Journal articles: 'Posterior ethmoidal'

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Yamamoto, Hiroki, Kazuhiro Nomura, Hiroshi Hidaka, Yukio Katori, and Naohiro Yoshida. "Anatomy of the posterior and middle ethmoidal arteries via computed tomography." SAGE Open Medicine 6 (January 1, 2018): 205031211877247. http://dx.doi.org/10.1177/2050312118772473.

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Objective: The aim of this study is to investigate the anatomy of the posterior and middle ethmoidal arteries from the viewpoint of an endoscopic sinus surgeon. Methods: Based on 100 computed tomography images, the anatomical position of the posterior ethmoidal artery in relation to the posterior ethmoid cells was classified into five types. The presence of the posterior and middle ethmoidal arteries, their distance from the skull base, and their length exposed in the ethmoid cells were measured. The association of patients’ age and sex, presence of the middle ethmoidal artery, and anatomical type of the posterior ethmoidal artery with the posterior ethmoidal artery distance from the ethmoid roof was analyzed. Results: The posterior ethmoidal artery’s position, relative to the ethmoid cell walls, was most often near the first wall, anterior to the optic canal (92.5%). The posterior ethmoidal artery’s distance from the skull base ranged from 0 to 6.4 mm (mean: 1.2 mm). Older age, longer length of the posterior ethmoidal artery exposed in the ethmoid cells, and absence of the middle ethmoidal artery were positively associated with a longer posterior ethmoidal artery distance from the skull base. Conclusion: Attention should be paid to the posterior and middle ethmoidal arteries.

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Levchenko, O. V., A. Yu Ovchinnikov, A. A. Kalandari, and M. A. Edzhe. "Transorbital clipping of the ethmoidal arteries as a method of early devascularization in cranioorbital tumors removal." Russian Otorhinolaryngology 19, no. 5 (2020): 106–12. http://dx.doi.org/10.18692/1810-4800-2020-5-106-112.

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Objective: To improve the results of surgical treatment of patients with cranioorbital tumors. For this purpose, for patient with high vascularized tumor of ethmoidal bone, adjacent to the medial wall of the orbit, early devascularization as the first stage and transnasal endoscopic removal of the tumor as the second stage was performed. Tumor devascularization was performed by clipping of anterior and posterior ethmoidal arteries through a transcaruncular endoscopic approach. For this, the incision of the conjunctiva, after infiltration with local anesthetics, was carried out posteriorly from the lacrimal caruncle, continuing it above and below the posterior border of the medial canthal ligament. Then, after dissection of the periosteum posterior to the posterior lacrimal crest, further stages of the surgical intervention are performed under the control of an endoscope with a viewing angle of 0°. Results. Transorbital endoscopic clipping of the ethmoid arteries allowed to significantly reduce the intensity of blood flow in the tumor tissue and perform endoscopic transnasal removal of the tumor with minimal blood loss. Intraoperative blood loss was 100 ml. No complications were recorded. Conclusion. Transorbital endoscopic clipping of the anterior and posterior ethmoidal arteries is an effective and safe method for early devascularization of partially embolized or non-embolized cranioorbital tumors. The technique is promising and requires further development.

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Nikam, Dr Vivek. "Unilateral Proptosis A Rare Presentation of Posterior Ethmoidal Sinus Mucocele." Journal of Medical Science And clinical Research 05, no. 06 (2017): 23122–25. http://dx.doi.org/10.18535/jmscr/v5i6.53.

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Singh, Bharath, and M. Med. "Combined internal maxillary and anterior ethmoidal arterial occlusion: the treatment of choice in intractable epistaxis." Journal of Laryngology & Otology 106, no. 6 (1992): 507–10. http://dx.doi.org/10.1017/s0022215100120006.

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AbstractWhilst it is generally accepted that the standard management for anterior or benign epistaxis is either cautery or anterior nasal packing, that of posterior or intractable epistaxis remains controversial. Various modalities of treatment, ranging from posterior nasal packing to arterial ligation and embolization, have been advocated but none have been unanimously accepted as the treatment of choice.The purpose of this paper was to determine the efficacy of internal maxillary arterial ligation versus combined internal maxillary arterial ligation and anterior ethmoid arterial coagulation in intractable epistaxis.Over a six year period, from 1985 to 1990,454 patients were admitted and treated for epistaxis. Forty-seven patients were diagnosed as having intractable epistaxis on the basis that the epistaxis failed to settle on anterior nasal packing. They were moved to the next step in management, which was combined anterior and posterior nasal packing. There were 30 failures, one was found to have choriocarcinoma of the maxilla, and was treated wtih cytotoxics, and the other 29 were moved to the next step, which was arterial ligation. Fifteen patients had internal maxillary arterial ligation, and 14 combined internal maxillary arterial ligation and anterior ethmoidal arterial coagulation.Large windows were created in both the anterior and posterior walls of the maxillary sinuses and all identifiable branches of the internal maxillary artery were dissected out carefully and two medium size ligating clips were placed over the main trunk, the sphenopalatine and the descending palatine branches. Single clips were placed on all other identifiable branches. Coagulation of the anterior ethmoidal artery was performed with a bipolar cautery. There were three (20 per cent) failures in the internal maxillary arterial ligation group and none in the combined internal maxillary arterial ligation and anterior ethmoidal arterial coagulation group. Furthermore, the three failures were successfully treated with anterior ethmoidal arterial coagulation. The conclusion is that combined internal maxillary and anterior ethmoidal arterial occlusion is the treatment of choice in intractable epistaxis.

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Gupta, Mudit. "Fronto-ethmoidal Mucocele with Frontal Sinus Destruction." UP STATE JOURNAL OF OTOLARYNGOLOGY AND HEAD AND NECK SURGERY VOLUME 7, VOLUME 7 NUMBER 2 NOV 2018 (2019): 35–39. http://dx.doi.org/10.36611/upjohns/19.8.

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Fronto ethmoidal mucocele is a benign but expansive pseudo cyst due to mucous secreting nature of fronto-ethmoid sinus. A rare presentation of frontoethmoidal mucocele was reported. Our subject a 61 years old female presented with frontoethmoidal mucocele of unusually large size and two in number which developed over 2 years. Two masses one above left supra-orbital region and next on forehead was noted along with diplopia and non-axial proptosis in left eye due to swelling. Similar findings were found on CT scan and diagnosis was confirmed during surgery. Endoscopic marsupialisation of fronto-ethmoid pyocele with incision & drainage of isolated pyocele in the frontal bone was performed under general anaesthesia. A puncture wound in the posterior table of frontal sinus which might have resulted in CSF rhinorrhoea was dealt at the same setting. Keywords: Fronto-ethmoidal mucocele, diplopia, two mucocele, CSF rhinorrhoea

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Greco, Marco Giuseppe, Francesco Mattioli, Maria Paola Alberici, and Livio Presutti. "Recurrent Massive Epistaxis from an Anomalous Posterior Ethmoid Artery." Case Reports in Otolaryngology 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/8504348.

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A 50-year-old man, with no previous history of epistaxis, was hospitalized at our facility for left recurrent posterior epistaxis. The patient underwent surgical treatment three times and only the operator’s experience and radiological support (cranial angiography) allowed us to control the epistaxis and stop the bleeding. The difficult bleeding management and control was attributed to an abnormal course of the left posterior ethmoidal artery. When bleeding seems to come from the roof of the nasal cavity, it is important to identify the ethmoid arteries always bearing in mind the possible existence of anomalous courses.

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Gupta, Rahul, RG Aiyer, VK Pandya, GB Soni, PJ Dhameja, and Mayank Patel. "Etiopathogenesis of Rhinosinusitis in Relation to Ethmoid Anatomy." An International Journal Clinical Rhinology 3, no. 1 (2010): 17–21. http://dx.doi.org/10.5005/jp-journals-10013-1020.

