RESUMO
The purpose of our study was to assess the prevalence of variations and type of sphenoid sinus and its adjacent structures pneumatization and its significance. This prospective study included 114 patients who underwent CT of the paranasal sinuses. The CT scan in axial, coronal and mid sagital section were analysed to assess the type of pneumatization of the sphenoid sinus and its adjacent structures like; anterior clinoid process, greater wing of sphenoid and pterygoid process. The sphenoid sinus pneumatization was classified into Conchal, Presellar, and Sellar types, later comprised of sellar and post-sellar types. Out of 114 cases of pneumatized sphenoid sinus, 5.2% cases were conchal type, 26.3% cases Presellar type and 68.4% cases sellar type. The one or more adjacent structures was pneumatized in 71 (62.2%) of cases. The adjacent structures which found to be pneumatized are anterior clinoid process in 26.3%, Pterygoid process in 23.6%, and greater wing of sphenoid in 12.3% cases. The pneumatization of adjacent structures was more prevalent in sellar type of sphenoid sinus, followed by pre-sellar type and no pneumatization in conchal type. The anterior clinoid process pneumatization was present in 26.1% of cases, in which 3 (2.6%) cases in pre-sellar type and 27 (23.5%) cases in sellar type. It was unilaterally pneumatized in 13 (11.4%) and bilaterally in (17 (14.9%) cases. The pterygoid process pneumatization was present in 27 (23.6%) of cases, unilateral in 16 (14%) cases and bilateral in 11 (9.6%) cases. The Greater wing of sphenoid pneumatization was found in 14 (12.3%) cases, no cases in conchal types, 2 (1.8%) in pre-sellar type, and 12 (10.4%) in sellar type There was no statistically difference found in between right and left side of sphenoid sinus and its structure pneumatization. The extent of pneumatization of the sphenoid sinus has clinical and surgical implications in sinus diseases, sellar and central skull base lesions.
RESUMO
Purpose of current study was to find out the incidence of displacement of facial nerve trunk from its normal anatomical position in relation to size and site of tumour in superficial lobe of parotid gland and its surgical significance. In the literature, the importance was given to the anatomical variations in branching pattern of facial nerve but not deviation. The knowledge of this variation is very important to prevent its injuries during superficial parotidectomy. The present study included 60 patients who underwent superficial parotidectomy for benign tumour involving the superficial lobe of parotid gland. The site and size of tumour noted pre operatively with help of ultrasound and CT scan and pathological diagnosis was made by FNAC. The superficial parotidectomy was performed and facial nerve was identified in all cases. In our study, 23 patients out of 60 were having displacement of facial nerve trunk from its normal anatomical position found during superficial parotidectomy. 10 out of 13 patients with tumor superior to facial nerve trunk were having displacement, 7 out of 18 had deviation with tumor inferior to nerve, 6 out of 29 patients had deviation of main trunk when the tumor involved whole of superficial lobe of gland.We conclude that the facial nerve trunk cannot be always traced at normal anatomical position by following the documented anatomical landmarks because of its displacement by tumour. Knowledge of this variation of facial nerve trunk can avoid the chances of damage to this nerve during superficial parotidectomy.
RESUMO
Supernumerary nostril is a very rare congenital anomaly, which includes additional nostril with or without accessory cartilage. In the present case of the left supernumerary nostril, a small cavity of around 3 mm diameter and accessory lower lateral cartilage were present. The cavity was lined with mucous membrane and filled with mucoid discharge .Nasal endoscopy of accessory nasal cavity revealed that it was small as compared to normal nasal cavity and did not communicate with the ipsilateral nasal cavity. The diameter of the normal anterior nasal opening was less on left side as compared to right side. Unilateral supernumerary nostril may occur because of the Assuring of the lateral nasal process during fetal growth.
Fosa nasal supernumeraria es una anomalía congénita muy poco frecuente, que incluye una nueva fosa nasal con o sin cartílago accesorio. En el presente caso de fosa nasal supernumeraria izquierda estaban presentes, una pequeña cavidad de unos 3 mm de diámetro y cartílago lateral accesorio inferior. La cavidad estaba revestida con membranas mucosas y llena con descarga mucoide. La endoscopía nasal de la cavidad nasal accesoria reveló que ésta era pequeña en comparación con la cavidad nasal normal y que no se comunicaba con la cavidad nasal ipsilateral. El diámetro normal de la apertura nasal anterior fue menor en el lado izquierdo en comparación con el lado derecho. La fosa nasal unilateral supernumeraria puede ocurrir a causa de las fisuras del proceso lateral nasal durante el crecimiento fetal.
