Comparison between Three-Dimensional and Triplanar Computed Tomography Imaging of the Frontal Recess

2009 ◽  
Vol 23 (5) ◽  
pp. 502-505 ◽  
Author(s):  
Seth J. Isaacs ◽  
Parul Goyal
Keyword(s):  
Computed Tomography ◽  
Frontal Sinus ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Ct Images ◽  
Outflow Tract ◽  
Sinus Surgery ◽  
3D Ct ◽  
Sinus Disease ◽  
Frontal Recess

Background Despite advances in endoscopic surgical techniques, management of frontal sinus disease remains challenging. Much of this is related to the complex nature of frontal recess anatomy. A thorough understanding of frontal recess anatomy is paramount for the safety and success of frontal sinus surgery. Three-dimensional (3D) computed tomography (CT) may allow surgeons to obtain a more complete preoperative assessment of frontal recess anatomy. The purpose of this study was to determine if reconstructed 3D CT images as an adjunct to conventional triplanar imaging provide additional information regarding the frontal recess anatomy. Methods A prospective study was performed. Two otolaryngologists reviewed the CT scans of 25 patients referred for routine paranasal sinus disease. The findings from review of the triplanar CT images were compared with the findings from review of the 3D reconstructions. Each study was assessed for (1) frontoethmoidal cells, (2) agger nasi cell, (3) subrabullar and frontal bullar cells, (4) intersinus septal cell, (5) superior uncinate process attachment site, and (6) and frontal sinus outflow tract. The examiners rated the usefulness of each study to identify each of the aforementioned anatomic subsites using a modified 5-point Likert scale. Results Intersinus septal cells, supraorbital ethmoid cells, and the anterior–posterior dimension of the frontal sinus outflow tract were better defined on the reconstructed 3D CT images. Conclusion Three-dimensional CT is a useful adjunct to the conventional triplanar studies for the evaluation of frontal sinus and recess anatomy. This technique can define certain anatomic variants more effectively than 2D multiplanar reconstructed images.

scholarly journals The Relationship Between the Width of the Frontal Recess and the Frontal Recess Cells in Japanese Patients

2019 ◽  
Vol 12 ◽  
pp. 117955061988494
Author(s):  
Seiichiro Makihara ◽  
Shin Kariya ◽  
Mitsuhiro Okano ◽  
Tomoyuki Naito ◽  
Kensuke Uraguchi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Frontal Sinus ◽  
Significant Positive Correlation ◽  
Japanese Patients ◽  
Cell Types ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Frontal Sinusitis ◽  
Frontal Recess ◽  
The Relationship

Objective: The agger nasi cell (ANC) is an easily identifiable landmark when approaching the frontal sinus. The success of endoscopic frontal sinus surgery may be influenced by the width of the frontal recess (FR). The aim of this study is to examine the relationship between the FR width and the ANC size in Japanese patients. In addition, the effect of various frontal recess cells (FRCs) on the development of frontal sinusitis has been examined. Materials and methods: Multiplanar computed tomography (CT) scans of the nasal cavities and paranasal sinuses in 95 patients (190 sides) before endoscopic sinus surgery were reviewed. The presence of FRCs, the thickness of the frontal beak (FB), the ANC size, and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR were evaluated in patients with and without frontal sinusitis. Results: The prevalence of the ANC, frontal cell types 1, 2, 3, and 4, frontal bullar cell (FBC), suprabullar cell, supraorbital ethmoid cell, and interfrontal sinus septal cell was 85.3%, 11.6%, 0%, 7.9%, 0%, 25.3%, 45.8%, 16.8%, and 15.3%, respectively. The ANC volume showed a significant positive correlation with the A-P length of the FI and FR. The incidence of frontal sinusitis in the patients with FBCs was significantly higher than that without FBCs. Conclusion: A large ANC offers a greater potential to facilitating the approach to the frontal sinus because of the extensiveness of the FR in Japanese patients. The presence of FBCs may be related to a higher incidence of frontal sinusitis.

