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1.
Int Arch Otorhinolaryngol ; 28(3): e394-e399, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38974620

ABSTRACT

Introduction Functional endoscopic sinus surgery and endoscopic skull base surgery are frequently performed surgeries today. Nasal septal deviation is a common finding and can affect the surgical area. Therefore, it is important to examine the effect of this deviation on other anatomical structures. Objective The aim of the present study was to determine whether there is a relationship between the degree of nasal septal deviation and anterior skull base structures using computed tomography (CT). Methods A total of 312 patients (aged 18 to 65 years old) whose paranasal sinus CT images were available were included in the study. Measurements were obtained on images retrieved from Picture Archiving and Communication System (PACS) and Horos image archive systems in the bone window in the coronal and axial plane. Results The mean age of 312 patients was 33.00 years old (standard deviation [SD] 11.22 years). The presence of septal deviation was not associated with changes in olfactory fossa (OF) depths, Keros degrees, and the angle between the lateral lamella and the cribriform lamella. However, OF depths and Keros degrees on the deviated side of the septum were found to change at a significant level ( p < 0.05). No significant association was observed between the degree of septal deviation and cribriform lamella-lateral lamella angle. Conclusion The study showed significantly increased OF depth and Keros degree on the deviated side of the nasal septum. Performing CT scans before endoscopic sinus surgery and endoscopic skull base surgery is important to increase the chances of a successful surgical outcome and to reduce complications.

2.
Int Arch Otorhinolaryngol ; 28(1): e70-e75, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38322450

ABSTRACT

Introduction The advent of the endoscope has enabled the use of the endonasal approach for a variety of diseases. Studying the ethmoidal canals is important for surgeries of the paranasal sinuses and the anterior base of the skull. Objective To investigate the ethmoidal canals and evaluate their structure, the presence of vessels and nerves, their location, and to perform an anatomopathological study of their contents. Methods We evaluated 20 cadavers (20 left and 20 right nasal cavities) through endoscopic dissection of the anterior base of the skull and exposure of the medial periorbita and dura mater; then, the ethmoidal canals were located and measured in relation to the anterior wall of the sphenoid sinus and between the ethmoidal canals, followed by removal of their content for histological analysis. Results Vessels were present in 75% of the left anterior ethmoidal canals, 70% of the left posterior ethmoidal canals, 75% of the left middle ethmoidal canals, 85% of the right anterior ethmoid canals, and 64.5% of the right posterior ethmoid canals; 50% of the right middle ethmoidal canals contained one vessel. Conclusion The ethmoidal canal does not necessarily contain an ethmoidal artery. Studies with a larger sample should be performed to quantify the correct proportion of arteries and ethmoidal canals.

3.
Int. arch. otorhinolaryngol. (Impr.) ; 28(1): 70-75, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1557997

ABSTRACT

Abstract Introduction The advent of the endoscope has enabled the use of the endonasal approach for a variety of diseases. Studying the ethmoidal canals is important for surgeries of the paranasal sinuses and the anterior base of the skull. Objective To investigate the ethmoidal canals and evaluate their structure, the presence of vessels and nerves, their location, and to perform an anatomopathological study of their contents. Methods We evaluated 20 cadavers (20 left and 20 right nasal cavities) through endoscopic dissection of the anterior base of the skull and exposure of the medial periorbita and dura mater; then, the ethmoidal canals were located and measured in relation to the anterior wall of the sphenoid sinus and between the ethmoidal canals, followed by removal of their content for histological analysis. Results Vessels were present in 75% of the left anterior ethmoidal canals, 70% of the left posterior ethmoidal canals, 75% of the left middle ethmoidal canals, 85% of the right anterior ethmoid canals, and 64.5% of the right posterior ethmoid canals; 50% of the right middle ethmoidal canals contained one vessel. Conclusion The ethmoidal canal does not necessarily contain an ethmoidal artery. Studies with a larger sample should be performed to quantify the correct proportion of arteries and ethmoidal canals.

