Computed tomography assessment of the ethmoid roof based on Keros classification in Iraqi patients undergoing functional endoscopic sinus surgery

2021 ◽  
Vol 4 (2) ◽  
pp. 365-370
Author(s):  
Baseem Natheer Abdulhadi ◽  
Ali Ibrahim Shyaa ◽  
Laith ALTamimi

Background: Among the most popular methods employed to classify the depth of the olfactory fossa is Keros classification. This study aims to assess Keros classification of the ethmoid roof, any possible association between Keros types and gender, and the incidence of asymmetry between right and left sides among Iraqi patients.  Methods: A retrospective cross-sectional study was conducted at Al-Shaheed Gazi Al-Hariri Teaching Hospital, Medical City, Baghdad, Iraq. The archived reports and the CT scans images (nose and paranasal sinuses) of 126 patients who have undergone functional endoscopic sinus surgery between January 2019 and January 2020 were reviewed. Univariate and bivariate statistical analysis was performed using SPSS version 24. The statistically significant was considered at less than 0.05. Results: More than half of patients were females (54.0%) with a mean age of 31.52 ± 11.38 (SD) years (range: 10-57 years). Among the total patients, the mean depth of olfactory fossa (OF) was 3.58 ± 0.02 mm. Results showed that Keros type I was the most common type (71.0%), followed by type II (27.4%) and type III (1.6%) respectively. The difference in the olfactory fossa depth between the right and left sides was ≥ 1 mm in 16 (12.7%) patients and < 1 mm in 110 (87.3%) patients. Moreover, there was no significant relation between symmetry/asymmetry and gender ( p-value > 0.05). Conclusion: Keros type I was the most common type, which carries the lowest risk of inadvertent intracranial injury during endoscopic sinus surgery; besides the relatively low percentage of asymmetry in the depth of the two olfactory fossae among patients, surgeons should always be cautious during surgery to avoid iatrogenic injury concerning the thin lateral lamella of the cribriform plate.

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S534-38
Author(s):  
Adnan Asghar ◽  
Sohail Aslam ◽  
Syed Muhammad Asad Shabbir Bukhari ◽  
Umar Ijaz ◽  
Shahid Iqbal ◽  
...  

Objective: To determine frequency of our complications of endoscopic sinus surgery without pre-operative CT-Scan and to compare this frequency with other similar studies done with the help of pre-operative CT-Scans. Study Design: Cross sectional study. Place and Duration of Study: ENT Department, Combined Military Hospital Skardu Pakistan, from Jun 2017 to Jun 2019. Methodology: Total 69 patients (116 Sides) were operated under general anesthesia by using 0 and 30 degree endoscopes to address the Maxillary sinusitis. Frequency of complications was compared to other studies by applying chi-square test for goodness of fit. The complications were also correlated to ages of patients by applying Spearman correlation analysis. Results: Mean age was 29.75 ± 10.9 years (range 15-75). Overall complications rate was 4.3% (5 out of 116 sides, 95% confidence interval 4.23-4.4). Peri-orbital ecchymosis and peri-orbital emphysema were most commonly occurring complications (4.3%). This complication rate was compared to few other studies, which proved that difference was not statistically significant. Correlation of occurrences of orbital complications with the age proved that there was no statistically significant correlation (Correlation coefficient r=-0.085, p-value 0.276). Conclusion: Isolated chronic maxillary sinusitis refractory to medical treatment can be treated by endoscopic sinus surgery without pre-operative CT-Scan.


2014 ◽  
Vol 7 (3) ◽  
pp. 100-104 ◽  
Author(s):  
Anilkumar Suryadev Harugop ◽  
Ramesh Mudhol ◽  
Amit Nargund ◽  
Shailaja Hugar ◽  
Amrit Kapoor ◽  
...  