Long-term stenting for chronic frontal sinus disease: case series and literature review

2010 ◽  
Vol 124 (11) ◽  
pp. 1216-1222 ◽  
Author(s):  
B Hunter ◽  
S Silva ◽  
R Youngs ◽  
A Saeed ◽  
V Varadarajan
Keyword(s):  
Frontal Sinus ◽  
Relevant Literature ◽  
Case Series ◽  
Outflow Tract ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Narrow Channels ◽  
Co Morbidity ◽  
Disease Case

AbstractObjective:The frontal sinus outflow tract consists anatomically of narrow channels prone to stenosis. Following both endonasal and external approach surgery, up to 30 per cent of patients suffer post-operative re-stenosis of the frontal sinus outflow tract, with recurrent frontal sinus disease. This paper proposes the surgical placement of a long-term frontal sinus stent to maintain fronto-nasal patency, as an alternative to more aggressive surgical procedures such as frontal sinus obliteration and modified Lothrop procedures.Design:We present a series of three patients with frontal sinus disease and significant co-morbidity, the latter making extensive surgery a significant health risk. We also review the relevant literature and discuss the use of long-term frontal sinus stenting.Results:These three cases were successfully treated with long-term frontal sinus stenting. Stents remained in situ for a period ranging from 48 to over 60 months.Conclusion:Due to the relatively high failure rates for both endonasal and external frontal sinus surgery, with a high post-operative incidence of frontal sinus outflow tract re-stenosis, long-term stenting is a useful option in carefully selected patients.

scholarly journals Utility of Intraoperative Flexible Endoscopy in Frontal Sinus Surgery

2017 ◽  
Vol 8 (2) ◽  
pp. ar.2017.8.0205 ◽  
Author(s):  
Eric T. Carniol ◽  
Alejandro Vázquez ◽  
Tapan D. Patel ◽  
James K. Liu ◽  
Jean Anderson Eloy
Keyword(s):  
Surgical Management ◽  
Frontal Sinus ◽  
Surgical Techniques ◽  
Disease Process ◽  
Flexible Endoscopy ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Frontal Sinus Surgery ◽  
Far Lateral ◽  
Draf Iii

Background Surgical management of the frontal sinus can be challenging. Extensive frontal sinus pneumatization may form a far lateral or supraorbital recess that can be difficult to reach by conventional endoscopic surgical techniques, requiring extended approaches such as the Draf III (or endoscopic modified Lothrop) procedure. Rigid endoscopes may not allow visualization of these lateral limits to ensure full evacuation of the disease process. Methods Here we describe the utility of intraoperative flexible endoscopy in two patients with far lateral frontal sinus disease. Results In both cases, flexible endoscopy allowed confirmation of complete evacuation of pathologic material, thereby obviating more extensive surgical dissection. Conclusion In cases where visualization of the far lateral frontal sinus is inadequate with rigid endoscopes, flexible endoscopy can be used to determine the need for more extensive dissection.

scholarly journals Standardised 3D-CT Lung Volumes for Patients with Idiopathic Pulmonary Fibrosis

2021 ◽  
Author(s):  
Yuko Tanaka ◽  
Yuzo Suzuki ◽  
Hirotsugu Hasegawa ◽  
Koshi Yokomura ◽  
Atsuki Fukada ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Pulmonary Function Tests ◽  
Three Dimensional ◽  
Ct Images ◽  
3D Ct ◽  
Pulmonary Physiology ◽  
Lung Physiology ◽  
Lower Lung

Abstract Background: The assessment of lung physiology via pulmonary function tests (PFTs) is essential for patients with idiopathic pulmonary fibrosis (IPF). However, PFTs require active participation, which can be challenging for patients with severe respiratory failure, such as during acute exacerbations (AE) of IPF. Recently advances enabled to re-construct of 3-dimensional computed-tomography (3D-CT) images. Methods: This is a retrospective multi-center cohort study. This study established a standardisation method and quantitative analysis of lung volume (LV) based on anthropometry using three-dimensional computed tomography (3D-CT) images. The standardised 3D-CT LV in patients with IPF at diagnosis (n=140) and during AE (cohort1; n=61 and cohort2; n=50) and those of controls (n=53) were measured. Results: The standardised 3D-CT LVs at IPF diagnosis were less than those of control patients, especially in the lower lung lobes. The standardised 3D-CT LVs were correlated with forced vital capacity (FVC) and validated using the modified Gender-Age-Physiology (GAP) index. The standardised 3D-CT LVs at IPF diagnosis were independently associated with prognosis. During AE, PFTs were difficult to perform, 3D-CT analyses revealed reduced lung capacity in both the upper and lower lobes compared to those obtained at diagnosis. Lower standardised 3D-CT LVs during AE were independently associated with worse outcomes in independent two cohorts. Particularly, volume loss in the upper lobe at AE had prognostic values.Conclusion: A novel image quantification method for assessing pulmonary physiology using standardised 3D-CT-derived LVs was developed. This method successfully predicts mortality in patients with IPF and AE of IPF, and may be a useful alternative to PFTs when PFTs cannot be performed.

