China
Africa
Explore chapters and articles related to this topic
Mucoceles of the Paranasal Sinuses
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Bony erosion leads to expansion of the sac beyond the sinus cavity into the cranial cavity or orbit. Symptoms depend on the sinus involved. A visible mass is often seen on the forehead (Figure 100.2a and b), medial canthus or in the gingivobuccal sulcus or cheek. Ophthalmologic symptoms are more common than rhinological and neurological symptoms.9 The most common ophthalmologic complaints are periorbital swelling, pain and exophthalmos (Figure 100.3). Displacement of the orbital contents can lead to limited ocular mobility, visual disturbance and diplopia.4,9 Optic neuropathy has been reported in up to 18% of patients who present with ophthalmologic symptoms and is due to direct compression of the optic nerve in the posterior ethmoid and sphenoid sinuses.9 A mucocele within a concha bullosa may present with nasal obstruction and /or secondary sinusitis. Epiphora and a cystic swelling in the medial canthus suggest the presence of a dacryocele.
Imaging of the nasopharynx, face and neck
Published in Sarah McWilliams, Practical Radiological Anatomy, 2011
o There are three pairs of bony conchae also called turbinates when including the mucosa in the nasal cavity: the superior, middle and inferior. The middle turbinates may be excessively pneumatized, called the concha bullosa. This may obstruct the ostiomeatal complex.
Ear, Nose, and Paranasal Sinus
Published in Swati Goyal, Neuroradiology, 2020
Apart from causing recurrent sinusitis, the following anatomical variations are pivotal to report, to avoid complications during surgery. Nasal septal deviation.Pneumatization of crista galli.Hypoplastic frontal sinus.Deep olfactory fossa – asymmetrical cribriform plate, that is developed more in the caudal direction. It may result in CSF leakage or meningitis, if it fractures during functional endoscopic sinus surgery (FESS).Agger nasi cells – the anterior-most cells of the anterior ethmoid complex, which may obstruct the frontal recess.Ethmoidal bulla − the posterior-most cells in the anterior ethmoidal complex.Haller cells – infraorbital ethmoid cells that may obstruct the ethmoidal infundibulum of the OMU.Onodi cells – posterior ethmoid cells that migrate to the anterior part of the sphenoid sinus. Its close relation to the optic nerve makes it clinically significant for reporting, prior to endoscopic sinus surgery.Supraorbital ethmoid cells are located posterolateral to the frontal sinus and may mimic multiple frontal sinuses on coronal CT.Paradoxical middle turbinate – abnormal curvature of the middle turbinate toward the midline.Concha bullosa – pneumatization of the middle turbinate, especially of its inferior. bulbous portion, which is one of the most frequently encountered anatomical variations.Pneumatization of the uncinate process.Pneumatization of the anterior clinoid process
Perioperative nasal and paranasal sinus considerations in transsphenoidal surgery for pituitary disease
Published in British Journal of Neurosurgery, 2020
Lisa Caulley, Ravindra Uppaluri, Ian F. Dunn
In the endoscopic era, a higher premium is placed on scrutinizing the nasal and sinus anatomy than in conventional microscopic approaches. Anatomic variants commonly encountered in the transsphenoidal approach include anomalies of the nasal septum and turbinates.24 Concha bullosa, an aeration of the middle turbinate,14 often correlates with patients with highly pneumatized ethmoid sinuses (Figure 2).25 A paradoxical middle turbinate refers to the abnormal curvature of the middle turbinate laterally adjacent to the nasal septum, as opposed to its standard medial curvature.14,25 Nasal septal deviation defines an asymmetric bowing of the nasal septum that may narrow the nasal corridor and may narrow one nare significantly.14 Large studies of septal abnormalities have concluded that non-deviated septums are only present in 7.5–23% of individuals, indicating a high prevalence of septal deviations in the general population.25 These abnormalities, particularly deviations of the caudal septum and bone spurs, may need to be addressed before surgeons can gain access to the nasal corridor. In the setting of clinical evaluation after previous endonasal pituitary surgery, particular attention should be paid to the extent of the septectomy defect and integrity of the nasoseptal flap pedicle.
Efficacy of hypertonic (2.3%) sea water in patients with aspirin-induced chronic rhinosinusitis following endoscopic sinus surgery
Published in Acta Oto-Laryngologica, 2019
Aleksandar Perić, Sandra Vezmar Kovačević, Aleksandra Barać, Dejan Gaćeša, Aneta V. Perić, Svjetlana Matković Jožin
The adult patients with AERD undergoing bilateral endoscopic fronto-spheno-ethmoidectomy and polypectomy with the same extent of surgery were eligible for this randomized, double-blind, parallel arm and prospective-controlled study. All patients were operated on by the same surgeon using the same technique. In cases of significant septal deformities, some anatomical variations (e.g. concha bullosa of the middle turbinate), or mucosal hypertrophy of the inferior turbinate, the surgeon performed additional surgical procedures (septoplasty, lateral resection of the concha bullosa and submucosal reduction of hypertrophied mucosa). This investigation was conducted in our Department of Otorhinolaryngology between May 2016 and April 2018 in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Ethics Committee of our institution approved the study protocol and we obtained written informed consent from each patient.
The importance of endoscopy in lacrimal surgery
Published in Expert Review of Ophthalmology, 2018
Akshay Gopinathan Nair, Swati Singh, Saurabh Kamal, Mohammad Javed Ali
Usually, a nasal endoscopy viewing system consists of rigid endoscope, a camera head, a fiber optic cable, a light source and a camera image processing system along with a viewing screen. The commonly used nasal endoscopes today are of two diameters: 2.7 mm for pediatric use or office endoscopies and 4 mm for routine adult surgeries. They have working length of 18 cm and come in a wide range of angulations: 0°, 30°, 45°, 70°, and 90° for different viewing purposes [7]. Pre-operative nasal endoscopy is important because it helps in identification of anatomical variations and assessment of co-morbidities before surgery. As mentioned earlier, despite having many advantages, not all ophthalmologists perform an endoscopic examination of the nose prior to an external DCR. Some of the findings that may potentially affect the surgical procedure itself and its outcomes include nasal septal deviation, paradoxical middle turbinate, concha bullosa, large bulla ethmoidalis, prominent uncinate process, thick frontal process of maxilla, thick lacrimal bone, posterior or high position of the lacrimal sac and sac in ethmoid sinus syndrome [8–12].