Endonasal Endoscopic Approach to Sphenoid Sinus Lesion

2021 ◽  
Vol 15 (9) ◽  
pp. 2876-2879
Author(s):  
Ikram Ullah ◽  
Anees Ur Rehman ◽  
Saulat Sarfraz ◽  
Sarfraz Latif ◽  
Zia Us Salam Qazi ◽  
...  
Keyword(s):  
Skull Base ◽  
Sphenoid Sinus ◽  
Image Intensifier ◽  
Lateral Wall ◽  
Postoperative Recovery ◽  
Endoscopic Approach ◽  
Sinus Surgery ◽  
Base Region ◽  
The Past ◽  
External Incisions

Background: Anatomical position of sphenoid sinus, sellar and parasellar regions are located in the skull base having difficulty to approach due to presence of vital structures in its proximity. The presence of carotid artery and optic nerve in its lateral wall make the situation difficult due to lack of illumination and visual limitation. In the past traditional techniques to approach this region like external ethmoidectomy, transseptal transsphenoidal routes were used causing significant trauma, bleeding and risk of possible complication in skull base region. Aim: to access the efficacy and safety of the endonasal endoscopic approach to the sphenoid sinus Method: This study was done in the department of ENT Shaikh Zayed hospital Lahore, 33 patients who were diagnosed to have lesions involving sphenoid sinus. Detailed history, thorough ENT examination, relative investigations were done and all were managed naso-endoscopically. Results: The review of these cases showed that the endoscopic technique was found to have the advantages of being minimally invasive with no external incisions. There is less trauma to the patient, no need for operating microscope or intraoperative image intensifier. Conclusion: The conclusion of our study showed that naso-endoscopes are excellent tools for better visualization due to availability of different angled scopes and good illumination. The disease is better assessed and cleared identifying landmarks with quicker postoperative recovery and lesser overall morbidity. Over the last few years, endoscopic approach to these regions has gained much popularity because of advances in optics, endoscopes and illumination. Keywords: Endoscopic sinus surgery, sphenoid sinus

scholarly journals Complications in Skull Base Surgery and Subsequent Repair

2020 ◽  
Vol 34 (04) ◽  
pp. 286-292
Author(s):  
Weitao Wang ◽  
Tom Shokri ◽  
Spiros Manolidis ◽  
Yadranko Ducic
Keyword(s):  
Skull Base ◽  
Endoscopic Sinus Surgery ◽  
Skull Base Surgery ◽  
Sinus Surgery ◽  
Skull Base Tumors ◽  
Viable Option ◽  
The Past ◽  
Tissue Transfer

AbstractOver the past several decades, endoscopic sinus surgery has revolutionized the approach to skull base surgery. Open skull base approaches remain a viable option for advanced skull base tumors. Complications have gone down with increased reliability of vascularized tissue transfer. In this article, the authors explore the various complications that can present following skull base surgery and review the approaches for repair when such issues are encountered.

scholarly journals Anatomic Study of Endoscopic Transnasal Approach to Petrous Apex

2020 ◽  
Vol 218 ◽  
pp. 03016
Author(s):  
Wenyuan He ◽  
Qingying Qin ◽  
Guxian Wang
Keyword(s):  
Skull Base ◽  
Sphenoid Sinus ◽  
Lateral Wall ◽  
Anterior Wall ◽  
Surgical Anatomy ◽  
Petrous Apex ◽  
Transnasal Approach ◽  
Long Time ◽  
Endoscopic Transnasal Approach ◽  
Micro Drill

With the development of Neurosurgery technology, there has been a qualitative leap forward with the appearance of microanatomy, which makes the deep brain tumors which were hard to be achieved in the past, and effectively reduces the mortality of patients. Petrous apex is a cone-shaped part of the anteromedial part of the temporal bone, which is deep. It has been a challenging area for surgical anatomy for a long time. In this paper, fresh adult perfused cadaveric head specimens and dry adult cadaveric head specimens were taken as the experimental objects. The anterior wall of sphenoid sinus and the internal septum of sphenoid sinus were excised under neuroendoscope. The structures of the lateral wall of sphenoid sinus were identified and dissected. The lateral wall of sphenoid sinus and the bone of skull base were opened with micro drill, The meninges were exposed and cut open, and the related structures were dissected, observed and photographed. The experimental results show that it is relatively safe to operate in the range of less than 8mm, and the rock tip can be found accurately. The measurement of the bony structure of the skull base is helpful for the surgeon to judge the course of the internal carotid artery and its adjacent structure.

