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Post-Traumatic Orbital Reconstruction: Anatomical Landmarks and the Concept of the Deep Orbit
Published in Niall MH McLeod, Peter A Brennan, 50 Landmark Papers every Oral & Maxillofacial Surgeon Should Know, 2020
The applied surgical anatomy of the sphenoid bone is discussed and reference is made to the significance of a segmentation of the sphenoid bone with respect to injuries which are sight threatening. While this is not strictly covered by the title of the paper, it is extremely useful advice. The term sphenoid trigone is used, and in my view, it is extremely important to consider in high-energy transfers to signpost the risk of optic nerve neuropathy. This is physically helpful in counseling relatives in unconscious patients that there may well be significant morbidity.
Neuropsychiatry: brain injury, mental health–substance use
Published in David B Cooper, Practice in Mental Health—Substance Use, 2018
The location and severity of brain injury will determine the deficits incurred. The frontal lobes are particularly vulnerable to the effects of traumatic brain injury due to their size and location. They are the largest of the lobes of the brain situated at the front of the cranium. Their proximity to the sphenoid bone, an irregular wedge-shaped bone situated at the base of the skull, increases their vulnerability following trauma.
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The sphenoid bone is a large, “winged” or butterfly-shaped bone in the central region of the skull that is only visible externally at pterion (a skull landmark defined in Section 3.2.1.1). It is marked on its dorsal surface by the fossa in which the pituitary gland sits. This bone resides at the boundary between neural crest- and mesoderm-derived skeletal components of the skull, with its rostral part and greater wings being of crest origin and the remaining, caudal portion from mesoderm. The anterior-most portion of the palatopterygoquadrate bar is incorporated into the greater wing of the sphenoid, the larger and more cranial of the “butterfly wings” (Plates 3.10 and 3.12). The pterygoid plates (Plates 3.8a and c and 3.10), then form by intramembranous ossification. As noted in the previous paragraph, the posterior portion of the palatopterygoquadrate bar ossifies endochondrally as the incus, the anvil-shaped middle ear bone (Plate 3.45a and c). In early development, the malleusincus (or “hammer-anvil”) joint thus functions as the primary jaw joint of the 1st branchial arch. During development, the mandible acquires a condylar process that contacts the growing zygomatic process of the temporal bone, forming the secondary, definitive adult jaw joint, which is formally named the temporomandibular joint to acknowledge the connection of the temporal bone with the mandible (Plate 3.28).
Acute Enophthalmos After Lumbar Puncture in a Patient with Type 1 Neurofibromatosis Related Sphenoid Wing Dysplasia
Published in Neuro-Ophthalmology, 2022
Deanna Ingrassia Miano, Gregory Byrd, Rani Kattoula, Aye Thet, Ryan Adkins, Ryan Cosgrove, Samantha S. Johnson
There is structural importance of the greater and lesser wings of the sphenoid bone as they serve in both anatomic support to the walls of the orbit as well as intracranial conduits for nervous and vascular components. Such structures include the optic nerve and ophthalmic artery and therefore compromise of the sphenoid bone may put patients at higher risk of visual complications. One ophthalmological complication of sphenoid wing dysplasia, which we report here is enophthalmos, or posterior displacement of the globe within the orbit.5,9 Through relative expansion of the orbit itself, the globe and surrounding orbital contents migrate posteriorly.5 Patients can present with a wide range of signs and symptoms depending on the aetiology, including pain, blurred vision, headache, and nausea, among other non-specific symptoms.5
In-silico investigation of airflow and micro-particle deposition in human nasal airway pre- and post-virtual transnasal sphenoidotomy surgery
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Khashayar Moshksayan, Hojat Bahmanzadeh, Mohammad Faramarzi, Sasan Sadrizadeh, Goodarz Ahmadi, Omid Abouali
The endoscopic direct transnasal sphenoidotomy (TNS) is one such surgery that is currently performed for sphenoid sinus disease and pituitary surgery. In TNS surgery, only the posterior portion of the superior turbinate, close to the sphenoid wall, is removed and an area of the anterior sphenoid sinus wall is cauterized (Har-El 2003). TNS has several advantages over its alternative, transethmoidal sphenoidotomy (TES), because it does not require the ethmoidectomy procedure, and thus avoids any of its subsequent side effects (Bahmanzadeh et al. 2015). Furthermore, TNS is minimally invasive, as it does not involve removing the uncinate process nor the basal lamella dissection (Schlosser and Bolger 2003). Therefore, TNS is a suitable alternative to other methods of sphenoid sinus surgery.
The Endoscopic Transnasal Approach to Orbital Tumors: A Review
Published in Seminars in Ophthalmology, 2021
Edith R. Reshef, Benjamin S. Bleier, Suzanne K. Freitag
The orbital surgeon should be familiar with the pertinent anatomy of the sinonasal cavity. The superior aspect of the nasal cavity has been separated from the orbit by the adjacent anterior and posterior ethmoid sinuses, which drain to the middle and superior meatus, respectively, and by the lamina papyracea, derived from the ethmoid bone to form a large portion of the medial wall of the orbit. The anterior and posterior ethmoids are divided by the basal lamella of the middle turbinate. The sphenoid sinuses lie posterior to the nasal cavity, communicating via the sphenoethmoidal recess. The basal lamella of the superior turbinate separates the sphenoid ostia from the posterior ethmoid sinuses. Inferior to the orbit and lateral to the nasal cavity lies the maxillary sinus, which drains to the middle meatus via the maxillary ostium (Figure 1).