4.
Article in Spanish | LILACS, COLNAL | ID: biblio-1413930

ABSTRACT

Introducción: muchos huesos que forman el esqueleto de la cabeza humana y muchas especies de animales están neumatizados. Se han planteado múltiples hipótesis con diversos enfoques con la intención de explicar la existencia de estos espacios aéreos. De todos los huesos con estas características en humanos, solamente los senos paranasales y la neumatización del hueso temporal han sido objeto de múltiples hipótesis. La diversidad de criterios denota un desacuerdo, si no con todos, con la mayoría de ellos. Material y métodos: esta teoría se basa en reflexiones personales apoyadas en radiografías e imágenes anatómicas de los huesos frontal y temporal, con el objetivo de ilustrar y reforzar las razones de la existencia de estas cavidades en todas las especies que las poseen. Resultados, discusión y conclusiones: estos espacios de aire se forman en el cuerpo de los huesos cortos como un mecanismo de defensa natural al reemplazar el tejido esponjoso para prevenir infecciones graves del mismo (osteomielitis), que dada su proximidad al cerebro y sus estructuras representaría un peligro para la vida. Consideramos que los laberintos etmoidales fueron creados con el objetivo de llenar el espacio vacío entre los huesos vecinos y dar estabilidad al esqueleto óseo circundante. La neumatización del hueso temporal (hueso compacto) fue creada para "alojar y proteger" importantes estructuras de los sentidos del oído y del equilibrio, los vasos y los nervios.


Introduction: Many bones that make up the skeleton of the human head and many species of animals are pneumatized. Multiple hypotheses with various approaches have been stated with the intention of explaining the existence of these airspaces. Of all the bones with these characteristics in humans, only the paranasal sinuses and pneumatization of the temporal bone have been the subject of multiple hypotheses. The diversity of criteria denotes disagreement, if not with all, with the majority of them. Material and methods: This theory is based on personal reflections supported by x-rays and anatomical images of the frontal and temporal bones, with the aim of illustrating and reinforcing the reasons for the existence of these cavities in all species that possess them. Results, discussion and conclusions: These air spaces are formed in the body of short bones as a natural defense mechanism by replacing the spongy tissue to prevent serious infections of the same (osteomyelitis), which given its close proximity to the brain and its structures would represent a danger to life from its emergence. We consider that the ethmoid labyrinths were created with the aim of filling the empty space between the neighboring bones to give stability to the surrounding bone skeleton. The pneumatization of the temporal bone, compact bone, was created to "house and protect" important structures of the senses of hearing and balance, vessels and nerves


Subject(s)
Humans , Bone and Bones , Osteomyelitis
5.
Int Forum Allergy Rhinol ; 8(9): 1073-1075, 2018 09.
Article in English | MEDLINE | ID: mdl-29979842

ABSTRACT

BACKGROUND: Aside from endoscopic and image guidance confirmation, the standard method of identifying the lamina involves the surgeon or an assistant applying gentle pressure on the globe externally. This globe push test requires the surgeon to remove one instrument from the endoscopic field or an assistant to press on the globe, and the test is most useful when either the periorbita or periorbital fat is exposed. We propose an alternative, equally accurate, and more efficient technique dubbed the lamina push test. METHODS: A blunt instrument is used to gently apply lateral pressure in the expected location of the medial orbital wall. If the lamina has been adequately skeletonized, the entire lamina will be seen to move as a unit. If residual ethmoid partitions are present, no movement or only localized movement is observed. RESULTS: Using the lamina push test, we have been able to safely identify the lamina papyracea in all patients undergoing endoscopic sinus surgery, without injury to the lamina or orbital contents. The use of direct pressure significantly increases the movement of an intact lamina. CONCLUSION: The lamina push test is a safe and effective technique for identification of the medial orbital wall, confirmation of removal of all lateral ethmoid partitions, and verification of lamina integrity. It enables more consistent identification of an intact lamina, allows the surgeon to keep both instruments in the endonasal surgical field, and does not require an assistant.


Subject(s)
Endoscopy/methods , Monitoring, Intraoperative/methods , Orbit/anatomy & histology , Paranasal Sinuses/surgery , Ethmoid Bone/anatomy & histology , Ethmoid Bone/surgery , Humans , Intraoperative Complications/prevention & control , Surgery, Computer-Assisted
6.
Rev. chil. cir ; 68(1): 69-71, feb. 2016. ilus
Article in Spanish | LILACS | ID: lil-780536

ABSTRACT

Abstract Background: Orbital floor fractures are a common finding in facial trauma and may be accompanied by medial orbital wall fracture in 7 to 53% of the cases. Isolated medial wall fractures are rare and usually asymptomatic, being detected as incidental findings. case report: We report a 75 years old female consultingin the emergency room due to a left orbital trauma. An orbital CAT scan identified a fracture of the medial orbit wall that did not require treatment.