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Abstract Introduction: Rhinosinusitis is one of the most common ENT disorders in the developed and developing world. The quest and identification of factors predisposing to chronic rhinosinusitis is the key for guiding appropriate management. Objectives The purpose of this study was to determine the prevalence of anatomical variations of the ethmoid sinus in patients with rhinosinusitis. This was done to assess and evaluate the significance of the anatomical variations of the ethmoid in the genesis of inflammatory sinus disease. Material and methods We reviewed 50 patients with rhinosinusitis, of which 38(76%) had anatomical variations of ethmoid and the extent of mucosal disease. Results Concha bullosa was found to be the most common anatomic variation and was seen in 25(50%) patients closely followed by variations in the uncinate process, paradoxically bend middle turbinate. The most commonly affected paranasal sinus was maxillary sinus (84%) followed by anterior ethmoidal sinus, posterior ethmoidal sinus, frontal sinus and sphenoid sinus in descending order. Conclusion Anatomical variations of the ethmoid sinuses are important etiological factors in the genesis of inflammatory sinus disease.

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Dhingra, Shruti, and Satyawati Mohindra. "Isolated Mucocele in an Infraorbital Ethmoidal Cell—Haller Cell: A Unique Presentation." An International Journal Clinical Rhinology 6, no. 1 (2013): 44–46. http://dx.doi.org/10.5005/jp-journals-10013-1147.

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ABSTRACT Haller cell was first described by 18th century Swiss anatomist Albrecht von Haller. Haller cells make up the posterior and superior wall of the ethmoid infundibulum. They can cause obstruction of ethmoidal infundibulum after enlargement. Isolated infection of the Haller cell is usually very rare and should be suspected in patients with visual complaints or facial pain. Diagnosis can be made on radiology. Here, we report a patient with complaints of left-sided eye pain for the last 4 months which was finally diagnosed as Haller cell mucocele and successfully managed via endoscopic marsupialization. How to cite this article Mohindra S, Dhingra S. Isolated Mucocele in an Infraorbital Ethmoidal Cell—Haller Cell: A Unique Presentation. Clin Rhinol An Int J 2013;6(1):44-46.

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Dhingra, Shruti, and Satyawati Mohindra. "Isolated Mucocele in an Infraorbital Ethmoidal-Haller Cell: A Unique Presentation." An International Journal Clinical Rhinology 6, no. 3 (2013): 129–30. http://dx.doi.org/10.5005/jp-journals-10013-1172.

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ABSTRACT Haller cell, was first described by 18th century Swiss anatomist Albrecht von Haller. Haller cells make up the posterior and superior wall of the ethmoid infundibulum. They can cause obstruction of ethmoidal infundibulum after enlargement. Isolated infection of the Haller cell is usually very rare and should be suspected in patients with visual complaints or facial pain. Diagnosis can be made on radiology. Here, we report a patient with complaints of left-sided eye pain for the last 4 months which was finally diagnosed as Haller cell mucocele and successfully managed via endoscopic marsupialization. How to cite this article Mohindra S, Dhingra S. Isolated Mucocele in an Infraorbital Ethmoidal-Haller Cell: A Unique Presentation. Clin Rhinol An Int J 2013;6(3):129-130.

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Sava, Cristina Julieta, Mihai Sandulescu, and Rusu Mugurel Cconstantin. "Sphenoidal and ethmoidal sinoliths." Romanian Journal of Rhinology 7, no. 28 (2017): 257–59. http://dx.doi.org/10.1515/rjr-2017-0028.

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Abstract Sinoliths are rarely found calculi of paranasal sinuses. The most rarely they were found in the sphenoidal sinuses. At a routine Cone Beam CT exam of a 52-year-old male patient clinically silent small sinoliths were found bilaterally in the sphenoidal sinuses and a larger posterior ethmoidal sinolith was found on the right side. To our knowledge, such multiple sinuses involvement has not been previously reported.

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Hosemann, W., R. Gross, U. Göde, Th Kühnel, and G. Röckelein. "The Anterior Sphenoid Wall: Relative Anatomy for Sphenoidotomy." American Journal of Rhinology 9, no. 3 (1995): 137–44. http://dx.doi.org/10.2500/105065895781873854.

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A total of 53 anatomical specimens of the posterior ethmoid and the adjacent anterior sphenoid sinus wall were examined in reference to the operative guidelines for endonasal sphenoidotomy. Six anatomical points of measurement were defined for clinical orientation, and both the absolute and the relative widths of each third (i.e. of each of three vertical sections) of the pars nasalis and the pars ethmoidalis of the anterior sphenoid sinus wall determined. The choana proved to be the most valuable regional anatomic landmark. In 43 cases (41%), a pervading ethmoidal cell was found, extending superiorly and medically all the way up to the nasal septum. In contrast with certain guidelines reported in the literature, 18% of the specimen (sides) showed a wider pars nasalis in the vertical middle third of the anterior sphenoid sinus wall as compared to the adjacent pars ethmoidalis. The thickness of the bone in the anterior wall was similar in both areas. The present measurements support Wigand's recommendation (1990) that the anterior sphenoid sinus wall be perforated paramedially, 10 mm superiorly to the choana.

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Manjila, Sunil, Efrem M. Cox, Gabriel A. Smith, et al. "Extracranial ligation of ethmoidal arteries before resection of giant olfactory groove or planum sphenoidale meningiomas: 3 illustrative cases with a review of the literature on surgical techniques." Neurosurgical Focus 35, no. 6 (2013): E13. http://dx.doi.org/10.3171/2013.10.focus13327.

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Object There are several surgical techniques for reducing blood loss—open surgical and endoscopic—prior to resection of giant anterior skull base meningiomas, especially when preoperative embolization is risky or not technically feasible. The authors present examples of an institutional experience using surgical ligation of the anterior and posterior ethmoidal arteries producing persistent tumor blush in partially embolized tumors. Methods The authors identified 12 patients who underwent extracranial surgical ligation of ethmoidal arteries through either a transcaruncular or a Lynch approach. Of these, 3 patients had giant olfactory groove or planum sphenoidale meningiomas. After approval from the institution privacy officer, the authors studied the medical records and imaging data of these 3 patients, with special attention to surgical technique and outcome. The variations of ethmoidal artery foramina pertaining to this surgical approach were studied using preserved human skulls from the Hamann-Todd Osteological Collection at the Museum of Natural History, Cleveland, Ohio. Results The extracranial ligation was performed successfully for control of the ethmoidal arteries prior to resection of hypervascular giant anterior skull base meningiomas. The surgical anatomy and landmarks for ethmoidal arteries were reviewed in anthropology specimens and available literature with reference to described surgical techniques. Conclusions Extracranial surgical ligation of anterior, and often posterior, ethmoidal arteries prior to resection of large olfactory groove or planum sphenoidale meningiomas provides a safe and feasible option for control of these vessels prior to either open or endoscopic resection of nonembolized or partially embolized tumors.

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Jones, N. S., and T. J. Woolford. "Endoscopic ligation of anterior ethmoidal artery in treatment of epistaxis." Journal of Laryngology & Otology 114, no. 11 (2000): 858–60. http://dx.doi.org/10.1258/0022215001904167.

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Arterial ligation of the anterior ethmoidal artery may be required in cases of persistent epistaxis and conventional techniques involving open surgery carry a recognized morbidity. We describe an endoscopic, intranasal technique for ligation of the anterior ethmoidal artery. This technique was performed in a patient who had a severe epistaxis following nasal trauma. Her epistaxis persisted in spite of anterior and posterior nasal packing. Endoscopy showed the bleeding to originate high and lateral to the middle turbinate. Endoscopic exploration defined the frayed end of the anterior ethmoidal artery. A ligaclip was placed with immediate and persistent arrest of her epistaxis. No further nasal packs or treatment were required.

