scholarly journals Towards the Understanding of Sinonasal Anatomical Variations - A Cadaveric Study

2009 ◽  
Vol 2 (3) ◽  
pp. 37-42
Author(s):  
Daisy Sahni ◽  
Rupa Mehta ◽  
Anjali Aggarwal

Abstract A thorough understanding of the sinonasal anatomy is required for the performance of a safe and successful surgery. With the aim to identify the variations in sinonasal anatomy in north Indian population twenty fresh cadaveric heads were dissected by messerklinger technique to identify various sinonasal anatomic variations in north Indian population. The variations in the key landmarks of nose and paranasal sinuses during endoscopic sinus surgery were noted and compared with other studies. Identification and differentiation of the normal and the abnormal sinonasal anatomic variations helps in preventing complications and giving optimum surgical results.

Author(s):  
Sumit Prinja ◽  
Jailal Davessar ◽  
Gurbax Singh ◽  
Simmi Jindal ◽  
Alisha Bali

<p class="abstract">Anatomic variations of the paranasal sinuses can lead to various diseases per se. The paranasal sinus anatomy should be carefully examined prior to performing endoscopic sinus surgery in terms of both existent pathologies and anatomic variations. The anatomy of the paranasal sinuses and its variations have gained importance, along with advances in coronal paranasal sinus computed tomography and extensive use of endoscopic sinus surgery. Rhinolith is a mass resulting from calcification of an endogenous or exogenous nidus within the nasal cavity. It is an uncommon disease that may present asymptomatically or cause symptoms like headache and nasal obstruction. A 24 year old woman was admitted in ENT department of GGS Medical College and Hospital, Faridkot with complaints of nasal obstruction, anosmia and headache persisting for 5 years. Right sided rhinolith was detected on anterior rhinoscopy. Bilateral concha bullosa with right sided rhinolith was reported on preoperative paranasal computed tomography scan. It is known that the paranasal sinuses have a number of anatomical variations. Sometimes severe anatomic variations predispose to rhinosinusitis. Herein we report a rare case, along with a review of the literature, to emphasize that severe anatomical variations should not be ignored.</p>


2002 ◽  
Vol 127 (6) ◽  
pp. 549-557 ◽  
Author(s):  
Ivica Klapan ◽  
Ljubimko Šimičić ◽  
Ranko Rišavi ◽  
Nada Bešenski ◽  
Karlo Pasarić ◽  
...  

One of the main objectives of our 3-dimensional (3D) computer-assisted functional endoscopic sinus surgery was to design a computer-assisted 3D approach to the presurgical planning, intraoperative guidance, and postoperative analysis of the anatomic regions of the nose and paranasal sinuses. Such an extremely powerful approach should allow better insight into the operating field, thereby significantly increasing the safety of the procedure. The last step to implementing the technology in the operating room was to connect the computer workstations and video equipment to remote locations by using a high-speed, wide-bandwidth computer network. During patient preparation, the surgeon in the operating room consulted remote experienced and skillful surgeons by viewing CT images and 3D models on computer workstations. The surgeon and consultants used software for CT image previews and 3D model manipulations on top of collaboration tools to define the pathosis, produce an optimal path to the pathosis, and decide how to perform the real surgical procedure. With tele-flythrough or tele-virtual endoscopy rendered through the use of 3D models, both surgeons can preview all the characteristics of the region (ie, anatomy, pathosis) and so predict and determine the next steps of the operation. This ensures greater safety thanks to the operation guidance and reduces the possibility of intraoperative error. The duration of the teleconsultation is thus shortened, which may prove the greatest benefit of tele-3D computer-assisted surgery. If this method were used, clinical institutions would spend less money for telesurgical consultation.


