Frontal mucopyocele with bone erosion in a 7-year-old  child - exclusively endoscopic endonasal approach - a case  report

A mucocele is a benign lesion that predominantly affects the paranasal sinuses, with a slow growth rate and expansive pattern. When infected, it is known as mucopyocele. Presentation of a frontal mucopyocele can be found more frequently in adults. In contrast, it is rarely seen in children since pneumatization of the sinuses usually takes place after age 7. This report aims to present one case of a frontal mucopyocele as an important complication of a pansinusitis in a 7-year-old child and discuss the diagnosis, surgical approach, and differentials. Endoscopic endonasal surgery is a safe approach and must be taken into consideration in these situations.

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Endoscopic Endonasal Approach to the Optic Canal: Anatomic Considerations and Surgical Relevance

Operative Neurosurgery ◽

10.1227/neu.0000000000000900 ◽

2015 ◽

Vol 11 (3) ◽

pp. 431-446 ◽

Cited By ~ 21

Author(s):

Kumar Abhinav ◽

Yancy Acosta ◽

Wei-Hsin Wang ◽

Luis R Bonilla ◽

Maria Koutourousiou ◽

...

Keyword(s):

Ophthalmic Artery ◽

Human Head ◽

Optic Canal ◽

Falciform Ligament ◽

Endoscopic Endonasal Approach ◽

Endoscopic Endonasal Surgery ◽

Endonasal Surgery ◽

Endoscopic Endonasal ◽

Dural Opening ◽

Anatomic Relationship

Abstract BACKGROUND Increasing use of endoscopic endonasal surgery for suprasellar lesions with extension into the optic canal (OC) has necessitated a better endonasal description of the OC. OBJECTIVE To identify the osseous OC transcranially and then investigate its anatomic relationship to the key endonasal intrasphenoidal landmarks. We also aimed to determine and describe the technical nuances for safely opening the falciform ligament and intracanalicular dura (surrounding the optic nerve [ON]) endonasally. METHODS Ten fresh human head silicon-injected specimens underwent an endoscopic transtuberculum/transplanum approach followed by 2-piece orbitozygomatic craniotomy to allow identification of 20 OCs. After completing up to 270° of endonasal bony decompression of the OC, a dural incision started at the sella and continued superiorly across the superior intercavernous sinus. Subsequently the dural opening was extended anterolaterally across the dura of the prechiasmatic sulcus, limbus sphenoidale, and planum. RESULTS Endonasally, the length of the osseous OC was approximately 6 mm and equivalent to the length of the lateral opticocarotid recess, as measured anteroposteriorly. The ophthalmic artery arose from the supraclinoidal carotid artery at approximately 2.5 mm from the medial osseous OC entrance. Transcranial correlation of the endonasal dural incision confirmed medial detachment of the falciform ligament and exposure of the preforaminal ON. CONCLUSION The lateral opticocarotid recess allows distinction of the preforaminal ON, roofed by the falciform ligament from the intracanalicular segment in the osseous OC. This facilitates the preoperative surgical strategy regarding the extent of OC decompression and dural opening. Extensive endonasal decompression of the OC and division of the falciform ligament is feasible.

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Sinonasal quality of life in patients after an endoscopic endonasal surgery of a sellar tumour

Scientific Reports ◽

10.1038/s41598-021-02747-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Vlastimil Novák ◽

L. Hrabálek ◽

J. Hoza ◽

C.Hučko ◽

D. Pohlodek ◽

...

Keyword(s):

Quality Of Life ◽

Nasal Congestion ◽

Cranial Base ◽

Fascia Lata ◽

Endoscopic Endonasal Approach ◽

Endoscopic Endonasal Surgery ◽

Endonasal Surgery ◽

Endoscopic Endonasal ◽

Snot 22

AbstractEndoscopic endonasal approach uses the nasal cavity and paranasal sinuses to access the cranial base and may be a source of post-surgical morbidity in many patients with a sellar tumour. The objective of the presented study was to evaluate sinonasal quality of life and assess the effect of chosen reconstruction of the cranial base on the final condition. 65 patients, 33 male and 32 female who underwent an endoscopic endonasal surgery due to sellar expansion, were included into this prospective study. Sinonasal quality of life was evaluated using the Sinonasal Outcome Test-22 (SNOT-22) questionnaire before the surgery and six months after the surgery. Sinonasal quality of life was evaluated for the total cohort of patients and for patients after reconstruction (fascia lata, muscle) and without reconstruction. The minimum follow-up period was one year. There was no significant difference between the score (SNOT-22) before the surgery (average 14.4 points) and after the surgery (average 17.5 points), p = 0.067 in the whole cohort. Statistically significant differences were found in the following items—the need to blow nose, nasal congestion, loss of smell and taste, and thick discharge from the nose. The comparison of subgroups with and without the reconstruction yielded statistically significant differences in favour of patients with reconstruction in the following items—lack of high-quality sleep and feeling exhaustion. The endoscopic endonasal approach in patients with a sellar tumour is a gentle method with minimal effects on sinonasal quality of life over a period longer than six months. The most common complaints are the need to blow nose, nasal congestion, loss of smell and taste, and thick discharge from the nose. Cranial base reconstruction using the muscle and fascia lata seems to be a potential factor positively influencing sinonasal quality of life.

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