for an average of 33 months. Outcome measures: Symptom burden (Visual Analogue Scale and Rhinosinusitis Outcome Measure), patency of neo-ostium and revision surgery. Results: At the end of follow up, ninety percent of patients had a patent neo-ostium, while 88% were either clinically better or completely asymptomatic. Thirty-nine patients required endoscopic revision surgery and 9 eventually underwent frontal sinus obliteration. Sixty percent of revision operations were performed during the first two years. RSOM showed a significant improvement in both general and nasal symptoms while on a VAS, headache improved significantly. The only factor weakly associated with re-stenosis was the presence of allergy. There were no major complications during any of the procedures. Conclusion: Draf III Procedure is safe and effective for patients who have failed conventional frontal sinus procedures and a valid alternative to frontal sinus obliteration. Although the revision rate may appear to be quite significant, it can often be performed as an outpatient procedure and needs to be balanced against the reduced morbidity and the ease of follow-up.

Endonasal Frontal Sinusotomy in Surgical Management of Chronic Sinusitis: A Critical Evaluation

1997 ◽  
Vol 11 (1) ◽  
pp. 1-10 ◽  
Author(s):  
W. Hosemann ◽  
Th. Kühnel ◽  
P. Held ◽  
W. Wagner ◽  
A. Felderhoff
Keyword(s):  
Surgical Management ◽  
Frontal Sinus ◽  
Nasal Polyposis ◽  
Critical Evaluation ◽  
Endoscopic Endonasal ◽  
Minimum Diameter ◽  
Patient Complaints ◽  
Safety And Reliability ◽  
Frontal Sinuses

Frontal sinusotomy was performed on 110 patients undergoing routine endoscopic endonasal ethmoidectomy and the minimum diameter of the frontal sinus neo-ostium was determined intraoperatively. A total of 82 patients could be subjected to follow-up and redetermination of the neo-ostium diameter 13 months later. A postoperative CT was scheduled in 62 cases. The average minimum diameter of the frontal sinus neo-ostium, measured intraoperatively, was 5.6 mm (0–11 mm). After completion of wound healing, 81% of the frontal sinuses could be explored by probing or even inspected by rigid endoscopy. The average minimum diameter of the neo-ostia determined postoperatively was 3.5 mm (0–11 mm). Patients exhibiting aspirin sensitivity or diffuse nasal polyposis showed a more pronounced scarred constriction of the frontal sinus access compared to other cases. Neo-ostia exceeding 5 mm intraoperatively were preserved with a considerably higher percentage than those with diameters of less than 5 mm. Radiologically, the fenestrated frontal sinuses frequently showed continued or even increasing mucosal congestion. No conclusive relationship was found to exist between such post-operative clouding and frontal sinus accessibility (endoscopy and/or probing) or patient complaints. The investigations confirm the safety and reliability of frontal sinusotomy in surgical management of chronic paranasal sinusitis. The mucosa of the frontal sinus often reacts to surgery in the form of persistent or even newly developing mucosal swelling to which a specific pathophysiological significance cannot always be attributed.

scholarly journals Frontal Sinus Schwannoma: Case Report and Literature Review

2021 ◽  
Vol 3 (3) ◽  
pp. 61-63
Author(s):  
O. Benhoummad ◽  
Y. Labani ◽  
F. E. Rizkou ◽  
Y. Rochdi ◽  
A. Raji
Keyword(s):  
Frontal Sinus ◽  
Bone Destruction ◽  
Left Nasal Cavity ◽  
Radiologic Imaging ◽  
Neck Area ◽  
Cranial Fossa ◽  
Frontal Sinuses ◽  
Head Neck ◽  
Sinonasal Involvement

Whilst schwannomas are mostly developed in the head neck area, the sinonasal involvement is extremely rare, especially those of the frontal sinus. We report a patient with sinonasal schwannoma, invading both frontal sinuses, anterior cranial fossa, the left anterior ethmoidal sinus, and the left nasal cavity. Radiologic imaging showed an isodensed, T2 isointense, T1 hypointense, with heterogeneous enhanced postcontrast mass with bone destruction. The patient underwent resection of the tumor via two approaches, external one and endonasal one. The histological diagnosis was consistent with a schwannoma. The follow-up was marked by the presence of diplopia without any signs of meningitis or cerebrospinal fluid rhinorrhoea.

scholarly journals Radiological study of the myriad variations in frontal sinus anatomy: an institutional study

2019 ◽  
Vol 5 (2) ◽  
pp. 369
Author(s):  
Sreenivas Vepamininti ◽  
Soumya M. Seetharam ◽  
Jomy George ◽  
Hemanth Vamanshankar ◽  
Poonam K. Saidha
Keyword(s):  
Paranasal Sinuses ◽  
Frontal Sinus ◽  
Chronic Sinusitis ◽  
Signs And Symptoms ◽  
Anatomical Variations ◽  
Sinus Disease ◽  
Radiological Study ◽  
Medical College ◽  
Sinus Drainage ◽  
Axial Ct

<p class="abstract"><strong>Background:</strong> The frontal sinus is a challenging area for endoscopic surgeons. The variations in the frontal sinus differs so much among individuals that there are forensic applications. A detailed radiological study of the sinus is important for understanding the pathophysiology of sinusitis and as a prerequisite for frontal sinus drainage procedures. Aims and objectives were to document the anatomical variations of the frontal sinus (radiological) and to correlate the variations with the signs and symptoms of sinusitis.</p><p class="abstract"><strong>Methods:</strong> Coronal and axial CT paranasal sinuses scans of 30 consecutive patients who attended the Otolaryngology clinic OPD in St. John’s medical college and hospital, Bangalore, India with signs/symptoms of  chronic sinusitis were evaluated between January to July 2018.  </p><p class="abstract"><strong>Results:</strong> The average frontal sinus diameter in patients with sinusitis was 6.65 mm. The prevalence of frontal cells in our study was 48%. Agger nasi cells were the most common cells seen. Frontal sinus disease was found in 72% of the studied sides in the scans.</p><p class="abstract"><strong>Conclusions:</strong> Frontal sinus anatomy varies with different ethnicities. It is very important to study the frontal sinus anatomy before exploring the sinus for disease clearance and avoid surgical complications.</p>

