scholarly journals Transorbital Endoscopic Identification of Supernumerary Ethmoid Arteries

2016 ◽  
Vol 7 (3) ◽  
pp. ar.2016.7.0167 ◽  
Author(s):  
Angelique M. Berens ◽  
Greg E. Davis ◽  
Kris S. Moe
Keyword(s):  
Optic Nerve ◽  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Average Distance ◽  
Total Sample ◽  
Sinus Surgery ◽  
Lateral Nasal Wall ◽  
Orbital Wall ◽  
Medial Orbital Wall ◽  
Anterior Lacrimal Crest

Background Anterior and posterior ethmoid arteries supply the paranasal sinuses, septum, and lateral nasal wall. Precise identification of these arteries is important during anterior skull base procedures, endoscopic sinus surgery, and ligation of ethmoid arteries for epistaxis refractory to standard treatment. There is controversy in the literature regarding the prevalence of supernumerary ethmoid arteries. Objective This study examined the prevalence of supernumerary ethmoid arteries by using direct visualization after transorbital endoscopic dissection. Methods Nineteen cadaveric specimens were evaluated by using a superior lid crease (blepharoplasty) incision and an endoscopic approach to the medial orbital wall. Ethmoid arteries were identified as they pierced the lamina papyracea coplanar with the skull base and optic nerve. The distances from the anterior lacrimal crest to the ethmoid arteries and optic nerve were measured with a surgical ruler under endoscopic guidance. Results Thirty-eight cadaveric orbits were measured. Overall, there were three or more ethmoid arteries (including anterior and posterior arteries) in 58% of orbits, with 8% of the total sample that contained four or more ethmoid arteries. The average number of ethmoid arteries was 2.7. Bilateral supernumerary ethmoid arteries were noted in 42% of the specimens. The distance between the anterior lacrimal crest and the anterior ethmoid, posterior ethmoid, and optic nerve averaged 20, 35, and 41 mm, respectively. The average distance to the supernumerary or middle ethmoid artery was 29 mm. Conclusion This study found supernumerary ethmoid arteries in 58% of cadaveric specimens, a prevalence much higher than previously reported. Recognition of these additional vessels may improve safety during endoscopic sinus surgery and skull base surgery, and may permit more effective ligation for refractory epistaxis originating from the ethmoid system.

Medial orbital protrusion - a potentially hazardous anomaly during endoscopic sinus surgery

1999 ◽  
Vol 113 (8) ◽  
pp. 754-755 ◽  
Author(s):  
J. C. Lim ◽  
P. J. Hadfield ◽  
S. Ghiacy ◽  
N. R. Bleach
Keyword(s):  
Computed Tomography ◽  
High Risk ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Developmental Anomaly ◽  
Sinus Surgery ◽  
Ct Scans ◽  
Orbital Wall ◽  
Medial Orbital Wall

AbstractWe report the case of a 57-year-old patient with a presumed developmental anomaly of the medial orbital wall. The resultant protrusion of orbital contents into the ethmoidal complex was clearly demonstrated on coronal computed tomography (CT) scans of the paranasal sinuses. This anomaly presents a high risk of iatrogenic injury to the medial rectus and orbit during functional endoscopic sinus surgery and has not previously been described.

Medial Orbital Wall Reconstruction to Facilitate Endoscopic Sinus Surgery for Erosive Polypoidal Sinus Disease

2019 ◽  
Vol 35 (1) ◽  
pp. e3-e6
Author(s):  
Megan R. Silas ◽  
Johnathan V. Jeffers ◽  
Asim V. Farooq ◽  
Jacquelynne P. Corey ◽  
Hassan A. Shah
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Sinus Disease ◽  
Orbital Wall ◽  
Medial Orbital Wall

Lateral nasal wall extension of the nasoseptal flap for skull‐base and medial orbital wall defects

2019 ◽  
Vol 9 (9) ◽  
pp. 1041-1045 ◽  
Author(s):  
Justin McCormick ◽  
Mark Allen ◽  
Joshua J. Kain ◽  
Jaime A Pena‐Garcia ◽  
Do‐Yeon Cho ◽  
...  
Keyword(s):  
Skull Base ◽  
Lateral Nasal Wall ◽  
Nasoseptal Flap ◽  
Orbital Wall ◽  
Medial Orbital Wall

scholarly journals Summary Experience with endoscopic sinus surgery for the blowout fracture of the medial orbital wall

1998 ◽  
Vol 8 (2) ◽  
pp. 157-161
Author(s):  
Manabu Nakanoboh ◽  
Tsuyoshi Matsunaga ◽  
Taichi Furukawa ◽  
Muneo Nakaya ◽  
Satoshi Kitahara
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Blowout Fracture ◽  
Orbital Wall ◽  
Medial Orbital Wall

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.