Endoscopic management of lesions of the sella turcica

1995 ◽  
Vol 109 (10) ◽  
pp. 956-962 ◽  
Author(s):  
Dharambir S. Sethi ◽  
Prem K. Pillay
Keyword(s):  
Pituitary Adenomas ◽  
Sphenoid Sinus ◽  
Sella Turcica ◽  
Sinus Surgery ◽  
Endoscopic Management ◽  
Operating Microscope ◽  
The Past ◽  
Sellar Lesions ◽  
Minimally Invasive Surgical ◽  
Ablative Surgery

AbstractThe excellent visualization and minimally invasive surgical technique of endoscopic sinus surgery was applied to the management of 40 patients with sellar lesions. Endoscopic management of sellar lesions offers, not only the advantage of improved visualization, but also magnification, and a panoramic perspective of the important relationships of the sella turcica. In the past year, we have managed 40 subjects with sellar lesions, endoscopically: 38 patients had pituitary adenomas and two a craniopharyngioma.At our hospital, the endoscope has replaced the operating microscope for surgery for pituitary adenomas and other sellar lesions. The endoscopic approach to the sphenoid sinus and the sella is performed by an ENT surgeon and the ablative surgery performed by a neurosurgeon.Our experiences, using the endoscope to perform surgery on sellar and parasellar lesions, are reported and the advantages, over the operating microscope, which is traditionally used are discussed. The technique for endoscopic management of sellar lesions is described.

Endonasal Endoscopic Approach to Anterior Skull Base Fibrous Dysplasia

2016 ◽  
Vol 77 (S 02) ◽  
Author(s):  
Suha Beton ◽  
Hazan Basak ◽  
Selcuk Mulazimoglu ◽  
Cem Meco
Keyword(s):  
Skull Base ◽  
Fibrous Dysplasia ◽  
Anterior Skull Base ◽  
Endoscopic Approach

Endovenous procedures in varicose veins

Phlebologie ◽  
2008 ◽  
Vol 37 (05) ◽  
pp. 229-236
Author(s):  
N. Cayne ◽  
G. Jacobowitz ◽  
P. Lamparello ◽  
T. Maldonado ◽  
C. Rockman ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Treatment Options ◽  
Postoperative Recovery ◽  
Comparable Efficacy ◽  
Intense Pulse Light ◽  
Efficacy And Safety ◽  
Endovenous Laser Ablation ◽  
The Past ◽  
Early Evidence ◽  
Endovenous Treatment

SummaryOver the past ten years endoveous treatment options for varicose veins have evovled considerably, offering clinicians a multitude of options to meet the needs of their patients. The endothermal ablation procedures have moved to the forefront as the choice modality for treating truncal reflux. Both radiofrequency ablation and endovenous laser ablation are widely accepted and interchangeable, showing comparable efficacy and safety. Although numerous endovenous laser wavelengths exist, the data indicates that the differences do not affect the efficacy or postoperative recovery of the procedure. The endovenous laser innovation that has shown early evidence of improved patient outcome is the jacket-tip fiber. The versatility of sclerotherapy makes it a critical component in the endovenous treatment of varicosities. Although not approved by the Food and Drug Administration (USA), the use of a foamed sclerosing agent is the fastest growing segment of sclerotherapy and an important treatment modality in the future of varicose vein treatment. Cutaneous lasers and intense pulse light devices contribute a crucial element, enabling clinicians to treat minute veins that may be impossible to treat with other therapies.

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 Levels of Evidence in Rhinology and Skull Base Surgery Research

2021 ◽  
pp. 019459982098713
Author(s):  
Jennifer A. Silver ◽  
Marco Mascarella ◽  
George Tali ◽  
Rickul Varshney ◽  
Marc A. Tewfik ◽  
...  
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Absolute Number ◽  
High Quality ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
The Past ◽  
Significant Difference ◽  
Surgery Research ◽  
Based Medicine

Objective The purpose of this study was to evaluate the quality of evidence of rhinology and rhinologic skull base surgery (RSBS) research and its evolution over the past decade. Study Design Review article. Setting We reviewed articles from 2007 to 2019 in 4 leading peer-reviewed otolaryngology journals and 3 rhinology-specific journals. Methods The articles were reviewed and levels of evidence were assigned using the Oxford Centre for Evidence-Based Medicine 2011 guidelines. High quality was defined as level of evidence 1 or 2. Results In total, 1835 articles were reviewed in this study spanning a 13-year period. Overall, the absolute number of RSBS publications increased significantly 22.6% per year, from 108 articles in 2007 to 481 in 2019 ( P < .001; 95% CI, 7.9-37.2). In 2007, only 13 articles, or 15%, were high quality, and this grew to 146 articles, or 39%, in 2019. A 14.0% per year exponential increase in the number of high-quality publications was found to be statistically significant ( P < .001; 95% CI, 7.2, 20.7). Overall, high-quality publications represented just 25.8% of RSBS articles overall. There was no significant difference in quality between rhinology-specific journals and general otolaryngology journals (χ2 = 3.1, P = .077). Conclusion The number of overall publications and of high-quality RSBS publications has significantly increased over the past decade. However, the proportion of high-quality studies continues to represent a minority of total RSBS research.

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