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van Rensburg, L. J., C. J. Nortje, and R. E. Wood. "Pneumosinus Dilatans of the Ethmoid Sinus—Incidental Finding on a Cephalometric Radiograph." British Journal of Orthodontics 22, no. 2 (1995): 179–83. http://dx.doi.org/10.1179/bjo.22.2.179.

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A case of pneumosinus dilatans of the posterior ethmoidal region is presented. The condition known as pneumosinus dilatans is discussed, as are accessory ethmoidal air cells with respect to their most common location and radiographic appearance. The diagnostic imaging features of this condition are described and a recommendation of views to adequately delineate this disorder are given. The importance of an adequate and thorough review of the cephalometric radiograph for pathologic conditions is stressed.

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Edelstein, David R., Lisa Liberatore, Sheila Bushkin, and Jin C. Han. "Applied Anatomy of the Posterior Sinuses in Relation to the Optic Nerve, Trigeminal Nerve, and Carotid Artery." American Journal of Rhinology 9, no. 6 (1995): 321–34. http://dx.doi.org/10.2500/105065895781808702.

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Retrobulbar hemorrhage and visual loss are among the most serious complications of endoscopic sinus surgery. To minimize the occurrence of these risks, the surgeon's knowledge of the specific locations of the neurovascular structures is of paramount importance. In this study, the location of the internal carotid artery (ICA), optic nerve, trigeminal nerve, and anterior and posterior ethmoidal arteries were evaluated by cadaver dissection and anatomic and radiographic measurements. Fifty cadavers were studied using endoscopic techniques, calibrated instruments, and photographic documentation. The average distances from the columella to the optic nerve and ICA were 8.31 cm and 8.57 cm respectively. Mean distances to the anterior ethmoidal artery, posterior ethmoidal artery, ostium of the sphenoid, and posterior wall of the sphenoid sinus were also determined. Measurements derived from 50 normal cranial MRI studies yielded similar results. The ICA was clearly identified in 95%, and the optic nerve in 72% of sagittal MRI studies. The interrelationship of the maxillary division of the trigeminal nerve with the lateral sphenoid wall, optic nerve, and carotid artery was also studied. Sagittal section MRI scans were very useful in determining the critical relationships between the optic nerve, carotid artery, and sphenoid sinus. Comparisons and contrasts are made between the usage of CT scans and MRI in the delineation of these structures.

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Halbach, Van V., Randall T. Higashida, Grant B. Hieshima, Charles B. Wilson, Stanley L. Barnwell, and Christopher F. Dowd. "Dural Arteriovenous Fistulas Supplied by Ethmoidal Arteries." Neurosurgery 26, no. 5 (1990): 816–23. http://dx.doi.org/10.1227/00006123-199005000-00014.

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Abstract Eight patients with dural arteriovenous fistulas (DAVFs) located on the floor of the anterior cranial fossa and supplied by enlarged ethmoidal branches of the ophthalmic artery are described. Five patients showed the classical symptom of intracerebral hemorrhage (all five had ipsilateral frontal lobe hematomas and one also had an associated a subdural hematoma). Two patients exhibited atypical symptoms of proptosis, chemosis, elevated intraocular pressure, and loss of vision secondary to an ethmoidal DAVF, which drained posteriorly to the cavernous sinus. The eighth patient exhibited proptosis and chemosis secondary to a cavernous sinus DAVF and was incidentally found to have an asymptomatic ethmoidal DAVF. One additional patient had two separate dural fistulas: one located on the cribriform plate and the second located in the posterior fossa. Seven of the eight patients were cured by surgical excision of the fistula site; in the remaining patient spontaneous obliteration followed a surgical procedure for a cavernous DAVF. DAVFs involving the floor of the anterior cranial fossa usually present with hemorrhage, but can present with ocular symptoms or be entirely asymptomatic and are effectively treated by surgical excision of the fistula site.

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D., Brouzas, Charakidas A., Androulakis M., and Moschos M. "Traumatic Optic Neuropathy after Posterior Ethmoidal Artery Ligation for Epistaxis." Otolaryngology–Head and Neck Surgery 126, no. 3 (2002): 323–25. http://dx.doi.org/10.1067/mhn.2002.122387.

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Caliot, Ph, JL Plessis, D. Midy, M. Poirier, and JC Ha. "The intraorbital arrangement of the anterior and posterior ethmoidal foramina." Surgical and Radiologic Anatomy 17, no. 1 (1995): 29–33. http://dx.doi.org/10.1007/bf01629496.

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Agababov, A. "Post ocular optic neuritis of rhinogenic origin. Вrüскnеr (Zentr. f. d. gesam. Ophtalmologie. Bd. III, H. 12)". Kazan medical journal 19, № 1 (2021): 99. http://dx.doi.org/10.17816/kazmj78711.

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According to the author's data, this suffering, in most cases arising from multiple sclerosis, is not so rare (3-17%) depending on the disease (mainly empyema) of nearby cavities, namely sinus sphenoidalis and posterior ethmoidal cells.

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Avcı, Emel, Erinç Aktüre, Hakan Seçkin, et al. "Level I to III craniofacial approaches based on Barrow classification for treatment of skull base meningiomas: surgical technique, microsurgical anatomy, and case illustrations." Neurosurgical Focus 30, no. 5 (2011): E5. http://dx.doi.org/10.3171/2011.3.focus1110.

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Object Although craniofacial approaches to the midline skull base have been defined and surgical results have been published, clear descriptions of these complex approaches in a step-wise manner are lacking. The objective of this study is to demonstrate the surgical technique of craniofacial approaches based on Barrow classification (Levels I–III) and to study the microsurgical anatomy pertinent to these complex craniofacial approaches. Methods Ten adult cadaveric heads perfused with colored silicone and 24 dry human skulls were used to study the microsurgical anatomy and to demonstrate craniofacial approaches in a step-wise manner. In addition to cadaveric studies, case illustrations of anterior skull base meningiomas were presented to demonstrate the clinical application of the first 3 (Levels I–III) approaches. Results Cadaveric head dissection was performed in 10 heads using craniofacial approaches. Ethmoid and sphenoid sinuses, cribriform plate, orbit, planum sphenoidale, clivus, sellar, and parasellar regions were shown at Levels I, II, and III. In 24 human dry skulls (48 sides), a supraorbital notch (85.4%) was observed more frequently than the supraorbital foramen (14.6%). The mean distance between the supraorbital foramen notch to the midline was 21.9 mm on the right side and 21.8 mm on the left. By accepting the middle point of the nasofrontal suture as a landmark, the mean distances to the anterior ethmoidal foramen from the middle point of this suture were 32 mm on the right side and 34 mm on the left. The mean distance between the anterior and posterior ethmoidal foramina was 12.3 mm on both sides; the mean distance between the posterior ethmoidal foramen and distal opening of the optic canal was 7.1 mm on the right side and 7.3 mm on the left. Conclusions Barrow classification is a simple and stepwise system to better understand the surgical anatomy and refine the techniques in performing these complex craniofacial approaches. On the other hand, thorough anatomical knowledge of the midline skull base and variations of the neurovascular structures is crucial to perform successful craniofacial approaches.

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Wong, Danny K. C., Angus Shao, Raewyn Campbell, and Richard Douglas. "Anterior Ethmoidal Artery Emerging Anterior to Bulla Ethmoidalis: An Abnormal Anatomical Variation in Waardenburg's Syndrome." Allergy & Rhinology 5, no. 3 (2014): ar.2014.5.0094. http://dx.doi.org/10.2500/ar.2014.5.0094.

