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Rhinology and Facial Plastics
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Adnan Darr, Karan Jolly, Shahzada Ahmed, Claire Hopkins
Ethmoid system can be divided into lamellae: In order of structure encountered when undertaking an ethmoidectomy First: Uncinate processSecon: Ethmoid bullaThird: Basal lamellaFourth: Superior turbinate AEA is found between the second and third lamella, behind the face of the bulla unless a suprabulbar recess is present
Rhinolaryngoscopy for the Allergist
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Jerald W Koepke, William K Dolen
Surgical creation of an antral window in the middle meatus (less commonly the inferior meatus) and exteriorization (or marsupialization) of the ethmoid and sphenoid sinuses can establish drainage in selected patients with chronic sinusitis, when other measures have failed. With the fiberoptic endoscope, one may assess patency of the antral window and inspect the surrounding mucosa for signs of inflammation or polypoidal growth. It may be possible to insert the endoscope into the maxillary sinus to examine the mucosa. Ethmoidectomy and sphenoidectomy are performed to establish drainage from and provide aeration to these areas in order to treat chronic inflammation and infection. At times, extensive surgery is indicated.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Biopsies prior to definitive treatment are not routine for simple polyps, but should a biopsy demonstrate a malignant lesion, then a wide local excision via lateral rhinotomy or FESS and PORT is needed. Ethmoidectomy is usually achieved by piecemeal excision. Post-operative epiphora due to blocked nasolacrimal ducts is not uncommon.
Systematic literature review of humanistic and economic burdens of chronic rhinosinusitis with nasal polyposis
Published in Current Medical Research and Opinion, 2020
Stephanie Chen, Anna Zhou, Benjamin Emmanuel, David Garcia, Emily Rosta
Regarding the economic burden, one year following diagnosis, patients with CRSwNP had significantly more systemic prescriptions, underwent significantly more medical procedures, demonstrated greater utilization of health care resources and had significantly greater mean health care costs compared with matched controls. Ethmoidectomy was the most commonly performed procedure for patients with CRSwNP. For patients with CRSwNP and respiratory comorbidities, health care needs increased approximately 6 months before ESS, but decreased after surgery, reaching baseline levels within 3–4 months. For patients who underwent ESS, CRSwNP was associated with greater risk for revision surgery and greater health care expenditures compared with CRSsNP. CRSwNP was associated with approximately three missed workdays per year. Estimates of mean annual productivity cost associated with refractory CRSwNP were high, but varied across studies. ESS was reported to be cost effective compared with medical management alone, as was EDS-FLU compared with ESS for the treatment of CRSwNP.
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
There are few intranasal anatomical structures that prohibit endonasal skull base surgery, but structures along the endonasal corridor may require resection or mobilization.23 Surgical access can involve a range of procedures including, unilateral luxation of the middle turbinate, complete bilateral ethmoidectomy, and may require complementary procedures such as septectomy.23 Planned endonasal procedures are intended to develop a large surgical corridor to the posterior nasal cavity that accommodates four-hand surgery, while preserving sinonasal anatomy and function, maintaining ostia patency, minimizing crusting and preventing scar formation.3,13,26 The use of careful endoscopic sinus surgical techniques reduces sinonasal morbidity, including crusting, scarring or osteogenesis following trauma, with comparable or superior surgical results.27
Recovery period of sinonasal quality of life and its associated factors after endoscopic endonasal approach for anterior skull base tumors
Published in Acta Oto-Laryngologica, 2019
Jae-Cheul Ahn, Sung-Woo Cho, Dong-Kyu Kim, Doo Hee Han, Dong-Young Kim, Chae-Seo Rhee, Chul Hee Lee, Yong Hwy Kim, Sun Ha Paek, Tae-Bin Won
Total consecutive 250 patients were included; there were 101 male and 149 female and their mean age was 48.6 ± 16.1 years old at the time of surgery. There were 29 revision cases (Table 1). The most common pathology was pituitary adenoma followed by craniopharyngioma (Table 1). Expanded EEA was performed for 22.0% of cases where craniopharyngioma and meningioma took 43.6% and 38.1%, respectively. Posterior ethmoidectomy was the most common combined nasal surgery followed by middle turbinate resection and septoplasty (Table 1). About half (45.6%) of cases did not use calcium hydroxyapatite nor nasoseptal flap. About a quarter (26.4%) of cases used only calcium hydroxyapatite and 19.6% of cases used only nasoseptal flap. Both calcium hydroxyapatite and nasoseptal flap was used for 8.4% of cases. Gamma knife surgery was postoperatively conducted for 27.6% of cases. Intraoperative CSF leakage was observed in 46.0% of cases. Postoperative CSF leakage, synechia, and mucosal edema in nasal cavity were observed in 3.2%, 12.0%, and 5.6% of cases, respectively.