ABSTRACT Objective To determine whether topical application of mitomycin- C at the conclusion of FESS decreases the incidence of postoperative adhesion formation. Study design Prospective cross-sectional study. Materials and methods Between June 2011 and June 2013, 42 patients (65 sides) aged between 16 and 66 years diagnosed to have chronic rhinosinusitis (CRS) underwent FESS. At the conclusion of the ESS, cotton ribbon wick soaked with 1 ml mitomycin-C (0.4 mg/ml) was placed in right/left/ both middle meati, near the widened sinus ostia for a period of 4 minutes. Following application, nasal cavity was irrigated with sterile normal saline. Patients were examined weekly for 1 month after surgery. Additional examinations were done at the end of 2nd and 3rd months postoperatively. At the end of 3 months follow-up, the outcome was assessed subjectively by symptoms and objectively by endoscopic findings. Results At the end of 3 months follow-up, a significant decrease (80%) in symptom scores was observed (6.64 ± 1.80, p < 0.001). Similarly in sinonasal outcome test (SNOT) score we observed a significant reduction (71%) in scores (17.76 ± 8.17, p < 0.001) and 3.1% cases showed adhesions. Conclusion CRS patients have remarkable improvement in their symptoms after FESS. Topical application of mitomycin-C at the conclusion of FESS/ESS has a role in prevention of adhesion formation. How to cite this article Harugop AS, Mudhol R, Nargund A, Hugar S, Kapoor A, Shetty R. Efficacy of Mitomycin-C for Prevention of Adhesion Formation after Functional Endoscopic Sinus Surgery in Cases of Chronic Rhinosinusitis: A Prospective Cross-sectional Study. Clin Rhinol An Int J 2014;7(3):100-104.


2021 ◽  
Vol 12 ◽  
pp. 215265672199342
Author(s):  
Arthur Uyesugi ◽  
Shannon Moldowan ◽  
Keighly Bradbrook ◽  
Theodore Schuman

Objectives YouTube is the second most visited website in the world and can be a useful resource for patients to gain insight into surgical procedures. A multitude of studies have evaluated the quality of otolaryngology-specific healthcare information available on the YouTube platform, but to our knowledge, the online content regarding functional endoscopic sinus surgery available on this site has not been systematically evaluated. Study Design Cross sectional study. Setting Online. Methods YouTube was searched using the keywords “sinus surgery.” Variables including video length, total number of views, authorship (academic, private practice physician, patient, or third party), objective (advertisement, informative, or patient perspective), inclusion of intra-operative footage, and discussion of balloon sinuplasty were recorded and analyzed by a single reviewer. Results Two-hundred twenty-two videos met inclusion criteria, with a median length of 4 minutes, and a median of 3349 views. The majority of videos were informative (n = 145, 65%), narrated (n = 151, 68%), and did not mention balloon sinuplasty (n = 189, 85%) nor contain intra-operative footage (n = 116, 52%). Private practice physicians were the most common authors (n = 113, 51%), followed by patients (n = 70, 32%), third parties (n = 28, 13%) and academics (n = 11, 5%). Conclusions Sinus surgery is one of the most common ambulatory procedures performed. Online resources such as YouTube can be useful for improving health literacy and patient comfort with medical topics such as functional endoscopic sinus surgery, but it is important for clinicians and patients to understand that there is a spectrum in the authorship, content, and quality of sinus surgery related videos posted online.


Author(s):  
Manish Agrawal ◽  
Pooja Arya ◽  
Deepchand Meghwal ◽  
Vivek Samor ◽  
Gaurav Gupta ◽  
...  

<p class="abstract"><strong>Background:</strong> Functional endoscopic sinus surgery (FESS) is a challenging procedure for otorhinolaryngologists. Navigation can reassure the surgeon’s judgement and enhance surgical performance and prevent complication. The study done with aim of comparison between FESS with navigation and conventional FESS and explore other indication of navigation in endoscopic sinus surgery in difficult clinical scenario.</p><p class="abstract"><strong>Methods:</strong> This is a cross-sectional study on patients with sino-nasal disease. 100 patients in whom the ability to identify surgical site is assumed to be compromised by various conditions like previous surgery, massive/ recurrent polyposis, front oethmoidal mucocele, frontal, sphenoid sinus disease were included in the study. Patients were randomly allocated into two groups, group A (50 patients) FESS with navigation and group B (50 patients) conventional FESS. Pre-operative preparation time, intraoperative time, blood loss (Fromme–Boezzaart scoring), surgeon satisfaction, patient satisfaction (SNOT-20), complications were documented on a preformed, pretested proforma. Equipments used were –StealthStation S7 system, CD for recording intraoperative findings.  </p><p class="abstract"><strong>Results:</strong> Preoperative preparation time duration was applicable for group A only. Intraoperative time was slightly and insignificantly higher in group A. Blood loss according to Fromme-Boezzaart scoring had lesser scoring values in group A and difference among gradings was statistically insignificant. Surgeons satisfaction and confidence was statistically significant higher in group A. The SNOT-20 score values were lower and insignificant in group A.</p><p class="abstract"><strong>Conclusions:</strong> FESS with navigation is more convenient to surgeon, appears to be safer tool.</p>


