scholarly journals Computed tomographic Assessment of Lateral Lamella of Cribiform Plate and Comparison of Depth of Olfactory Fossa

2010 ◽  
Vol 49 (178) ◽  
Author(s):  
M Bista ◽  
M Maharjan ◽  
S Shrestha ◽  
T KC
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Cribriform Plate ◽  
Sinus Surgery ◽  
Tomographic Images ◽  
Medical College ◽  
Computed Tomographic ◽  
Diagnostic Center ◽  
The Right ◽  
Median Height

INTRODUCTION: Endoscopic sinus surgery is an upcoming branch in rhinological practice but with some major risks since it has to play around the skull base area. Lateral lamella of cribriform plate is the thinnest area of the skull base. Thus this study is undertaken to evaluate the height of lateral lamella of cribriform plate and the depth of olfactory fossae by the help of computed tomographic images. METHODS: Computed tomographic study of 50 patients was done in Advanced Imaging and Diagnostic center, Kathmandu Medical College. Coronal sections at the centre of infra-orbital foramina were taken as reference slide. The height of cribriform plate point was subtracted from the height of medial ethmoidal roof point to measure the length of lateral lamella of cribriform plates on both sides. RESULTS: The median height of LLCP in 100 slides was 2.8 mm. LLCP height was 0 to 3.9 mm in 86 slides, 4 to 7 mm in 12 slides and greater than 7mm in 2 slides. The LLCP length was greater in right side in 28 (56%) patients and was greater in left side in 19 (38%) patients. It was equal in both sides in only three patients (6%). CONCLUSIONS: As regards the length of LLCP; 0 to 3.9 mm length was most common. The olfactory fossa depth was more in the right side compared to the left side. Thus, right side is more vulnerable to injury during surgery. Thus adequate caution has to be exercised by the rhinological surgeon during endoscopic sinus surgery. Keywords: lateral lamella of Cribriform plate, medical ethmoidal roof, olfactory fossa.  

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.

Don't sue the surgeon: remineralisation of the skull base or a defect that never existed?

2011 ◽  
Vol 125 (12) ◽  
pp. 1294-1297
Author(s):  
C Hopkins ◽  
S Dhillon ◽  
G Rogers ◽  
D Roberts
Keyword(s):  
Computed Tomography ◽  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Semicircular Canals ◽  
Time Frame ◽  
Sinus Surgery ◽  
Operative Exploration ◽  
Intracranial Complications ◽  
Operative Findings ◽  
The Right

AbstractIntroduction:Intracranial complications are recognised as rare, but serious, sequelae of endoscopic sinus surgery.Case report:A 56-year-old woman was referred after developing meningitis following elective functional endoscopic sinus surgery. Computed tomography demonstrated a significant defect of the skull base in the right posterior ethmoid, clearly visible on both coronal and sagittal sections. Operative exploration demonstrated the skull base to be intact in the posterior ethmoid area identified on the scan, and the overlying mucosa appeared undisturbed. Scans were reviewed in the light of operative findings; coronal and sagittal images were found to be reconstructions. Directly acquired coronal computed tomography, undertaken three weeks after surgery, demonstrated a complete bony plate in the right posterior ethmoid at the site previously identified as dehiscent.Discussion and conclusion:We speculate that the posterior ethmoid defect was actually an artefact of reconstruction. We cannot exclude the alternative possibility of remineralisation, but given the time frame this seems unlikely. This case highlights the need for caution when interpreting reconstructed images of the thin bony plates of the skull base and lamina papyracea, as regards both clinical significance and medicolegal reporting. While virtual defects have been reported in the superior semicircular canals as a result of reconstructed images, we believe this to be the first reported case demonstrating a similar problem in the anterior skull base.

scholarly journals Management of an Unusual Intranasal Foreign Body Abutting the Cribriform Plate: A Case Report and Review of Literature

2019 ◽  
Vol 12 ◽  
pp. 117955061985860
Author(s):  
Mingyang L Gray ◽  
Catharine Kappauf ◽  
Satish Govindaraj
Keyword(s):  
Foreign Body ◽  
Skull Base ◽  
Foreign Bodies ◽  
Cribriform Plate ◽  
Sinus Surgery ◽  
Csf Leak ◽  
Intracranial Involvement ◽  
History Of ◽  
Initial Imaging ◽  
The Right

