Nasal encephalocele following ignored trauma- treated by endoscopic excision with skull base defect repair

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.

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Surgical Repair of Skull Base Defect Following Standard or Extended Endoscopic Transsphenoidal Surgery for Pituitary Tumors

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0032-1314002 ◽

2012 ◽

Vol 73 (S 02) ◽

Author(s):

P. Farneti ◽

V. Sciarretta ◽

D. Mazzatenta ◽

M. Zoli ◽

G. Frank ◽

...

Keyword(s):

Skull Base ◽

Transsphenoidal Surgery ◽

Surgical Repair ◽

Pituitary Tumors ◽

Endoscopic Transsphenoidal Surgery ◽

Skull Base Defect

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Managing CSF Leak with Temporalis Muscle Flap for Challenging Skull Base Defect after Radiation Therapy

10.1055/s-0040-1702551 ◽

2020 ◽

Author(s):

Wei-Hsin Wang ◽

Ming-Ying Lan

Keyword(s):

Radiation Therapy ◽

Skull Base ◽

Muscle Flap ◽

Csf Leak ◽

Temporalis Muscle ◽

Temporalis Muscle Flap ◽

Skull Base Defect

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Endoscopic sinus surgery the art of new era

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v9ispl1.1279 ◽

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.

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

Egyptian Journal of Neck Surgery and Otorhinolaryngology ◽

10.21608/ejnso.2021.212144 ◽

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

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

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949210101106 ◽

1992 ◽

Vol 101 (11) ◽

pp. 916-919 ◽

Cited By ~ 16

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.

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PARANASAL SINUS MUCOCELE AND ITS COMPLICATIONS: RETROSPECTIVE ANALYSIS AND LITERATURE REVIEW

10.36106/ijsr/5934204 ◽

2021 ◽

pp. 1-3

Author(s):

Sudhagar Eswaran ◽

Namrataa S ◽

Prasanna Kumar S

Keyword(s):

Skull Base ◽

Retrospective Analysis ◽

Paranasal Sinus ◽

Paranasal Sinuses ◽

Vision Loss ◽

Delay In Diagnosis ◽

Diagnosis And Management ◽

Audit Data ◽

Tertiary Center ◽

Skull Base Defect

BACKGROUND: Mucocele is a true cystic expansile mass filled with mucus resulting from obstruction of the sinus ostia. Prompt diagnosis and management are needed to avoid complications due to the intracranial or intra-orbital extension. OBJECTIVES: To audit data of mucocele of the paranasal sinuses in a tertiary center, to review the literature regarding the clinical features and the management of mucocele in the paranasal sinus and to emphasize the iatrogenic causes of mucocele after the development of Endoscopic Skull Base Surgeries. MATERIALS AND METHODS: A retrospective analysis of etiology, clinical presentation, sinuses involved, operative technique, complication, recurrence were interpreted. RESULTS: The mean age of 16 patients managed is 49. Location:37% frontal,19% ethmoidal,19% frontoethmoidal,19% sphenoidal,6% maxillary. The iatrogenic cause was 44%. Symptoms included proptosis, external swelling, nasal block, and discharge, and vision loss. Complications were orbital abscess and skull base defect. 14 patients underwent endoscopic procedures-excision or marsupialization. One patient underwent craniotomy; one patient combined approach was performed. One patient had a recurrence. CONCLUSION: Mucocele of the paranasal sinuses is still a rare clinical scenario and it is imperative to note that any delay in diagnosis and management can lead to expansion and erosion of the bony wall of the sinuses and causing complications.

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