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Traumatic CSF rhinorrhea
Published in Jyotirmay S. Hegde, Hemanth Vamanshankar, CSF Rhinorrhea, 2020
Hemanth Vamanshankar, Jyotirmay S Hegde
The firm adherence of the dura to the anterior skull base makes it a more common site for leaks than the middle or posterior skull base.7 The cribriform plate, being thin and fragile, is covered only by the arachnoid layer. Small fractures here easily violate the arachnoid layer in the absence of the dura. Also, the cribriform is located in the midline, below the slight medial curve of the floor of the skull base, causing CSF to gravitate to this area.8 Sphenoid sinus (30%), frontal sinus (30%) and cribriform/ethmoid (23%) form the most common areas of leaks. However, when endoscopic surgical trauma is considered, ethmoid/cribriform (80%), frontal sinus (8%), and sphenoid sinus (4%) are the most common sites (Figure 5.1 A, B). Sphenoid sinus is the most common site after neurosurgical trauma. Temporal bone fractures can lead to CSF otorrhea and rhinorrhea.7 72% of temporal bone fractures lead to CSF rhinorrhea, according to Brodie and Thompson.9
Skull and Facial Radiography
Published in Russell L. Wilson, Chiropractic Radiography and Quality Assurance Handbook, 2020
Facial bone and sinus studies use the same views. Collimation and the small focal spot are very important. The Waters view is the single most useful view for sinus and facial bone or orbit injuries. Each view will demonstrate a particular area of the sinuses. The Caldwell will give a clear view of the frontal sinuses. The lateral view is good for the sphenoid sinus. The basilar view will demonstrate the sphenoid and ethmoid sinuses.
Mucor and Mucormycosis
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Rhinocerebral mucormycosis (ROCM) commonly occurs in patients with diabetes mellitus, malignancies, and hematopoietic stem cell or solid organ transplants. Beginning at the paranasal sinuses, invading sporangiospores germinate and spread to the palate, sphenoid sinus, cavernous sinus, orbits, or brain, leading to general symptoms (headache, nausea, fever, and lethargy), facial symptoms (weakness, numbness, and pain), nasal symptoms (purulent drainage, stuffiness and rhinorrhea, epistaxis, and nasal hypoesthesia), ocular symptoms (periorbital or retro-orbital pain, diplopia and blurred vision, amaurosis, and acute vision loss), and central nervous system symptoms (convulsions, altered mental status, dizziness, and unsteady gait).
Evaluation of nasal function after endoscopic endonasal surgery for pituitary adenoma: a computational fluid dynamics study
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Miao Lou, Luyao Zhang, Simin Wang, Ruiping Ma, Minjie Gong, Zhenzhen Hu, Jingbin Zhang, Yidan Shang, Zhenbo Tong, Guoxi Zheng, Ya Zhang
The original images were imported into MIMICS software (Materialise, Leuven, Belgium) for image segmentation and primary smoothing to reconstruct the airway structure. Due to the minimal influence of the paranasal sinuses on airflow, they were not included in the reconstruction of the models, except for the sphenoid sinus which was relevant to the present study. Thus, to create the preoperative model, the nasal cavity, pharynx, and sphenoid sinus were analyzed. EEA surgery was performed virtually on the preoperative model, from which 6 postoperative models were constructed using 6 variations of tissue excision: 1) EEA with small posterior septectomy (0.5 cm, sPS), 2) middle posterior septectomy (1.5 cm, mPS), 3) large posterior septectomy (2.5 cm, lPS), and 4) EEA with sPS and left middle turbinate resection (sPS-MTR), 5) mPS-MTR, and 6) lPS-MTR. Anterior inferior sphenoid sinus wall resection (approximately 1.5 cm in diameter) was performed in all six postoperative models. The effect of MTR and PS on nasal structure of typical sections were shown in Figure 1D.
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).
Neuro-Ophthalmic Literature Review
Published in Neuro-Ophthalmology, 2018
David Bellows, Noel Chan, John Chen, Hui-Chen Cheng, Peter MacIntosh, John H. Pula, Michael Vaphiades, Konrad P Weber
The authors report a retrospective evaluation spanning ten years. They describe cases of sphenoid sinus disease having neuro-ophthalmologic manifestations. They excluded describing non-inflammatory cases such as malignancy, and they excluded any cases wher pathology was localized anywhere outside the sphenoid sinus. In all, they found 67 cases of isolated sphenoid sinus disease, although only 23 were included in the report. It would have been helpful if they reported why the other cases were not included, but it is possible these were the non-inflammatory cases. The authors noted that neuro-ophthalmologic manifestations are non-specific, and include optic neuropathy, third nerve, and sixth nerve palsy. Fungal sinusitis was the most common diagnosis where post-operative pathology differed from preliminary radiographic diagnosis. Sphenoidotomy with drainage was the main treatment in all patients, and the authors recommend NOT treating with steroids until the infectious lesion is cleared. They found patients with diplopia responded much better to treatment than patients with optic neuropathy.