2021 ◽  
Vol 10 (38) ◽  
pp. 3351-3355
Author(s):  
Ganesh Manohar Vihapure ◽  
Akshay Sorade ◽  
Kaenat Ahmed ◽  
Lakshmi Sravya Yarlagadda ◽  
Khaleel Basha Munnaru

BACKGROUND The paranasal sinuses (PNS) have various anatomical difference. Computed tomography (CT) is an excellent means of providing anatomical information of this region, disease extent, assisting endoscopic evaluation and guiding treatment. Functional endoscopic sinus surgery (FESS) has become an increasingly popular treatment for chronic sinus diseases. CT of the paranasal sinuses has become a roadmap for FESS. The present study focuses on the assessment of the efficacy, safety and benefits of functional endoscopic sinus surgery in cases of maxillary pathologies and also study the anatomical variations in maxillary sinus in computed tomography and its usefulness in planning and management of chronic sinonasal diseases. METHODS It was a prospective study and a total of 80 patients were included in this study from July 2019 to June 2020 in the Otolaryngology Department, KIMS, Karad. Standard surgical steps were applied in each case according to the extent of disease. All patients underwent standard post-operative care. All findings were recorded and studied. RESULTS Total number of patients were 80. Of which, 31 (38.75 %) patients were operated for ethmoidal polyp, 24 (30 %) for chronic rhinosinusitis, 10 (12.5 %) for antrochoanal polyp, 9 (11.25 %) for rhinosporidiosis and 6 (7.5 %) for inverted papilloma. Postoperative complications were periorbital echymoses (13 %), synechiae (2.5 %), epiphora (2.5 %), infection (2.5 %), hemorrhage (4 %). Complete relief of symptoms were noted in 81.67 % cases. CONCLUSIONS Successful outcome and patient satisfaction post treatment can be obtained by careful evaluation and patient selection by history, examination and most importantly, proper imaging of the sinuses. KEY WORDS Maxillary Sinus, Sinusitis, Nasal Polyp, Paranasal Sinus Disease, Computed Tomography (CT)


1994 ◽  
Vol 73 (8) ◽  
pp. 548-552 ◽  
Author(s):  
Bruce W. Jafek ◽  
Bruce Murrow ◽  
Edward W. Johnson

Recent advances in endoscopic evaluation of the nose and paranasal sinuses and endoscopic sinus surgery, coupled with the development of standardized testing of olfactory acuity, have permitted improved correction of olfactory dysfunction. Conversely, increase in the number of operations performed has increased the number of injuries to the olfactory pathways. The mechanisms of loss and potential preventive and corrective measures are reviewed with a goal to minimize the numbers of these complications.


2022 ◽  
Vol 9 (3) ◽  
pp. 54-57
Author(s):  
Sajjad Ali Hashmi Syed ◽  
Sadaf Tanveer Khan ◽  
Jawwad Ali Hashmi Syed

Abstract Introduction: For Functional Endoscopic Sinus Surgery (FESS), the surgeon needs an accurate depiction of the anatomy of paranasal sinuses and their variations. Computed tomography (CT Scan) fulfills this requirement by providing detailed anatomy, the anatomical variants, and the extent of the disease in and around the Para nasal sinuses. The aim of this study is to show the anatomy of the Frontal sinus as delineated by the computed tomography. Materials and Methods: STUDY DESIGN: Cross section Descriptive Study. Out of 337 patients above 12 years of age who were referred for computed tomography of paranasal sinuses in the Dept. of Radio- Diagnosis, Govt. Medical College and Hospital from December 2015 till October 2017, 200 adults(males and females) were randomly selected.Of the 200 subjects studied 37(18.5%) subjects had hypoplastic/ non or poorly pneumatised frontal sinuses of which 31 (15.5%) were bilateral and 6 (3%) were unilateral i.e. on right side. Observations and results: Intra frontal cell were seen in about 64 (32%) subjects of which 26 (13%) on right side, 24 (12%) were on left side and 14 (7%) were bilateral. Extension of pneumatisation into crista galli was seen in 16 (8%) subjects and into orbital roof was seen in 6 (3%) subjects. Conclusion: The findings in this study show that anatomical variations in the Para nasal sinuses and nasal cavity are common. Computed tomography is fundamental radiologic investigation for diagnosis of the Sino nasal lesions or pre and post-surgical assessment.