Motion Analysis of the Trapeziometacarpal Joint Using Three-dimensional Computed Tomography

2016 ◽  
Vol 21 (01) ◽  
pp. 78-84 ◽  
Author(s):  
Tetsuya Kimura ◽  
Hiroaki Takai ◽  
Tatsuo Azuma ◽  
Koichi Sairyo
Keyword(s):  
Computed Tomography ◽  
Range Of Motion ◽  
Three Dimensional ◽  
Ct Images ◽  
Metacarpal Bone ◽  
Joint Surface ◽  
3D Ct ◽  
Trapeziometacarpal Joint ◽  
Wide Range ◽  
Contact Surfaces

Background: Zancolli theorized that the first metacarpal bone axially rotates on the semispheroidal part of the trapezium, which is controlled by ligaments. This study used three-dimensional computed tomography (3D-CT) to describe the motion of the first metacarpal bone on the trapezium. Methods: 3D-CT images were taken of the left hand of 30 healthy volunteers (mean age [Formula: see text] years, 15 men and 15 women). They were divided into five groups: radial abduction, retroposition, adduction, palmar abduction, and opposition. The range of motion of radial abduction and palmar abduction of the trapeziometacarpal joint was measured from the first metacarpal bone to the second metacarpal bone. The range of motion of pronation was measured following Cheema's method. The main contacts of the joint surface of trapezium and the first metacarpal bone were determined on the 3D-CT images. Results: Pronation of the trapeziometacarpal joint was [Formula: see text] in radial abduction, [Formula: see text] in retroposition, [Formula: see text] in adduction, [Formula: see text] in palmar abduction, and [Formula: see text] in opposition. Radial abduction was [Formula: see text] in radial abduction, [Formula: see text] in retroposition, [Formula: see text] in adduction, [Formula: see text] in palmar abduction, and [Formula: see text] in opposition. Palmar abduction was [Formula: see text] in radial abduction, [Formula: see text] in retroposition, [Formula: see text] in adduction, [Formula: see text] in palmar abduction, and [Formula: see text] in opposition. The contact surfaces of the trapezium and the first metacarpal bone were dorsal and ulnar in radial abduction, radial and ulnar in retroposition, and volar-ulnar and volarradial in opposition, respectively, while they were both central in adduction and both radial in palmar abduction. Conclusions: The range of motion of the trapeziometacarpal joint was 44° for radial abduction/adduction, 48° for palmar abduction/adduction, and 57° for pronation/supination. The varying contact surfaces of the trapezium and the first metacarpal bone enabled a wide range of motion.

scholarly journals Comparative Evaluation of Anatomical and Pathological Features on Computed Tomography Scan with Intraoperative Findings in Frontal Sinus Pathology

2017 ◽  
Vol 10 (1) ◽  
pp. 6-10
Author(s):  
Sourav Chakraborty ◽  
Deepak Verma ◽  
Himani Lade ◽  
Noor UD Malik
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Frontal Sinus ◽  
Comparative Evaluation ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Pathological Features ◽  
Computed Tomography Scan ◽  
Sinus Disease ◽  
Tomography Scan

ABSTRACT To compare the anatomical and pathological features on computed tomography (CT) scan with intraoperative findings in cases of frontal sinus disease. This prospective study was conducted in a tertiary referral center, and a total of 30 patients who were refractory to conservative medical treatment undergoing endoscopic sinus surgery for frontal sinus disease were included in the study. Preoperative CT scans were done with axial and coronal cuts with a sagittal reconstruction to obtain a better idea about the frontal recess anatomy. The areas that were studied preoperatively on CT scan were frontal sinus pathology, pattern of sinus involvement, superior attachment of uncinate process, frontal sinus drainage pathway, agger nasi cell, frontal cell, frontal bullar cell, and supraorbital ethmoidal cell. A good correlation was obtained between the CT findings and intraoperative findings. How to cite this article Chakraborty S, Verma D, Lade H, Malik NUD. Comparative Evaluation of Anatomical and Pathological Features on Computed Tomography Scan with Intraoperative Findings in Frontal Sinus Pathology. Clin Rhinol An Int J 2017;10(1):6-10.