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In endoscopic sinus surgery, the anterior ethmoidal artery (AEA) is usually identified as it traverses obliquely across the fovea ethmoidalis, posterior to the bulla ethmoidalis and anterior to or within the ground lamella's attachment to the skull base. Injury to the AEA may result in hemorrhage, retraction of the AEA into the orbit, and a retrobulbar hematoma. The resulting increase in intraorbital pressure may threaten vision. Waardenburg's syndrome (WS) is a rare congenital, autosomal dominantly inherited disorder, distinguished by characteristic facial features, pigmentation abnormalities, and profound, congenital, sensorineural hearing loss. We present a case of AEAs located anterior to the bulla ethmoidalis in a 36-year-old male with WS and chronic rhinosinusitis. The anatomic abnormality was not obvious on a preoperative computed tomography scan and was discovered intraoperatively when the left AEA was injured, resulting in a retrobulbar hematoma. The hematoma was immediately identified and decompressed endoscopically without lasting complications. The AEA on the right was identified intraoperatively and preserved. The characteristic craniofacial features in WS were probably associated with the abnormal vascular anatomy. Endoscopic sinus surgeons should be aware of these potential anatomic anomalies in patients with abnormal craniofacial development.

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Husain, Zaidi Sayeed Haider. "A Study of Posterior Ethmoidal Foramen Absence in North Indian Crania." International Journal of Advanced and Integrated Medical Sciences 2, no. 4 (2017): 173–74. http://dx.doi.org/10.5005/jp-journals-10050-10099.

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Cankal, F., N. Apaydin, H. I. Acar, et al. "Evaluation of the anterior and posterior ethmoidal canal by computed tomography." Clinical Radiology 59, no. 11 (2004): 1034–40. http://dx.doi.org/10.1016/j.crad.2004.04.016.

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Moriyama, Hiroshi, Masaya Fukami, Kiyoshi Yanagi, Nobuyoshi Ohtori, and Kensaku Kaneta. "Endoscopic Endonasal Treatment of Ostium of the Frontal Sinus and the Results of Endoscopic Surgery." American Journal of Rhinology 8, no. 2 (1994): 67–70. http://dx.doi.org/10.2500/105065894781874449.

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We discuss a procedure for opening the nasofrontal duct and the postoperative findings in endoscopic endonasal surgery. The route of the anterior ethmoidal artery was also studied. The subjects of this study were 57 patients (105 sides) who had frontal sinus disease. The patients all underwent surgery for chronic sinusitis between 1990 and 1992. Patients undergoing revision surgery were excluded. All patients were operated on by the same surgeon. In each patient, following anterior and posterior ethmoidectomy, the frontal sinus ostial region was opened using a 70 endoscope, while carefully monitoring the anterior ethmoidal artery. The agger nasi was left intact. The cells around the ostium were opened using a curved suction tip and upward bent forceps, and the lamellae were removed to achieve the greatest possible communication with the frontal sinus. In 77 sides (73.4%), the communication between the frontal and ethmoidal sinuses was well maintained. The ostium was patent with edematous mucosa in 18 sides (17.1%). The opened ostium could not be confirmed due to presence of polyp, etc., in 10 sides (9.5%). During surgery, the route of the anterior ethmoidal artery was confirmed in 70.8%; and of these cases, it was located anterior to the third ground lamella in about 50%.

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Sjogren, Phayvanh P., Rajendra Waghela, Shaelene Ashby, Richard H. Wiggins, Richard R. Orlandi, and Jeremiah A. Alt. "International Frontal Sinus Anatomy Classification and Anatomic Predictors of Low-Lying Anterior Ethmoidal Arteries." American Journal of Rhinology & Allergy 31, no. 3 (2017): 174–76. http://dx.doi.org/10.2500/ajra.2017.31.4428.

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Background The International Frontal Sinus Anatomy Classification (IFAC) was introduced to more accurately characterize ethmoid and frontal sinus pneumatization patterns. The prevalence of IFAC cells and their anatomic associations have not been described. Objective The goal was to examine the prevalence of IFAC cells and determine radiologic features associated with a low-lying anterior ethmoidal artery (LAEA). Methods Imaging of adult patients who underwent computed tomographies from January 2015 to March 2016 were retrospectively reviewed by using the IFAC classification. We also measured the distance from the skull base to the anterior ethmoidal artery (AEA), the height of the lateral lamella of the cribriform plate, and anterior-posterior diameter from the anterior wall of the frontal sinus to the skull base (APF). Patients with a history of sinus surgery, trauma, malignancy, or congenital anomaly were excluded. Statistical analysis was performed by using Pearson correlation coefficients and χ2 tests. Results A total of 95 patients met the inclusion criteria. There was a significant association between supraorbital ethmoid cells and an LAEA (p < 0.001), with a significant effect size (ϕ = 0.276, p = 0.007). An inverse relationship was observed between Keros type I classification I and an LAEA (p < 0.001), with a significant effect size (ϕ = -0.414, p = 0.000). Significant associations were found between the AEA distance from the skull base and the cribriform lateral lamella height (R = 0.576, p < 0.001). In addition, there was a significant association between the AEA distance from the skull base and the APF (R = 0.497, p < 0.001). Conclusion The presence of a supraorbital ethmoid cell and a wide APF were associated with an LAEA. There was a significant relationship between Keros type I classification and the AEA adjacent to the skull base. Delineation of these anatomic relationships may be helpful during endoscopic sinus surgery to avoid complications.

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Chiesa Estomba, Carlos Miguel, Frank Alberto Betances Reinoso, and Carmelo Santidrian Hidalgo. "A safe way to find the posterior ethmoidal cells: navigation with cottonoid." Romanian Journal of Rhinology 6, no. 21 (2016): 41–43. http://dx.doi.org/10.1515/rjr-2016-0005.

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Abstract BACKGROUND. Functional endoscopic sinus surgery (FESS) is a reliable option in the treatment of sinus pathology, but the presence of the anatomical variant and difficult cases like massive polyposis or revision FESS can generate some problems to surgeons. MATERIAL AND METHODS. After performing an unciformectomy, a partial anterior ethmoidectomy and maxillary ostium antrostomy, we slide a cottonoid back to the basal lamella of the middle turbinate with a Cottle dissector and introduce it in the superior meatus. After that, we return to the middle meatus and proceed to open the basal lamella finding the cottonoid placed there previously. RESULTS. An easy technique, safe and reproducible, that allows us to advance in our dissection, avoiding damaging important structures. CONCLUSION. In this paper we present a safe way to approach the posterior ethmoidal cells complex in the classic way through the basal lamella of the middle turbinate, under the guidance of a cottonoid, a safe and easy maneuver to do this procedure in the beginning of our formation or in complex cases.

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Ishida, Yoshiya, Akihiro Katayama, Masaaki Adachi, and Yasuaki Harabuchi. "A Case of Posterior Ethmoidal Sinus Cyst Involving Anterior Skull Base Bone Defects." Practica Oto-Rhino-Laryngologica 103, no. 5 (2010): 431–37. http://dx.doi.org/10.5631/jibirin.103.431.

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Cavada, Marina N., Carolyn A. Orgain, Raquel Alvarado, Raymond Sacks, and Richard J. Harvey. "Septal Perforation Repair Utilizing an Anterior Ethmoidal Artery Flap and Collagen Matrix." American Journal of Rhinology & Allergy 33, no. 3 (2018): 256–62. http://dx.doi.org/10.1177/1945892418816959.