2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Sudeep Mishra ◽  
Shyam Thapa Chhetri ◽  
Ashok Raj Pant ◽  
Shankar Prasad Shah ◽  
Sriti Manandhar

Introduction: Endoscopic sinus surgery is a well-known approach for sino-nasal pathologies. Due to close proximity to the brain and orbit, the surgeon should be aware of the sino-nasal anatomy and its associated variations. Detailed preoperative assessment of the sinus computed tomography scans reduces the frequency of severe complications in patients undergoing an endoscopic sinus surgery. So, the aim of this study is to find the prevalence of dangerous ethmoid in a tertiary center in eastern Nepal. Methods: A descriptive cross-sectional study was performed in a Computed tomography scan of 50 patients with chronic sinusitis undergoing endoscopic sinus surgery from February 2018 to August 2018 in the department of Otolaryngology and Radiology of BP Koirala institute of health sciences after taking ethical approval from Institutional Review Committee of the institute. Measurements are taken in the coronal plane. The depth of the lateral lamella of the cribriform plate was defined according to the Keros classification which defines the dangerous ethmoid. and side. Data entered in MS excel. Statistical analysis was performed in SPSS version 11.5. Results: Keros type I, II, and III were noted in 17 (17%), 54 (54%) and 29 (29%) of cases respectively. The mean width of the olfactory fossa, medial orbital wall distance and distance from medial nasal concha were 3.57mm, 8.77mm & 17.78mm respectively. Conclusions: The most common type of dangerous ethmoid was keros type II. Conclusions: The most common type of dangerous ethmoid was keros type II.


2020 ◽  
Vol 7 (43) ◽  
pp. 2442-2447
Author(s):  
Shahul Hameed A ◽  
Abdul Salam R.T ◽  
Dilna Dilna

BACKGROUND In recent times, due to advancement in sinus endoscopes and sinus surgery instruments and the acquirement of skills, the variety of sinonasal diseases being treated and the indications for transnasal endoscopic approaches have increased dramatically. They include chronic rhinosinusitis and sinonasal polyposis to sinonasal tumours, skull base and orbital pathology. We wanted to study the role and outcome of endoscopic sinus surgery in the management of sinonasal disease. METHODS A cross sectional study was conducted among 200 patients attending the Department of ENT, Govt. Medical College, Kozhikode, over a period 2 years with sinonasal diseases. Demographic details, ENT examination, CT scan Paranasal Sinuses (PNS) and endoscopic examination of the nasal cavity were performed in all patients. Clinical signs were recorded and classified according to their pathologies. All the patients were subjected to functional endoscopic sinus surgery. Operative methods and results were recorded. RESULTS Among the 200 patients, 144 (72 %) were males and 56 (28 %) were female patients in the present study. Among the 200 patients, 126 (63 %) were in the age group of 21 to 50 years. 40 / 200 (20 %) patients belonged to the age group of 0 to 20 Years. 34 / 200 (17 %) patients belonged to the age group of 51 to 70 years. CONCLUSIONS The diseases of the nose and paranasal sinuses ranged from inflammatory aetiology to neoplasms. Use of conventional tools for diagnosis and management of such a variety of diseases had their own limitations and demerits. Whereas endoscopic view of the disease sites was exceptionally clear and well-illuminated, giving an added edge to the ability to inspect the recesses with angled distal endoscopes. Definition of micro anatomical sites was well defined by the CT scan especially around osteo-meatal complex, and its anatomical variants. Functional endoscopic sinus surgery was an excellent and safe procedure. The prognosis in surgically treating sinonasal pathologies with FESS was good in terms of lesser morbidity and minimal chances of recurrence. KEYWORDS Sinusitis, Endoscopic Sinus Surgery, CT Scan PNS, Skull Base Surgery, Sinonasal Tumours


2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Zehwa Mazhar ◽  
Rabia Manzoor ◽  
Shazia Kanwal ◽  
Ghazala Iqbal