Resumen Introducción: Las fracturas del suelo de la órbita son habituales en los traumatismos faciales y entre un 7 y un 53% de los casos se asocian con fracturas de la pared medial. Pero las fracturas aisladas de la pared medial son infrecuentes y la mayoría asintomáticas, siendo un hallazgo habitualmente incidental. Sin embargo, ciertos signos de alarma (limitación de la movilidad del recto medial, siendo habitual que aparezca de forma retardada por isquemia del músculo debido al atrapamiento) pueden plantear una cirugía urgente. Descripción del caso: Presentamos un caso de una paciente de 75 años que acude al Servicio de Urgencias de nuestro hospital remitida por médico de atención continuada por traumatismo sobre órbita izquierda. A la exploración presenta importante hematoma periorbitario y malar, sin alteraciones visuales. En TC orbitaria se identifica fractura de la pared medial de la órbita que, en ausencia de clínica acompañante, no requiere tratamiento alguno.


Subject(s)
Humans , Female , Aged , Orbital Fractures/diagnostic imaging , Multidetector Computed Tomography , Ethmoid Bone/injuries , Facial Injuries/complications
7.
Rev. méd. Chile ; 143(2): 257-261, feb. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-742578

ABSTRACT

Orbital emphysema is a rare complication of orbital and facial trauma, involving the sinuses and occasionally the nasal cavity. Most cases occur as a result of trauma but spontaneous orbital emphysema has been reported. Clinical manifestations are often delayed until the upper airway pressure increases as when blowing or coughing. Along with the fracture, the rupture of the underlying mucosa is essential for emphysema to manifest. We report a 29-years-old male who consulted in the emergency room due to eyelid swelling after a Valsalva maneuver, a couple of hours after suffering a facial injury secondary to a fall. In the presence of eyelid emphysema, the patient underwent craniofacial imaging studies, confirming an ethmoidal lamina papyracea fracture.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive , Bronchiectasis , Bronchography , Health Status , Phenotype , Principal Component Analysis , Pulmonary Diffusing Capacity , Pulmonary Emphysema , Quality of Life , ROC Curve , Respiratory Function Tests , Tomography, X-Ray Computed
8.
Rev. bras. cir. plást ; 28(3): 507-510, jul.-set. 2013. ilus
Article in English, Portuguese | LILACS | ID: lil-776132

ABSTRACT

Fractures of the naso-orbitoethmoid complex (NOE) remain one of the most challenging tasks in facial reconstruction and account for 2.1% of facial trauma cases. Clinical analyses of NOE fractures showed that they usually affect the telecanthus and cause deformities that would then require retropositioning of the nasal pyramid. Therefore, computed tomographyis an essential technique for further assessment and to identify bone dislocations and fistulas. Treatment involves reconstruction of the intercanthal distance, nasal projection, and internal orbital structures.


A fratura do complexo nasoetmoideorbital (NEO) permanece como uma das tarefas mais desafiadoras no trauma facial. Corresponde a 2,1% dos casos de trauma de face. Achados clínicos clássicos das fraturas NEOs são telecanto e deformidade com retroposicionamento da pirâmide nasal. O estudo com tomografia computadorizada é imprescindível para determinar detalhes e procurar localizar deslocamentos ósseos e fístulas. O tratamento é direcionado à reconstrução da relação intercantal, da projeção nasal e das estruturas internas da órbita.


Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Middle Aged , Nose Deformities, Acquired/surgery , Orbital Fractures/surgery , Ethmoid Bone/surgery , Ethmoid Bone/injuries , Nasal Bone/surgery , Nasal Bone/injuries , Plastic Surgery Procedures/methods , Tomography, X-Ray Computed , Methods , Patients , Therapeutics , Wounds and Injuries
9.
Rev. imagem ; 31(1/2): 19-23, jan.-jun. 2009. ilus
Article in Portuguese | LILACS | ID: lil-542444

ABSTRACT

As células etmoidais compreendem diversas cavidades que podem apresentar variações anatômicasnos indivíduos. Algumas variações merecem atenção quando associadas a sinusopatias e à necessidade de intervenção cirúrgica. A tomografia computadorizada, considerada padrão-ouro na investigação de doenças da cavidade nasal e no mapeamento anatômico dos seios paranasais, oferece informações acerca da anatomia das células etmoidais, essenciais para a minimização dos riscos cirúrgicos. O presente trabalho tem o objetivo de, mediante revisão bibliográfica, avaliar aimportância da tomografia computadorizada na investigação de variações anatômicas das célulasetmoidais para o planejamento pré-cirúrgico. Células não recorrentes, como as células de Haller, célula de Onodi e a aeração do agger nasi, permitem que a abordagem endoscópica seja planejada com cautela. A avaliação do teto etmoidal resulta em maior segurança quanto aos limites superiores da fossa nasal. O tamanho e o nível de pneumatização da bolha etmoidal, da crista etmoidal e da concha nasal média são importantes ao se avaliar os acessos endoscópicos, a gravidade dadoença, e até mesmo sua origem.