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Background Nasal septal perforation repair remains a challenge with no standard technique for repair recognized. Objective To describe the combination of an anterior ethmoidal artery flap with a collagen matrix inlay as a successful technique for nasal septal perforation repair. Methods A case series of consecutive patients who underwent nasal septal perforation repair with an anterior ethmoidal artery flap with an inlay collagen graft was conducted. Demographic data, preoperative features of the perforation (size, location, and presence of chondritis), and postoperative outcomes were analyzed; closure rate, mucosalization rate (of the contralateral side at 21 and 90 days), and complications (crusting, bleeding, obstruction, infection, and rehospitalization <30 days) were documented. Results Thirteen patients (age: 49 ± 15 years, 30.8% women) were assessed. The perforation size was 1.6 ± 0.9 cm (range: 0.3–3.5 cm) and located 1.2 ± 0.5 cm (range: 0.5–2.0 cm) posterior to the columella. Chondritis was present in 69.2%. The closure rate was 100% (95% confidence interval [CI]: 77%–100%) at both 21 and 90 days. One patient required a free mucosa graft to an area of persistent crusting on the contralateral side (7.7%). Complications were low; bleeding 0%, obstruction 7.7% (requiring corticosteroid injection of anterior ethmoidal artery flap), and 0% infection/rehospitalization. Conclusion Anterior ethmoidal artery flap with an inlay collagen matrix is a reliable technique to repair nasal septal perforation. This technique, with robust vascularity and wide angle of rotation, enables the closure of perforations both large (<50% total septum) and with anterior locations.

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Isaacson, Glenn, and Janet M. Monge. "Arterial Ligation for Pediatric Epistaxis: Developmental Anatomy." American Journal of Rhinology 17, no. 2 (2003): 75–81. http://dx.doi.org/10.1177/194589240301700202.

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Background Anatomic studies of adult skulls have aided in the design of operations for the surgical ligation of nasal feeding vessels in the treatment of severe epistaxis. Lack of appropriate specimens has prevented similar studies in children. We performed an anthropometric study of archeological specimens to learn the effects of growth on key anatomic relationships. Methods We studied the skulls of children who died between 200 and 8000 years ago, recovered from archeological digs around the world. Measurements of the distances from the posterior lacrimal crest to the foramina of anterior and posterior ethmoidal arteries and optic canal and the pyriform aperture to the foramen of the sphenopalatine artery were made and compared with postnatal age, estimated from facial growth and dental eruption patterns. Results There is rapid growth in the orbit and midface during the first 6 years of life and gradual growth between 7 years and adulthood. The length of the medial wall of the orbit doubles during development with disproportionate enlargement of its anterior half. Conclusion Arterial ligation is sometimes required for intractable pediatric epistaxis, especially after trauma. The changing relationships of critical structures in the orbital must be understood to allow safe ethmoidal artery ligation. The transantral approach to the maxillary artery is greatly limited by lack of midfacial development and maxillary pneumatization. We describe the necessary parameters for endoscopic, transnasal sphenopalatine artery ligation in growing children.

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Mélot, A., J. V. Chazot, L. Troude, S. De la Rosa, H. Brunel, and P. H. Roche. "Ruptured posterior ethmoidal artery aneurysm and Moyamoya disease in an adult patient. Case report." Neurochirurgie 62, no. 3 (2016): 171–73. http://dx.doi.org/10.1016/j.neuchi.2016.04.001.

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Fleissig, Efrat, Oriel Spierer, Ilan Koren, and Igal Leibovitch. "Blinding Orbital Apex Syndrome due to Onodi Cell Mucocele." Case Reports in Ophthalmological Medicine 2014 (2014): 1–3. http://dx.doi.org/10.1155/2014/453789.

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The onodi cell is a posterior ethmoidal cell that is pneumatized laterally or superiorly to the sphenoid sinus with close proximity to the optic nerve. A mucocele, a benign, expansile, cyst-like lesion of the paranasal sinuses, may uncommonly involve the onodi cell causing compression of the optic nerve and nearby structures. In this paper, we report a rare case of onodi cell mucocele causing orbital apex syndrome, with prompt recovery after endoscopic removal. However, optic neuropathy did not improve and the patient remained blind.

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Gouripur, Kranti, Udaya Kumar M., Anand B. Janagond, S. Elangovan, and V. Srinivasa. "Incidence of sinonasal anatomical variations associated with chronic sinusitis by CT scan in Karaikal, South India." International Journal of Otorhinolaryngology and Head and Neck Surgery 3, no. 3 (2017): 576. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20172291.

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Background: Variations in sinonasal anatomy of adults are common and vary among different populations. Their role in development of pathological conditions such as sinusitis, epistaxis, etc is debated. Having clear picture of sinonasal anatomy of a person is essential in avoidance of complications during surgery. This study was done to analyze sinonasal anatomy in adults from Karaikal region having chronic sinusitis by nasal endoscopy and CT scan imaging.Methods: A total of 50 patients undergoing endoscopic sinus surgery were studied by preoperative nasal endoscopy, CT scanning and endoscopy at the time of definitive surgery and variations recorded and analyzed. Results: The incidence of the sinonasal anatomical variations in CT scan study were – discharge in the frontal sinus (100%), agger nasi cells (96%), deviated nasal septum (70%), anterior ethmoidal cells (86%), posterior ethmoidal cells (58%), sinus lateralis (52%), frontal cells (50%), discharge in sphenoid sinus (50%), pneumatised superior turbinate (46%), INSA (34%), prominent bulla ethmoidalis (30%), supra orbital cells (26%), pneumatised septum(16%), medialised uncinate process (16%), paradoxical middle turbinate (16%), Haller cells (14%), supreme turbinate (14%), pneumatised inferior turbinate (12%), frontal recess obliteration (12%), absent pneumatisation of frontal sinus (12%), pneumatised middle turbinate (10%), Onodi cells (6%), pneumatised uncinate process (2%), maxillary sinus septation (2%).Conclusions: The high incidence of variations emphasises the need for proper preoperative assessment for safe and effective endoscopic sinus surgery.

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Di Mario, Alessia. "STEROID ELUTING ETHMOIDAL STENT VERSUS ANTERO-POSTERIOR ETHMOIDECTOMY: COMPARISON OF EFFICACY AND SAFETY IN ALLERGIC PANTIENS." Otolaryngologia Polska 70, no. 2 (2016): 6–12. http://dx.doi.org/10.5604/00306657.1199343.

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Cecchini, Giulio. "Anterior and Posterior Ethmoidal Artery Ligation in Anterior Skull Base Meningiomas: A Review on Microsurgical Approaches." World Neurosurgery 84, no. 4 (2015): 1161–65. http://dx.doi.org/10.1016/j.wneu.2015.06.005.

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HAYAKAWA, KIMIKO, HIROSHI YOSHIKAWA, MIYAKO SUZUKI, et al. "Variations in reciprocal distances between the ethmoidal sinus, sphenoidal sinus and posterior orbit : measurement on CTscans." Juntendo Medical Journal 49, no. 1 (2003): 89–96. http://dx.doi.org/10.14789/pjmj.49.89.

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Bolger, William E., and Christopher B. Mawn. "Analysis of the Suprabullar and Retrobullar Recesses for Endoscopic Sinus Surgery." Annals of Otology, Rhinology & Laryngology 110, no. 5_suppl (2001): 3–14. http://dx.doi.org/10.1177/00034894011100s501.

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Presently, the basic structures and spaces of the paranasal sinuses are more clearly understood by otolaryngologists than ever before. Yet, the more subtle and complex ethmoid features, especially of the ethmoidal pre-recesses and recesses, still elude many otolaryngologists. One of the most nebulous, elusive, and difficult-to-understand recesses is the sinus lateralis, or as it is more correctly called, the retrobullar and suprabullar recesses. The primary purpose of this investigation was to ascertain the prevalence of the sinus lateralis in humans. The secondary purpose was to better characterize this subtle feature of ethmoid anatomy. Human cadaver sinonasal complexes were meticulously dissected by both gross and endoscopic techniques. The hiatus semilunaris superior and sinus lateralis were present in all specimens. A separate and discrete retrobullar recess was present in 93.8%. Typically, a crestlike projection from the basal lamella to the lamina papyracea was noted within the posterior aspect of the retrobullar recess. A single, discrete, well-developed suprabullar recess was present in 70.9%, and a rudimentary suprabullar recess was present in 22.9%. In 7.2%, a single large cleft collectively excavated the retrobullar and suprabullar recess areas; separate retrobullar and suprabullar tracts were not present in this subgroup. Typically, the suprabullar recess was separate from and did not communicate with the frontal recess. The data from this investigation indicate that the separate terms retrobullar recess and suprabullar recess more accurately designate the anatomy and are recommended over the term sinus lateralis.