Purpose:  To check the reliability of the duo-chrome test in different age groups after best correction. Study Design:  Descriptive, Cross Sectional Study. Place and Duration of Study:  College of Ophthalmology and Allied Vision Sciences. King Edward Medical University, Lahore from September 2019 – December 2019. Methods:  Forty two cooperative patients of both genders more than 15 years of age were included but patients with poor fixation, any opacity or any other ocular pathology were excluded. Equipment used was Trial box Trial frame Auto-refractor and Snellen Chart. Group 1 composed of 17 patients (15 – 35 years of age). Group 2 (36 – 60 years) had 15 patients and group 3 (age 61-80 years) comprised of 10 patients. Data was collected on self-designed Performa. Duo Chrome was dependent variable and gender was independent variable. Data was analyzed by using statistical package for social science (SPSS22.00) and chi square test was applied. Results:  Out 42, 21 patients reported red, 12 reported green and 9 patients reported equally clear in the right eye. P value=0.156 showed that duo chrome test was equally reliable in every age group in the right eye. Similar results with p = 0.755 showed that duo chrome test was equally reliable in every age group in the left eye. Test when performed bilaterally, showed similar results. Out of 42 patients, 32 were satisfied and 10 were not satisfied with the test. Conclusion: Red Green duo-chrome test is equally reliable in all age groups to confirm refraction. Key Words: Duo chrome test, Refraction, Myopia, Hypermetropia.


2018 ◽  
Vol 08 (02) ◽  
pp. 72-76
Author(s):  
Mahrukh Kamran ◽  
Sahar Mubeen ◽  
Iffat Raza ◽  
Sanobar Bughio ◽  
Hira Waseem ◽  
...  

Objectives: To determine the effect of serum TSH on thyroid dimensions of each lobe and to measure the amount of effect of per unit increase in serum TSH on thyroid dimensions of each lobe in euthyroids. Study Design: It was a cross-sectional study. Setting: The study was conducted at Ziauddin University Hospital, Clifton, Karachi. Methodology: Healthy participants aged 21 years and above were included through convenient sampling. Serum Thyroid stimulating hormone was evaluated and ultrasound of thyroid gland TG of 192 euthyroid participants was performed. Spearman correlation and regression analysis was applied to evaluate the relationship between TSH and TG dimensions Results: Relationship of increase in serum TSH with decrease in light lobe AP dimension was most significant. (r= -0.142 P-Value=0.001) and CC dimension least significant (r= -0.0098 P-Value=0.001). Where as in the left lobe AP dimension decreases significantly with increase serum TSH (r= -0.147 P-value=0.001). 11.7% of total variation in AP dimension, 3.5% of total variation in ML dimension and 6.5% of total variation in CC dimension in right lobe thyroid are because of serum TSH. While 9.5% of the total variation in AP dimension in left lobe is also due to serum TSH. Conclusion: Negative and significant correlation between serum TSH and thyroid dimensions was observed. Serum TSH inversely and significantly affects all the dimensions of the right lobe and only one dimension in the left lobe


Objective: This study was carried out to determine the prevalence of microdontia among patients undergoing orthodontic treatment. Materials and Methods: This was a cross-sectional study conducted at Sindh Institute of Oral Health Sciences, (JSMU) from January-2020 to May-2020. Pre-treatment casts were taken of 140 subjects. The mesiodistal dimension of each tooth was recorded through the vernier caliper. Frequency and percentage were calculated for the presence of microdontia. The test applied was Pearson’s Chi-square test to assess the relationship between microdontia and variables like age and gender. P-value <0.05 was taken as statistically significant. Data analysis was performed on SPSS version 22. Results: A total of 140 subjects were selected i.e. 105 (75%) females and 35 (25%) males aged range 13 -30 years with mean age 18.29 ± 3.88. Out of 42, single tooth microdontia was found in 3 (7.1%), more than one tooth microdontia, and generalized microdontia was present in 36 (85.7%) and 3 (7.1%) respectively. Microdontia was found to be more common in the maxilla (n=42, 100%) than the mandible (n=14, 33.3%). It was found more common in females (n=37, 35.2%) as compared to males (n=5, 14.3%). Statistically significant relationship was found among gender and prevalence of microdontia (p=0.019) with a statistically insignificant relationship between age and presence of microdontia (p=0.228). Conclusions: Microdontia was found to be a frequent dental anomaly, was more common in maxilla and females with a significant association with gender.


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