The ethmoidal cells comprise many cavities that show many anatomicalvariations. Some of these variations deserve special attention when associated with sinusitis and the need of surgery. Computed tomography, considered a gold standard on the pathological investigation of the nasal cavity and the anatomic descriptionof paranasal sinus, offers informations about these cells, essential to minimize the surgical risks. The authors present a bibliographic revision of the importance of computed tomography on the investigation of anatomic variations of ethmoid cells. Not recurrent cells in all individuals, like Haller's cells, Onodi's cells and pneumatization of agger nasi, will do the endoscopic approach withprecaution. The ethmoidal roof evaluation will result in more safetyon the upper limits of the nasal cavity. The size and pneumatization level of ethmoidal bulla, ethmoidal crest, and middle nasal concha are important on the evaluation of the endoscopic accesses and the gravity of the striked pathology and even diagnose your origin.


Subject(s)
Humans , Male , Female , Endoscopy , Ethmoid Sinus/anatomy & histology , Ethmoid Sinusitis/surgery , Tomography, X-Ray Computed/methods
10.
Rev. bras. cir. cabeça pescoço ; 37(4): 212-214, out.-dez. 2008. ilus, tab
Article in Portuguese | LILACS-Express | LILACS | ID: lil-507896

ABSTRACT

Introdução: O osteoma é um tumor benigno de crescimento lento, composto de osso esponjoso ou compacto, originado no periósteo dos ossos craniofaciais. Objetivo: Relatar o perfil epidemiológico de pacientes portadores de osteomas craniofaciais. Métodos: Foi realizado um estudo multicêntrico retrospectivo dos casos diagnosticados no Serviço de Neurocirurgia do Hospital Governador João Alves Filho (Aracaju/SE), durante o período entre janeiro de 1999 a junho de 2008 e no Laboratório da Disciplina de Patologia Bucal da Faculdade de Odontologia de Pernambuco - FOP, da Universidade de Pernambuco - UPE, no período de julho de 1992 a julho de 2008. Foram analisados os indicadores gênero, faixa etária, localização topográfica, sintomatologia, tratamento, a partir de ficha própria de coleta de dados. Resultados: Foi observado que 14 casos (40%) possuíam localização craniana, enquanto em 21 casos (60%) o acometimento era facial. A localização topográfica craniana mais freqüente foi o osso frontal (57%), seguido pelo temporal (14%). Na face, o osso mandibular predominou com 67% dos casos. O gênero feminino mostrou-se predominante, com 60% dos casos. As lesões foram mais freqüentes na segunda década de vida (40%), independentemente se o acometimento foi craniano ou facial. Apresentaram-se comumente assintomáticas (62%), sendo os casos sintomáticos em sua maioria com localização craniana (57%). Conclusões: Os osteomas cranianos e faciais são mais freqüentes no osso frontal e mandibular, respectivamente. O gênero feminino e a segunda década de vida mostram mais acometimento. A maioria dos casos apresentou-se assintomática, porém, sintomáticos quando cranianos.


Introduction: Osteoma is a benign slow growth tumor, constituted by compacted or sponged bone with the origin in the skull and face periosteum. Objective: To report the epidemiologic pattern of patients with craniofacial osteomas. Methods: A multicentric retrospective study was done, regarding the cases diagnosed at Governador João Alves Filho Hospital Neurosurgery Service (Aracaju/SE) between January, 1999 and June, 2008 and at the Pernambuco School of Dentistry Oral Pathology Laboratory (FOP/UPE), between July, 1992 and July, 2008. It was analyzed gender, age, topographic site, symptomatology and treatment, through an own paper for data collection. Results: It was observed that 14 cases (40%) were in the skull and 21 cases (60%) in the face. At the skull, the frontal bone was most prevalent (57%), followed by temporal bone (14%). In the face, the mandible represented 67% of all cases. Lesions in females were predominant, with 60% and in the second decade of life (40%). They were mostly asymptomatic (62%), with the symptomatic cases frequently in the skull (57%). Conclusion: The skull and facial osteomas occur frequently in the frontal bone and mandible, respectively. The women and second decade of life show more involvement. Most cases appeared to be asymptomatic, being symptomatic when at the skull.

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