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Friedman, William H., and George P. Katsantonis. "Transantral Revision of Recurrent Maxillary and Ethmoidal Disease following Functional Intranasal Surgery." Otolaryngology–Head and Neck Surgery 106, no. 4 (1992): 367–71. http://dx.doi.org/10.1177/019459989210600409.

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Recurring disease in the maxillary sinus, despite inferior meatal antrostomies, has led to the widespread use of middle meatal antrostomy or simple decompression of the natural ostium of the middle meatus in attempts to restore function to the maxillary sinus. We have reported recurrent disease in the maxillary sinus in patients with stage III or stage IV hyperplastic rhinosinusitis in whom attempts at functional surgery of the middle meatus were unsuccessful in reversal of retrograde changes. One hundred patients who had previously undergone intranasal sphenoethmoidectomy with removal of the middle turbinate, decompression of the maxillary ostium, and removal of overt hyperplastic disease of the middle meatus underwent revision transantral ethmoidectomy. All recurrent or residual diseased mucosa was removed, including polyps, occasional mucoceles, and hyperplastic changes that occurred despite patency of a middle meatal maxillary ostium. In many of these patients the maxillary sinus was widely marsupialized secondarily into the posterior nasal vault. While the initial overall polyp recurrence rate after intranasal sphenoethmoldectomy in these patients was as high as 19.2%, the rate of polyp recurrence after transantral revision was less than 5% in from 18 to 48 months postoperatively. The experience in this series suggests that mucosal changes have played a primary role in unsuccessful treatment, independent of whether or not adequate functional egress for maxillary secretion, drainage, or ventilation has been created or restored. A brief review, statistical evaluation of patients, and overall evaluation of the relationship of ethmoid surgery to maxillary surgery are presented.

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Craiu, Catalina, Mihai Sandulescu, and Mugurel Constantin Rusu. "Variations of sphenoid pneumatization: a CBCT study." Romanian Journal of Rhinology 5, no. 18 (2015): 107–13. http://dx.doi.org/10.1515/rjr-2015-0013.

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AbstractBACKGROUND. The pneumatization pattern of the sphenoid sinus seems rather unpredictable, as resulted from previous studies. It is however extremely important for endoscopic approaches to target structures of the middle cranial fossa, such as the pituitary gland.MATERIAL AND METHODS. We aimed at documenting by Cone Beam Computed Tomography (CBCT) the possibilities of anatomic variation of the sphenoid sinus. 25 randomly selected patients were retrospectively analyzed.RESULTS. In 56%, the left and right sphenoidal sinuses were bilaterally symmetrical with respect to the sagittal pneumatization type: four patients had sellar types, one had presellar type and in nine cases the sphenoidal sinuses were reaching posteriorly to the sella turcica. Only in 8% of cases were found conchal types of pneumatization, but they were part of anatomical pictures including Onodi air cells. Such an Onodi cell presented a posterior (sphenoidal) recess reaching posteriorly and superiorly to the pterygopalatine fossa. The recesses of the sphenoid sinus were also documented: anterior or septal, ethmoidal, maxillary, clinoidal and lateral. In 32% was found a lateral recess only engaged between the vidian and maxillary nerve canals.CONCLUSION. It appears that CBCT is a reliable tool for accurate anatomic identification of the sphenoid sinus pneumatization pattern, on a case-by-case basis.

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Swain, Santosh Kumar. "Middle turbinate concha bullosa and its relationship with chronic sinusitis: a review." International Journal of Otorhinolaryngology and Head and Neck Surgery 7, no. 6 (2021): 1062. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20212136.

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Sinonasal diseases are serious health issues found in the clinical practice. Sinonasal diseases are often associated with anatomical variants in the sinonasal tract. There are numerous sinonasal anatomical variants found frequently in computed tomography (CT) scans of the paranasal sinuses. Middle turbinate concha bullosa is a common anatomical variant found in the nasal cavity. Pneumatization of the middle turbinate is called as concha bullosa. The pneumatization of the middle turbinate is mostly via the anterior ethmoidal air cells. Pneumatizations through posterior ethmoid air cells are also reported. There are three types of concha bullosa such as lamellar, bulbous and extensive. Majority of the patients with middle turbinate concha bullosa are asymptomatic. Sometimes this is accidentally detected during proper evaluation of the headache. Sometimes the middle turbinate concha bullosa is associated with chronic sinusitis. However, there are very few literatures which correlate the middle turbinate concha bullosa and chronic sinusitis. Although chronic sinusitis is a clinical diagnosis, the imagings like CT scan are useful to assess the extent of the disease and demonstrate the sinonasal anatomy. CT scan of the paranasal sinuses and diagnostic nasal endoscopy are important tests useful for evaluation of the middle turbinate concha bullosa and its relations with chronic sinusitis. This review article discusses on the details of the middle turbinate concha bullosa and its relationship with chronic sinusitis.

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YANG, JIAN, XIAOYONG CHEN, and JUNXING YANG. "The identity of Schizothorax griseus Pellegrin, 1931, with descriptions of three new species of schizothoracine fishes (Teleostei: Cyprinidae) from China." Zootaxa 2006, no. 1 (2009): 23–40. http://dx.doi.org/10.11646/zootaxa.2006.1.2.

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The identity of Schizothorax griseus Pellegrin, 1931, is clarified and the species redescribed. Three new species previously identified as S. griseus are described: S. nudiventris, from the Lancang Jiang, China; S. heterophysallidos, from the Nanpan Jiang, China; and S. beipanensis, from the upper Beipan Jiang, China. The group comprising Schizothorax griseus, S. nudiventris, S. heterophysallidos and S. beipanensis can be diagnosed from other members of this genus by the absence of an obvious horny sheath on the lower jaw; lower lip developed with three labial lobes in mature individuals; postlabial groove continuous, with a small labial lobe present in the middle of the lower lip; last unbranched dorsal-fin ray strong, its posterior edge with numerous serrae; and scales absent on ventral surface between pectoral fins in adults (except in S. griseus). Schizothorax griseus differs from S. nudiventris, S. heterophysallidos and S. beipanensis by the presence (vs. absence) of concealed scales in the skin on the ventral surface between the pectoral fins in adults; the presence (vs. absence) of a shallow ethmoidal groove before the nostrils; and having barbels much longer than eye diameter (eye diameter 33.4–93.7 % (vs. 57.2–160.0) of maxillary-barbel length). Schizothorax nudiventris is distinguished from S. heterophysallidos and S. beipanensis in having only the proximal ¾ (vs. entirety) of the last unbranched dorsal-fin ray strong; pelvic-fin origin opposite or posterior (vs. opposite or anterior) to vertical through dorsal-fin origin; and irregular black spots present (vs. absent) on side of body. Schizothorax heterophysallidos is distinguished from S. griseus, S. nudiventris and S. beipanensis in having a larger posterior chamber of the air bladder (vs. posterior chamber as large as, or slightly larger than, anterior one), length of posterior chamber 3–6 (vs. 2) times length of anterior chamber. Schizothorax beipanensis is distinguished from S. griseus by the absence (vs. presence) of scales on the thorax in mature individuals; absence (vs. presence) of black spots on side of body; and having the maxillary barbel 58.5–120.1 % SL (vs. 33.4–93.7 % SL).