2017 ◽  
Vol 10 (1) ◽  
pp. 87-92 ◽  
Author(s):  
Sergey A Karpishchenko ◽  
Natalya Yu Beldovskaya ◽  
Svetlana V Baranskaya ◽  
Artemiy A Karpov

Functional endoscopic sinus surgery (FESS) is an effective and safe surgical technique, which revolutionized the surgical management of nasal cavity and paranasal sinus diseases. The intimate connection between paranasal sinuses and the orbit places the orbital content at a risk of injury during sinus surgery, especially that of ethmoid sinuses. The orbit, the optic nerve, extraocular muscles and the lacrimal drainage system could be damaged during FESS. The risk of injury correlates to anatomical variations, degree and severity of disease, previous procedure results, and surgical experience. Ophthalmic complications can vary in severity from minor ones, such as localized hematomas, to extremely dangerous, such as optic nerve injury, that could lead to complete blindness. In order to minimize the risk of such complications, it is necessary to consider probable anatomic variations of paranasal sinuses and orbit, which are to be detected by CT scan before surgery.


Author(s):  
G. Ramesh Babu ◽  
G. Ravi Kumar ◽  
V. Krishna Chaitanya

<p class="abstract"><strong>Background:</strong> Drainage and ventilation of paranasal sinuses are important for normal function which depends on effective mucociliary clearance. In present study we tried to emphasize variations in lateral wall of nose and clinical features leading to nose and paranasal sinus disease using diagnostic nasal endoscopy and variations in CT scan of paranasal sinuses. The objectives of the study are to observe various anatomical variations in nose and paranasal sinuses and their clinical presentation using diagnostic nasal endoscopy and CT scan of paranasal sinuses and to compare various anatomical variations in nose and paranasal sinuses.</p><p class="abstract"><strong>Methods: </strong>Present study included 54 patients presenting in Department of ENT, Head and Neck Surgery, during February 2015 to February 2017.   </p><p class="abstract"><strong>Results:</strong> Diagnostic nasal endoscopy findings reveal that most common finding was polypoidal changes in nasal mucosa in 36 (66.67%) of patients, followed by mucopurulent discharge in 26 (48.14%), postnasal discharge in 20(37.03%) and 4 (7.40%) patients showed prominent agger nasi cell. CT scan of paranasal sinuses revealed multiple sinus involvement in 41 (75.92%) of patients with partial involvement of sinuses. Complete sinus opacification with pan sinusitis was observed in 9 (16.67%), blockade at osteomeatal complex was observed in 46 (85.18%), paradoxical middle turbinate was observed in 5 (9.25%), Concha bullosa was observed in 12 (22.23%) of patients.</p><p class="abstract"><strong>Conclusions:</strong> Each variation have an anatomic and surgical significance, hence each and every case should be individually studied in detail before undergoing functional endoscopic sinus surgery to maximize patient benefit and to prevent unnecessary complications. Diagnostic nasal endoscopic examination is clinical guide to evaluate disease.</p>


Author(s):  
P. K. Roopa Rajavarthini ◽  
I. Venkatraman

Multi detector computed tomography (MDCT) scan of paranasal sinuses has become mandatory for all patients undergoing functional endoscopic sinus surgery. It depicts the anatomical variations in much simpler way and acts as a roadmap for endoscopic sinus surgery. In this study the maximum of participants were in the age group of 41- 50 years (32 %). The mean age of the study participants was observed to be 43.8 ± 15.6 years. HRCT PNS results shows nasal septum was found to be the most common anatomical variant (DNS- 94%). Concha Bullosa in right side were seen in 37.5% and left side were 21.9% (total unilateral cases- 59.4%) and bilateral Concha Bullosa were seen in 40.6% of the cases. Agger nasi were found to be present in 58% of the CRS cases among which right AN was 41%, left side was 30.8%, and bilateral AN were seen in 28.2% of the cases and Paradoxical Middle Turbinate were seen in 42% of cases in our study. Medialised uncinate was seen in 22% of the cases.


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