Anatomic Variations of Ethmoid Roof and Risk of Skull Base Injury in Endoscopic Sinus Surgery: Statistical Correlations

2021 ◽  
pp. 194589242110205
Author(s):  
Gian Luca Fadda ◽  
Alessio Petrelli ◽  
Federica Martino ◽  
Giovanni Succo ◽  
Paolo Castelnuovo ◽  
...  
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Horizontal Plane ◽  
Uncinate Process ◽  
Cribriform Plate ◽  
Sinus Surgery ◽  
Evaluation Methodology ◽  
Anatomic Variations ◽  
Imaging Evaluation ◽  
Plane Passing

Background Recent developments in endoscopic sinus surgery (ESS) have increased the need to investigate the complex anatomic variations in the ethmoid roof and skull base, to inform the surgeon about the risk of damaging these crucial areas during ESS. Objective To offer a detailed description of sinus anatomy focusing on the key surgical landmarks in ESS and frontal recess surgery to standardize a systematic approach during the preoperative sinuses imaging evaluation. Methodology: A total of 220 computed tomography (CT) scans were reviewed to obtain six sets of measurements: the depth of the cribriform plate (CP); the length of the lateral lamella of the cribriform plate (LLCP); the angle formed by the LLCP and the continuation of the horizontal plane passing through the CP; the position of the anterior ethmoidal artery (AEA) at the skull base; the extent of frontal sinus pneumatization (FSP); the type of superior attachment of the uncinate process (SAUP). Results The length of the LLCP was statistically significantly correlated with the different Keros classification types, the angle formed by the LLCP with the continuation of the horizontal plane passing through the CP, and with the AEA position at the skull base. The depth of the olfactory fossa was correlated with FSP. Conclusions According to the Keros and Gera classifications, the data obtained from these evaluations allow the assessment of anatomic-radiological risk profiles and can help identify those patients who are high risk for ethmoid roof injury.

scholarly journals The Swansea Floating Endoscopic Assistant: A Surgical Handling Aid

Reports ◽  
2018 ◽  
Vol 1 (3) ◽  
pp. 22
Author(s):  
Jayan George ◽  
Amir Farboud ◽  
Hassan Elhassan ◽  
Heikki Whittet
Keyword(s):  
Lumbar Spine ◽  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Mechanical Effect ◽  
The Other ◽  
Muscular Fatigue ◽  
Sinus Surgery ◽  
Double Loop ◽  
Repetitive Movements

Endoscopic sinus surgery is a rapidly advancing area of Otolaryngology. Operations can be lengthy and are often performed by a single surgeon. Repetitive movements can also lead to muscular fatigue. To mitigate against this, we regularly deploy two retractable Flexi™ compact leads, one bigger than the other connected together and suspended from the theatre operating light arm using velcro ties. The leads are then wrapped around the endoscope using a cotton crepe bandage, in a double loop with a reef knot. The larger lead attaches to the focus/zoom adjustment part of the endoscopic camera, and the smaller lead attaches to the scope 20 cm from the tip allowing the scope to float when suspended, with a slight downward tilt towards the patient. The mechanical effect this produces allows an advantageous reduction in the scope’s weight from 404 g un-suspended, to 65 g with the setup described. This subsequently reduces stress on the elbows, shoulders neck and lumbar spine. The Swansea Floating Endoscopic Assistant adheres to basic ergonomic principles and has the potential for application in other areas of Otorhinolaryngology and Skull Base Surgery.

scholarly journals The Prevalence of an Onodi Cell in Adult Thai Cadavers

2003 ◽  
Vol 82 (3) ◽  
pp. 200-204 ◽  
Author(s):  
Sanguansak Thanaviratananich ◽  
Kowit Chaisiwamongkol ◽  
Suthee Kraitrakul ◽  
Watcharachai Tangsawad
Keyword(s):  
Optic Nerve ◽  
High Risk ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Minimum Amount ◽  
Bone Thickness ◽  
Optic Nerve Injury ◽  
Nasal Endoscope ◽  
Anatomic Dissection ◽  
Onodi Cell

Endoscopic sinus surgery in patients who have an Onodi cell (sphenoethmoid cell) carries a high risk for optic nerve injury. We meticulously dissected 65 embalmed cadaver adult half-heads and attempted to identify an optic canal bulge in each with a nasal endoscope. Our aims were to determine the prevalence of an Onodi cell in adult Thai cadavers, to ascertain the prevalence of an overriding ethmoid cell, and to measure the length of an overriding ethmoid cell's superior and posterior extensions in relation to the anterior sphenoid wall. Moreover, we attempted to determine the minimum amount of bone thickness between an Onodi cell and the optic nerve. We found that an Onodi cell was present in 39 of the 65 specimens (60.0%). We also found that an overriding ethmoid cell was present in 14 specimens, which accounted for 21.5% of the total number of specimens and 36.8% of 38 Onodi cell-positive specimens (the presence or absence of an overriding ethmoid cell was not recorded in one of the 39 Onodi cell-positive specimens). The distance of the overriding ethmoid cell's superior and posterior extensions from the anterior sphenoid wall ranged from 3 to 13 mm (median: 7) and from 4 to 16 mm (median: 9.5), respectively. Measurements of the minimum amount of bone thicknesses between each Onodi cell and optic nerve ranged from 0.03 to 0.54 mm (median: 0.08). Our study demonstrated that the prevalence of an Onodi cell in adult Thai cadavers was as great as the prevalence reported in the only other gross anatomic dissection study performed in Asia and much higher than rates generally reported in Western countries.

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