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Li, J., Q. S. Ran, B. Hao, X. Xu, and H. F. Yuan. "Transsphenoidal Optic Canal Decompression for Traumatic Optic Neuropathy Assisted by a Computed Tomography Image Postprocessing Technique." Journal of Ophthalmology 2020 (August 12, 2020): 1–6. http://dx.doi.org/10.1155/2020/1870745.

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The endoscopic transethmoidal approach is favored for the lack of external scars, a wide field of view, and rapid recovery time. But the effect of iatrogenic trauma should not be ignored due to the removal of the uncinate process and anterior and posterior ethmoidal sinus. Anatomically, the optic nerve is close to the sphenoid sinus and Onodi cell. In order to preserve the uncinate process and ethmoidal sinus, we perform endoscopic transsphenoidal optic canal decompression (ETOCD), which is less invasive. However, the anatomy of sphenoid sinus is quite variable, and the anatomical landmarks are rare. Therefore, identifying the position of optic canal is particularly important during surgery. To solve this, we use a postprocessing technique to identify the position of the optic nerve and internal carotid artery on the sphenoid sinus wall. Our results find that VA in 13 patients improved, with a total improve rate of 59.1%. No serious complications were found. We also found that the length of optic canal is different and the medial wall of the optic canal was the longest (p<0.05). The middle section of the optic canal is the narrowest, which was significantly different from cranial mouth and orbital mouth (p<0.05). We assumed that decompression may not require removal of all medial wall. If we remove the length of the shortest wall on the medial wall of the optic canal, the compression may be relieved. Thus, ETOCD was a feasible, safe, effective, and less-invasive approach for patients with TON. The CT postprocessing imaging facilitated recognition of the optic canal during surgery. The decompression length of the medial wall may not need to be completely removed, especially near the cranial mouth.

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Gosavi, Shilpa N., Surekha D. Jadhav, and Balbhim R. Zambare. "ORBITAL MORPHOLOGY WITH REFERENCE TO BONY LANDMARKS. 20 La morfología de la órbita en relación a los parámetros óseos." Revista Argentina de Anatomía Clínica 6, no. 1 (2016): 20–25. http://dx.doi.org/10.31051/1852.8023.v6.n1.14094.

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Las órbitas óseas son cavidades del esqueleto situadas a cada lado de la nariz. Se conocen las diferencias raciales en las medidas orbitales. El objetivo del presente estudio era determinar las distancias de varias fisuras y foramen en la órbita en relación a ciertos puntos de referencia óseos / quirúrgicos sobre los márgenes orbitales en la población india, lo que puede ser útil durante la cirugía orbital. La distancia de canal óptico (OC), fisura orbitaria superior (SOF), fisura orbital inferior (IOF) y forámenes lagrimales (LF) se mide a partir de puntos de referencia como cresta lacrimal anterior (ALC) para la pared medial, muesca/foramen supra orbital (SN) para la pared superior, sutura cigomática frontal (FZ) de la pared lateral y un punto en el margen inferior (OIM) justo encima del agujero infraorbitario. Se midió la distancia del foramen etmoidal anterior y posterior (AEF y PEF) de ALC. Se observó la presencia de foramen etmoidal media (MEF) y forámenes lagrimales (LF).La distancia media de OC fue 39,71 ±2,67 mm(deALC), 45,11 ±3,4 mm(de SN) , 48,32 ±2,8 mm(de FZ ) y 45,97 ±3,9 mm(de OIM). La distancia segura para el nervio óptico para cada pared orbital se calcula restando5 mmde la distancia más corta medida. The bony orbits are skeletal cavities located on either side of the nose. Racial differences in orbital measurements are known. The aim of the present study was to determine the distances of various fissures and foramen in the orbit with reference to certain bony / surgical landmarks on the orbital margins in Indian population which can be useful during various surgical procedures. The distance of optic canal (OC), superior orbital fissure (SOF), inferior orbital fissure (IOF), lacrimal foramen (LF) were measured from landmarks like anterior lacrimal crest (ALC) for medial wall, supraorbital foramen/ notch (SON) for superior wall, fronto-zygomatic suture (FZ) for lateral wall and a point on inferior margin (IOM) just above the infraorbital foramen. Distance of anterior and posterior ethmoidal foramen (AEF and PEF) from ALC was measured. The incidence of middle ethmoidal foramen (MEF) and lacrimal foramen (LF) was noted. The mean distance of OC was 39.71 ±2.67 mm(from ALC), 45.11 ±3.4 mm(from SN), 45.97 ±3.9 mm(from FZ) and 48.32 ±2.8 mm(from IOM). The safe distance for optic nerve for each orbital wall was derived by subtracting5 mmfrom the shortest measured distance.

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Jittapiromsak, Pakrit, Pushpa Deshmukh, Peter Nakaji, Robert F. Spetzler, and Mark C. Preul. "Transfrontoethmoidal approach to medial intraconal lesions." Journal of Neurosurgery 111, no. 6 (2009): 1131–40. http://dx.doi.org/10.3171/2009.6.jns081325.

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Object The standard superior craniotomy approach through the orbital roof is obstructed by numerous muscles, nerves, and vessels. Accessing the medial intraconal space also involves considerable brain retraction. The authors present a modified approach through the frontal sinus that overcomes these limitations. Methods Seven fixed silicone-injected cadaveric specimens were dissected bilaterally. In addition to the superior orbital wall, the ethmoidal sinuses and medial orbital wall were removed. The anatomical relationships between the major neurovascular complexes in the medial intraconal space and the optic nerve were observed. Results Intraconally, working space was created both in a “superior window” between the superior oblique and levator palpebrae muscle and in a “medial window” between the superior oblique and medial rectus muscle. The superior window mainly created an ipsilateral trajectory to the deep target. The medial window, which created a contralateral trajectory, provided a more inferior view of the medial intraconal space. Removal of the medial orbital wall further widened the exposure obtained from the superior window. The combination of these working windows makes the medial surface of the optic nerve available for exploration from multiple angles. Most of the major neurovascular complexes of the posterior orbit can be retracted safely without impinging on the optic nerve. Conclusions This novel extradural transfrontoethmoidal approach affords a direct view to the medial posterior orbit without major conflicts with intraconal neurovascular structures and requires minimal brain manipulation. The approach appears to offer advantages for medially located intraconal lesions.

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Cazac, Tabita Larisa, Ioana Andreea Dărămuș, B. C. Dumitrescu, and C. Toader. "OLFACTORY GROOVE MENINGIOMAS – CLINICAL PRESENTATION, TREATMENT AND OUTCOMES." Journal of Surgical Sciences 2, no. 1 (2015): 34–48. http://dx.doi.org/10.33695/jss.v2i1.104.

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Olfactory groove meningiomas are benign tumors, which arise in the midline of the anterior cranial fossa, over the cribriform plate and frontosphenoid suture. They represent approximately 10 percent of all intracranial meningiomas, more likely to occur in women in the fifth and sixth decades of life. They often involve the area from the grista galli to the posterior planum sphenoidale, and can be either simetric, bilateral or unilateral based on their midline origin. We report the case of a 45-year-old man who presented with an episode of loss of consciousness, progressive mental disturbances, impairment of visual acuity, anosmia and headache. Gadolinium-enhanced T1-weighted MR images showed a well-defined, hyperintense mass, located in the anterior cranial fossa, measuring 45/50/61 mm, with homogenous enhancement and a broad dural attachment to the cribriform plate, from crista galli to the planum sphenoidale. Preoperative Angiography revealed tumor vascularization from anterior and posterior ethmoidal arteries, branches of ophthalmic artery and branches of external carotid artery. The olfactory groove meningioma was successfully resected using a bifrontal approach with frontal sinuses opened in order to avoid brain retraction. Cranialization with pericranium of frontal sinuses was performed at the end of surgical procedure. Improvement of visual acuity was noted, mental disturbances and seizures remitted, but cerebrospinal leakage occurred, resolved via recranialization of frontal sinuses and lumbar punctions. The last postoperative computer-tomography investigation showed total surgical removal with no recurrence or residual tumor. Total tumor removal must be performed with coagulation of its arachnoid attachments and resection of hyperostotic bone in order to avoid recurrence, but with least brain retraction.

