The Morphometric Analysis of the Ethmoid Roof for Endoscopic Sinus Surgery With Multidetector Computed Tomography
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Most potential major complications in endoscopic sinus surgery are related to the ethmoid bone. To prevent complications, it is necessary to define the concept of a "dangerous ethmoid." The coronal multidetector computed tomography (MDCT) scans of a total of 271 patients, including 101 patients under 18 years old and 170 patients over 18 years old, were examined. For each patient, the depth of the olfactory fossa (DOF), the width of the olfactory fossa (WOF), the angle between the lateral lamella and the cribriform plate (LLCPA), the length of the lateral lamella (LLL), the distance between the nasal floor and the ethmoid roof (NFERL), and the width of the olfactory cleft (WOC) were recorded. The Keros and Gera types were determined. NFERL was found to be significantly higher in males across all age groups. WOC was significantly higher in males only under 18 years old. Only LLCPA was found to be significantly higher on the right side in both sexes. It was determined that NFERL increased with age, while WOC increased with age until 18. Keros type III and Gera type C, which are called dangerous types, were detected in 28 and 24 cases in total, respectively. The data obtained from significant anatomical landmarks in pediatric and adult cases provide useful information about the region in preoperative planning. The analysis results of the prevalence of Keros and Gera classifications allow the identification of high-risk anatomical conditions within the ethmoid.Keywords:
Multidetector computed tomography
Endoscopic sinus surgery
Ethmoid sinus
Functional endoscopic sinus surgery' (FESS) is a common otolaryngologic procedure, with over 250,000 operations performed annually. Computerized surgical navigation systems are available to assist the rhinologic surgeon in the complex dissection required for FESS. Our objective was to determine whether this system provided quantifiable benefits in FESS. We retrospectively reviewed 203 patients with chronic sinusitis who underwent endoscopic sinus surgery, and divided them into two groups based on whether or not computerized surgical navigation was used. There was no statistically significant difference between the two groups in terms of surgery duration, extent of surgery, percent of complementary procedures, percent of supplementary procedures, complexity of surgery, and percent revision surgery. Computer-assisted surgery (CAS) was 6.7% more expensive than sinus surgery without computerized surgical navigation (p = 0.01). However, the intangible benefits of CAS may outweigh the added expense. (American
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INTRODUCTION:Middle turbinate is a dynamic structure which is in a crucial position that plays a significant role in pathogenesis of rhinosinusitis and headache.The goal of treating sinus disease with surgery has evolved from removing all diseased sinus mucosa to specific exenteration of the tissue causing obstruction.Once ventilation is restored, it is postulated that the mucosa may regain near normal appearance and function.This study was conducted to evaluate and observe the benefits following partial middle turbinate resection during FESS on various symptoms of rhino sinusitis.METHODOLOGY: This is a random control trial.All the patients with chronic rhino sinusitis, was selected, studied, and subjected for FESS with partial middle turbinate resection for 50 patients and 50 patients subjected for FESS with middle turbinate preservation.All the patients were observed in post operative follow up for five months and the data was subjected for statistical analysis.RESULTS: In our study there was strongly significant p value of 0.000, 0.002, and 0.000 for edema, discharge and synechiae respectively and moderately significant p value of 0.047 for crusts with respect to DNE findings.In the patients with partial middle turbinate resection, the post operative DNE results also show improvement of 80% in edema, 40% in discharge, 40% in scarring, 30% in synechiae and 20% in crusts compared to the patients with preserved middle turbinate.CONCLUSION: Partial Middle turbinectomy appears to be a positive variable and an adjuvant technique in patients with inflammatory disease of paranasal sinus, in terms of the improvement and maintenance of ventilation of osteomeatal complex, especially if anatomical anomalies present.Partial middle turbinectomy is recommended whenever exposure is compromised.
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Mucocele
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Key points Expanded types of functional endoscopic sinus surgery (FESS) significantly improve quality of life and reduce revision surgeries rates, supporting their early application for moderate‐to‐severe cases. Minimal clinically important difference may play as a crucial role in defining surgical treatment response (i.e., responder and super‐responder conditions). Expanded FESS benefits patients with chronic rhinosinusitis with nasal polyps but more data are required to have a clearer understanding of its uses due to varied approaches and reported outcomes in the literature.
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We were pleased to read the informative article by Rene et al .1 The authors refer to “Odoni cells” as, “aerated posterior ethmoid air cells along the optic canal.” Could it be that they meant to refer to the cells as “Onodi cells”? Onodi described a number of variations of posterior ethmoid anatomy.2 Endoscopic sinus surgeons …
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Chronic rhinosinusitis (CRS) and polyposis cavi nasi (PCN) are two frequently occurring, disabling diseases. Many international studies have obtained very good results with the functional endoscopic sinus surgery (FESS) technique in cases of resistance to conservative treatment. This is the first study in Denmark that attempts to compare Danish results with international results.The study included 31 patients operated on in the period 1 January-31 December 2002 in the ENT Department, Aarhus University Hospital. After a retrospective journal study, all patients were followed up on by means of a postoperative cross-sectional examination, with a questionnaire and endoscopic inspection of the nasal cavity.We found significant improvement as regarded sense of smell, degree of nasal obstruction, rhinorrhoea and facial pain. The endoscopic inspections showed a significant reduction in nasal polyps. Eighty-six percent of the patients said they would recommend the same kind of surgery to a similar patient.The study showed good results using functional endoscopic sinus surgery on Danish patients with CRS and PCN. The Danish population of those suffering from CRS and PCN undergoing surgery was not comparable to those in international studies. The study raised questions concerning the lack of national references and database programme.
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In the article titled “Safety and efficacy of pediatric functional endoscopic sinus surgery for the treatment of pediatric chronic rhinosinusitis”, published on pages 616–622, Issue 4, Volume 33 of The Egyptian Journal of Otolaryngology, [1] the name of one of the authors and affiliation is missing. The name of the author is “Asser Abdel Raouf Elsharkawy” and the author’s affiliation is “Department of Otolaryngology, Faculty of Medicine, Mansoura University, Mansoura, Egypt”.
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This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The aim of this review is to assess the effectiveness of functional endoscopic sinus surgery as a treatment for patients with chronic rhinosinusitis.
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This article discusses the importance of anesthesia in endoscopic sinus surgery. Bloodless field is rather vital during endoscopic sinus surgical procedures. Advantages of having a bloodless field during sugery are: reduced incidence of complications, reduced operating time. Major aim of anesthetist in FESS should be to reduce blood pressure to such a level that bleeding is minimized. This article discusses the importance of anesthesia in endoscopic sinus surgery. Major aim of anesthetist in FESS should be to reduce blood pressure to such a level that bleeding is minimized. The other aspect of reducing bleeding during endoscopic sinus surgical procedure is preparation of nasal mucous membrane. Various steps that can be followed to reduce bleeding during endoscopic sinus surgery are: 1. Mucosal preparation 2. Hypotensive anaesthesia 3. Positioning of the patient 4. Good anatomical knowledge 5. Use of proper instruments
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Endoscopic sinus surgery
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