scholarly journals The Prevalence of Frontal Cells and Their Relation to Frontal Sinusitis: A Radiological Study of the Frontal Recess Area

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ahmed Z. Eweiss ◽  
Hisham S. Khalil
Keyword(s):  
Frontal Sinus ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Radiological Study ◽  
Frontal Recess ◽  
Mucosal Disease ◽  
Significant Difference ◽  
Axial Ct ◽  
Frontal Sinuses

Background. The frontal recess area represents a challenge to ENT surgeons due to its narrow confines and variable anatomy. Several types of cells have been described in this area. The agger nasi cells are the most constant ones. The frontal cells, originally classified by Kuhn into 4 types, have been reported in the literature to exist in 20%–41% of frontal recesses. Aim of the Study. To identify the prevalence of frontal recess cells and their relation to frontal sinus disease. Methods. Coronal and axial CT scans of paranasal sinuses of 70 patients admitted for functional endoscopic sinus surgery (FESS) were reviewed to identify the agger nasi, frontal cells, and frontal sinus disease. Data was collated for right and left sides separately. Results. Of the 140 sides reviewed, 126 (90%) had agger nasi and 110 (78.571%) had frontal cells. 37 frontal sinuses were free of mucosal disease, 48 were partly opacified, and 50 were totally opacified. There was no significant difference found in frontal sinus mucosal disease in presence or absence of frontal cells or agger nasi. Conclusions. The current study shows that frontal cells might be underreported in the literature, as the prevalence identified is noticeably higher than previous studies.

scholarly journals Remote Training of Functional Endoscopic Sinus Surgery With Advanced Manufactured 3D Sinus Models and a Telemedicine System

2021 ◽  
Vol 8 ◽  
Author(s):  
Masanobu Suzuki ◽  
Erich Vyskocil ◽  
Kazuhiro Ogi ◽  
Kotaro Matoba ◽  
Yuji Nakamaru ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
Three Dimensional ◽  
South Australia ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Telemedicine System ◽  
Frontal Recess ◽  
Travel Restrictions ◽  
3D Printed

Objective: Traditionally, cadaveric courses have been an important tool in surgical education for Functional Endoscopic Sinus Surgery (FESS). The recent COVID-19 pandemic, however, has had a significant global impact on such courses due to its travel restrictions, social distancing regulations, and infection risk. Here, we report the world-first remote (Functional Endoscopic Sinus Surgery) FESS training course between Japan and Australia, utilizing novel 3D-printed sinus models. We examined the feasibility and educational effect of the course conducted entirely remotely with encrypted telemedicine software.Methods: Three otolaryngologists in Hokkaido, Japan, were trained to perform frontal sinus dissections on novel 3D sinus models of increasing difficulty, by two rhinologists located in Adelaide, South Australia. The advanced manufactured sinus models were 3D printed from the Computed tomography (CT) scans of patients with chronic rhinosinusitis. Using Zoom and the Quintree telemedicine platform, the surgeons in Adelaide first lectured the Japanese surgeons on the Building Block Concept for a three Dimensional understanding of the frontal recess. They in real time directly supervised the surgeons as they planned and then performed the frontal sinus dissections. The Japanese surgeons were asked to complete a questionnaire pertaining to their experience and the time taken to perform the frontal dissection was recorded. The course was streamed to over 200 otolaryngologists worldwide.Results: All dissectors completed five frontal sinusotomies. The time to identify the frontal sinus drainage pathway (FSDP) significantly reduced from 1,292 ± 672 to 321 ± 267 s (p = 0.02), despite an increase in the difficulty of the frontal recess anatomy. Image analysis revealed the volume of FSDP was improved (2.36 ± 0.00 to 9.70 ± 1.49 ml, p = 0.014). Questionnaires showed the course's general benefit was 95.47 ± 5.13 in dissectors and 89.24 ± 15.75 in audiences.Conclusion: The combination of telemedicine software, web-conferencing technology, standardized 3D sinus models, and expert supervision, provides excellent training outcomes for surgeons in circumstances when classical surgical workshops cannot be realized.