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Porter, M. J., H. S. Cheung, R. Ambrose, S. F. Leung, and C. A. van Hasselt. "Abnormalities of the paranasal sinuses in patients with nasopharyngeal carcinoma: a computed tomographic study." Journal of Laryngology & Otology 110, no. 1 (1996): 23–26. http://dx.doi.org/10.1017/s0022215100132645.

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AbstractA retrospective study of computed tomography scans of the paranasal sinuses of 131 control subjects in Hong Kong revealed minor mucosal abnormalities in more than half of the ethmoid sinuses. Major abnormalities were present in seven per cent of maxillary, five per cent of anterior ethmoid and four per cent of posterior ethmoid sinus. In 85 patients with nasopharyngeal carcinoma the prevalence of minor mucosal abnormalities in the sinuses was similar to that of the control group but major mucosal abnormalities were significantly more common in the anterior and posterior ethmoids at 15 per cent and 21 per cent of the respective sinuses (p<0.001).

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Netto, Dante Simionato, Sergio Ricardo Rios Nascimento, and Cristiane Regina Ruiz. "Metric analysis of basal sphenoid angle in adult human skulls." Einstein (São Paulo) 12, no. 3 (2014): 314–17. http://dx.doi.org/10.1590/s1679-45082014ao2933.

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Objective To analyze the variations in the angle basal sphenoid skulls of adult humans and their relationship to sex, age, ethnicity and cranial index. Methods The angles were measured in 160 skulls belonging to the Museum of the Universidade Federal de São Paulo Department of Morphology. We use two flexible rules and a goniometer, having as reference points for the first rule the posterior end of the ethmoidal crest and dorsum of the sella turcica, and for the second rule the anterior margin of the foramen magnum and clivus, measuring the angle at the intersection of two. Results The average angle was 115.41°, with no statistical correlation between the value of the angle and sex or age. A statistical correlation was noted between the value of the angle and ethnicity, and between the angle and the horizontal cranial index. Conclusions The distribution of the angle basal sphenoid was the same in sex, and there was correlation between the angle and ethnicity, being the proportion of non-white individuals with an angle >125° significantly higher than that of whites with an angle >125°. There was correlation between the angle and the cranial index, because skulls with higher cranial index tend to have higher basiesfenoidal angle too.

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Djambazov, Karen B., Borislav D. Kitov, Christo B. Zhelyazkov, Atanas N. Davarski, and Alexandrina R. Topalova. "Mucocele of the Sphenoid Sinus." Folia Medica 59, no. 4 (2017): 481–85. http://dx.doi.org/10.1515/folmed-2017-0049.

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AbstractMucocele of the paranasal sinuses is a rare disease with slow evolution. It is a benign, encapsulated and destructive formation filled with mucous fluid and tapistrated with respiratory epithelium. Of all the paranasal sinuses, the sphenoid sinus is affected in only 1-7% of the cases. We present two cases of mucocele of the sphenoid sinus involving the posterior ethmoidal cells. We consider here their clinical presentation, use of neuroimaging in the diagnosis, surgical care and postoperative results. Both patients presented with a history of persistent headache and in addition, one of them had a paresis of the right oculomotor and abducens nerves. A transnasal endoscopic sphenoidectomy was performed in both patients, in one - with an evacuation of the mucocele and marsupialization, and in the other - with a balloon dilatation of the natural foramen of the sinus. Postoperatively, a complete reversal of the symptoms was observed in both patients. Mucocele of the paranasal sinuses should be considered as a diagnosis in cases of persistent headache with a primarily retrobulbar location and eye symptoms. Computed tomography and magnetic resonance imaging can be used to successfully diagnose the disease. The transnasal endoscopic sphenoidectomy is the therapeutic method of choice which allows evacuation of the mucocele, while the marsupialization allows good drainage and prevents recurrence.

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Bolzoni Villaret, Andrea, Paolo Battaglia, Manfred Tschabitscher, et al. "A 3-Dimensional Transnasal Endoscopic Journey Through the Paranasal Sinuses and Adjacent Skull Base: A Practical and Surgery-Oriented Perspective." Operative Neurosurgery 10, no. 1 (2013): 116–20. http://dx.doi.org/10.1227/neu.0000000000000172.

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Abstract An endoscopic approach through the transnasal corridor is currently the treatment of choice in the management of benign sinonasal tumors, cerebrospinal fluid leaks, and pituitary lesions. Moreover, this approach can be considered a valid option in the management of selected sinonasal malignancies extending to the skull base, midline meningiomas, parasellar lesions such as craniopharyngioma and Rathke cleft cyst, and clival lesions such as chordoma and ecchordosis. Over the past decade, strict cooperation between otorhinolaryngologists and neurosurgeons and acquired surgical skills, together with high-definition cameras, dedicated instrumentation, and navigation systems, have made it possible to broaden the indications of endoscopic surgery. Despite these improvements, depth perception, as provided by the use of a microscope, was still lacking with this technology. The aim of the present project is to reveal new perspectives in the endoscopic perception of the sinonasal complex and skull base thanks to 3-dimensional endoscopes, which are well suited to access and explore the endonasal corridor. In the anatomic dissection herein, this innovative device came across with sophisticated and long-established fresh cadaver preparation provided by one of the most prestigious universities of Europe. The final product is a 3-dimensional journey starting from the nasal cavity, reaching the anterior, middle, and posterior cranial fossae, passing through the ethmoidal complex, paranasal sinuses, and skull base. Anatomic landmarks, critical areas, and tips and tricks to safely dissect delicate anatomic structures are addressed through audio comments, figures, and their captions.

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Sack, Jayson, Puya Alikhani, Siviero Agazzi, and Harry van Loveren. "Endoscopic Transnasal Coagulation of Anterior and Posterior Ethmoidal Arteries before Open Resection of Large Anterior Skull Base Meningiomas: A Novel Combined Approach and Review of Two Illustrative Cases." Journal of Neurological Surgery Part B: Skull Base 78, S 01 (2017): S1—S156. http://dx.doi.org/10.1055/s-0037-1600819.

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Nanda, Manpreet Singh, Shenny Bhatia, and Vipan Gupta. "Epidemiology of nasal polyps in hilly areas and its risk factors." International Journal of Otorhinolaryngology and Head and Neck Surgery 3, no. 1 (2016): 77. http://dx.doi.org/10.18203/issn.2454-5929.ijohns20164788.

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Background: Nasal polyps are common nasal disorders with unknown etiology and high recurrence and high prevalence of 1-4% which affect the quality of patient life. The aim of the study was to find out the prevalence of nasal polyps in our hilly region and find out its etiological or risk factors for better prevention and cure of the disease.Methods: 60 patients with nasal polyps were included in this study and were assessed for age and sex distribution, types of polyps, main clinical symptoms and their duration, their major etiological or risk factors through detailed history taking, physical and nasal examination, anterior and posterior rhinoscopy, diagnostic nasal endoscopy and computerized tomography scan. Results: Nasal polyps are more common in males and in middle age group. Most of the common types are bilateral and ethmoidal polyps. Most of the patients were symptomatic with nasal obstruction and nasal discharge as main symptoms. There was strong correlation between nasal polyps and recurrent nasal infection, allergy and asthma. In this region we found familial inheritance of this disease and high rate of polyp recurrence after medical or surgical therapy.Conclusions: Nasal polyps are common in hilly region with high rate of recurrence with nasal infection, allergy and asthma being the important etiological factors.

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Journal articles on the topic 'Posterior ethmoidal'

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