A 35-year-old man with history of schizophrenia presented 3 weeks after placing a screw in his right nostril. Initial imaging showed a screw in the right ethmoid sinus with the tip penetrating the right cribriform plate. On exam, the patient was hemodynamically stable with purulent drainage in the right nasal cavity but no visible foreign body. While most nasal foreign bodies occur in children and are generally removed at the bedside, intranasal foreign bodies in adults tend to require further assessment. The foreign body in this case was concerning for skull base involvement and the patient was brought to the operating room (OR) with neurosurgery for endoscopic sinus surgery (ESS) and removal of foreign body. The screw was removed and the patient recovered with no signs of cerebrospinal fluid (CSF) leak postoperatively. Any concern for skull base or intracranial involvement should call for a full evaluation of the mechanism of injury and intervention in a controlled environment.

scholarly journals Onodi cells and endoscopic sinus surgery

2020 ◽  
Vol 6 (6) ◽  
pp. 1041
Author(s):  
Manish Munjal ◽  
Suneet Bhatia ◽  
Porshia Rishi ◽  
Nitika Tuli ◽  
Harjinder Singh ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Sphenoid Sinus ◽  
Surgical Intervention ◽  
Sinus Surgery ◽  
Optic Nerve Injury ◽  
Medical College ◽  
Computed Tomographic ◽  
Operative Evaluation

<p class="abstract"><strong>Background:</strong> The optic nerve is susceptible to injury during endoscopic surgical intervention in the sphenoethmoidal region.</p><p class="abstract"><strong>Methods:</strong> This was a retrospective analysis of 157 axial computed tomography sections through the sphenoid sinus of randomly selected cases from the departments of Otorhinolaryngology and Neurosurgery, Dayanand Medical College and Hospital, Ludhiana was undertaken during the period 2002 to 2004.  </p><p class="abstract"><strong>Results:</strong> A computed tomographic study of the Onodi cells, of this region was carried out in 157 axial scans. The incidence of Onodi cells was 12.10% with predominance of left sided and indirect type of cells in our study.</p><p class="abstract"><strong>Conclusions:</strong> Thorough pre-operative evaluation of sphenoethmoidal region optic nerve and extent of pathology is essential to avoid the irreversible complication of optic nerve injury.</p><p class="abstract"> </p>

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.

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.

Incidence, risk factors, and outcomes of endoscopic sinus surgery after endoscopic skull‐base surgery

2020 ◽  
Vol 10 (4) ◽  
pp. 521-525
Author(s):  
Ravi R. Shah ◽  
Ivy W. Maina ◽  
Neil N. Patel ◽  
Vasiliki Triantafillou ◽  
Alan D. Workman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Sinus Surgery ◽  
Endoscopic Skull Base Surgery ◽  
Incidence Risk

scholarly journals "Silent sinus syndrome": One more indication for functional endoscopic sinus surgery

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 65-68
Author(s):  
Ljiljana Jovancevic ◽  
Slobodan Savovic ◽  
Slavica Sotirovic-Senicar ◽  
Maja Buljcik-Cupic
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Rare Condition ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Orbital Trauma ◽  
Silent Sinus Syndrome ◽  
Slow Development ◽  
The Right

Introduction. Silent sinus syndrome is a rare condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and downward displacement of the orbital floor. Patients with this syndrome present with ophthalmological complaints, without any nasal or sinus symptoms. Silent sinus syndrome has a painless course and slow development. It seems to be a consequence of maxillary sinus hypoventilation due to obstruction of the ostiomeatal unit. The CT scan findings are typical and definitely confirm the diagnosis of silent sinus syndrome. Case report. We present the case of a 35-year-old woman, with no history of orbital trauma or surgery. She had slight righthemifacial pressure with no sinonasal symptoms. The patient had no double vision nor other ophthalmological symptoms. The diagnosis of silent sinus syndrome was based on the gradual onset of enophthalmos and hypoglobus, in the absence of orbital trauma (including surgery) or prior symptoms of sinus disease. On paranasal CT scans there was a complete opacification and atelectasis of the right maxillary sinus with downward bowing of the orbital floor. The patient was treated with functional endoscopic sinus surgery, with no orbital repair. Conclusion. Silent sinus syndrome presents with orbithopaties but is in fact a rhinologic disease, so all ophthalmologists, rhinologists and radiologists should know about it. The treatment of choice for silent sinus syndrome is functional endoscopic sinus surgery, which should be performed with extra care, by an experienced rhinosurgeon.

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