scholarly journals Three-Dimensional Reconstruction Algorithm of Computed Tomography Imaging for Surgical Treatment and Rapid Rehabilitation Nursing of Renal Cell Carcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Lijun Wang ◽  
Haiyan Lin ◽  
Hong Zheng ◽  
Yuying Jiang
Keyword(s):  
Computed Tomography ◽  
3D Reconstruction ◽  
Renal Cell ◽  
Three Dimensional ◽  
Life Quality ◽  
Reconstruction Algorithm ◽  
Nursing Intervention ◽  
Ct Images ◽  
3D Ct ◽  
Self Rating

This study was carried out to explore the promotion role of computed tomography (CT) imaging three-dimensional (3D) reconstruction technology and rapid rehabilitation nursing intervention (RRNI) in the treatment of patients with renal cell cancer (RCC) laparoscopic radical nephrectomy (LRN) in view of the patient’s condition. 98 RCC patients who were admitted to the hospital from July 2019 to July 2020 were selected as the research subjects, and all patients underwent the LRN and the RRIN. Of which, 46 RCC patients were scanned with CT images (regarded as the CT group), and 46 RCC patients were scanned with CT images based on 3D reconstruction algorithms (regarded as the 3D CT group). The clinical efficacy and the life quality, pain degree, and adverse mood changes before and after the RRN were analyzed and compared. The results showed that the surgery time in the 3D CT group and the CT group was 130.2 ± 42.8 minutes and 162.4 ± 38.5 minutes, respectively ( P < 0.05 ). The recurrence rate of RCC in both groups was 0%. The estimated blood loss in the 3D CT group and the CT group was 93.6 ± 35.5 mL and 90.3 ± 40.2 mL, respectively; the complication rate in the 3D CT and CT group was 5% and 12%, respectively; the hospital stay in the 3D CT and CT group was 12.5 ± 4.7 days and 12.1 ± 3.2 days, respectively, which had no statistical significance ( P > 0.05 ). The scores of visual analogue scale (VAS), 36-Item Short-Form Health Survey (SF-36), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) of patients in the two groups were statistically significant ( P < 0.05 ). It indicated that CT images based on the 3D reconstruction algorithm could be applied in LRN of RCC patients to shorten the surgery time and improve the surgical effect, and implementation of the RRN could relieve the adverse mood of RCC patients and effectively improve their life quality.

Pre- and Postoperative Imaging Analysis for Frontal Sinus Disease following Conservative Partial Middle Turbinate Resection

1998 ◽  
Vol 77 (4) ◽  
pp. 326-334 ◽  
Author(s):  
Iyad S. Saidi ◽  
John F. Biedlingmaier ◽  
Michael I. Rothman
Keyword(s):  
Frontal Sinus ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Mr Images ◽  
Sinus Disease ◽  
Frontal Recess ◽  
Postoperative Mri ◽  
Preoperative Ct ◽  
Magnetic Resonance Imaging Mri ◽  
Mucosal Thickening

The prudence of partial or complete middle turbinate resection during endoscopic sinus surgery (ESS) is controversial. The greatest concern regarding partial resection relates to the effect on the frontal recess and the development of frontal sinus disease. The purpose of this study was to radiographically evaluate the frontal sinus in patients who had undergone ESS with partial conservative middle turbinate resection. We reviewed the charts and operative records from 195 consecutive cases of ESS performed by a single surgeon (JFB) over a two-year period. Thirty-three of 117 patients who had undergone ESS with conservative partial middle turbinate resection without frontal recess exploration agreed to return for magnetic resonance imaging (MRI) of their sinuses. The preoperative computed tomography (CT) scans and postoperative MR images were reviewed and graded (1–3) by a single neuroradiologist. Significant frontal sinus disease (grades 2 and 3) was seen in 15 of 52 sides preoperatively (29%), and in 14 sides postoperatively (27%). During the postoperative MRI studies, only six frontal sinus sides demonstrated minimal mucosal thickening (grade 1) which had not been apparent on preoperative CT. This radiographic analysis suggests that conservative partial middle turbinate resection during ESS does not adversely affect the frontal sinus. We believe that the surgical technique employed when resecting the middle turbinate, and the avoidance of unnecessary dissection in the recess are both important factors in preventing the development of frontal sinus disease following ESS.

Sign in / Sign up

Export Citation Format

Share Document