Osteoplastic Frontal Sinusotomy

1976 ◽  
Vol 85 (4) ◽  
pp. 523-532 ◽  
Author(s):  
James M. Hardy ◽  
William W. Montgomery
Keyword(s):  
Postoperative Complications ◽  
Revision Surgery ◽  
Frontal Sinus ◽  
Chronic Sinusitis ◽  
Operative Approach ◽  
Indications For Surgery ◽  
Sinus Infection

The operative approach and findings of 250 osteoplastic frontal sinusotomy operations performed from 1956 through 1972 at the Massachusetts Eye and Ear Infirmary are reviewed. Indications for surgery were symptomatic and/or complicated disease of the frontal sinus, including primary chronic sinusitis and osteoma or trauma with or without associated infection. Immediate postoperative complications were minor. Follow-up of at least three years was obtained in 83% of the patients, and 93% of these have no significant symptoms to date. A distressing problem of persistent postoperative frontal pain is discussed in detail. Revision surgery has been performed in 6% of patients due to recurrent frontal sinus infection. The reasons for failure are analyzed, and recommendations are made to minimize the possibility of recurrence.

Incidental giant cystic pheochromocytoma: a case report and review of the literature

2020 ◽  
Vol 65 (2) ◽  
pp. 64-70
Author(s):  
Hollie Alice Clements ◽  
Michael SJ Wilson ◽  
David M Smith
Keyword(s):  
Preoperative Planning ◽  
Postoperative Recovery ◽  
Malignant Potential ◽  
Beta Blockade ◽  
Review Of The Literature ◽  
Case Presentation ◽  
Uneventful Postoperative Recovery ◽  
One Year ◽  
Urinary Metanephrines

Introduction Pheochromocytoma is a tumour arising from the adrenal medulla, which secretes catecholamines. Approximately 20% of pheochromocytomas are cystic and more likely to be asymptomatic. They should be surgically resected as all have a malignant potential and pose cardiovascular risk. Case presentation: We report the case of a 61-year-old female patient admitted electively for laparoscopic adrenalectomy for a large cystic pheochromocytoma detected incidentally. Diagnosis was confirmed preoperatively by elevated 24-h urinary metanephrines. The patient was treated preoperatively with alpha and beta blockade. Surgery was without complication; she had an uneventful postoperative recovery and no evidence of recurrence at one-year follow-up. Conclusion This case highlights the necessity of investigating for biochemical function in all adrenal lesions by measuring metanephrines, even when entirely cystic on imaging. Given the surgical and anaesthetic risk in resection of pheochromocytoma, attaining a preoperative diagnosis allows for careful preoperative planning and safe surgery.

scholarly journals Minimally Invasive Endoscopic Sinus Surgery for Frontal Sinus Pathologies Using Interventional Flexible Bronchoscopy: Case Reports

2021 ◽  
Vol 12 ◽  
pp. 215265672110308
Author(s):  
Yann Litzistorf ◽  
François Gorostidi ◽  
Antoine Reinhard
Keyword(s):  
Minimally Invasive ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Case Reports ◽  
Flexible Bronchoscopy ◽  
Sinus Surgery ◽  
Fungus Ball ◽  
Flexible Bronchoscope ◽  
Frontal Sinuses

Background: Lateral pathologies of the frontal sinus are difficult to visualize and treat with classical endoscopic sinus surgery (ESS) using rigid endoscopes and instruments. Hence, they often require extended endoscopic or external approaches. Methods and Results: We describe the advantages of using interventional flexible bronchoscopy in frontal ESS without extended approaches in 2 illustrated cases: (1) A fungus ball in the frontal sinus with a frontoethmoidal cell. The flexible bronchoscope allowed treatment of all recesses of the frontal sinuses and the opening of a frontoethmoidal cell through a Draf IIa. (2) A revision surgery with a frontoethmoidal cell obstructing drainage pathway was successfully treated with this same technique. Patients did not experience complications or recurrent symptomatology after, respectively, 4 and 15 months of follow-up. Conclusion: Flexible bronchoscopy allows a good visualization and treatment of lateral frontal sinus pathologies through limited endoscopic approaches. Through-the-scope instruments permit the resection of frontoethmoidal cells.

Intracranial Epidural Mucocele in a Cat

2005 ◽  
Vol 41 (1) ◽  
pp. 74-77 ◽  
Author(s):  
P. Filippo Adamo
Keyword(s):  
Computed Tomography ◽  
Viscous Fluid ◽  
Frontal Lobe ◽  
Frontal Sinus ◽  
Clinical Signs ◽  
Frontal Sinuses ◽  
The Right

An 18-month-old, spayed female, domestic shorthaired cat was presented with clinical signs of depression and reluctance to walk, which progressed to nonambulatory tetraparesis. Increased opacification of both frontal sinuses and a cyst-like abnormality causing compression and displacement of the right frontal lobe were seen on computed tomography. Bilateral frontal sinus trephination and right transfrontal craniotomy revealed clear, viscous fluid in the right frontal sinus and rostral fossa, compatible with an intracranial mucocele. At a 6-month follow-up examination, no signs of recurrence were appreciated.

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