Supreme Nasal Turbinate as an Additional Surgical Landmark in Endoscopic Sinus and Skull Base Surgeries

Siti Nazira Abdullah,Baharudin Abdullah

doi:10.7759/cureus.8132

Abstract

During endoscopic sinus and skull base surgeries, surgical landmarks are routinely used to guide surgeons navigating in the narrow corridor of the sinonasal region. Risk of complications is higher in difficult cases when there is excessive bleeding or alteration of the normal anatomical landmarks by tumour. An additional landmark is advantageous to prevent complications and serves as a guide. We present a case of supreme turbinate found incidentally during an endoscopic transsphenoidal surgery. Not much is known about the role of supreme turbinate. When it is present, the sphenoid ostium is located medial to its posteroinferior attachment, and behind its vertical part. Hence, the identification of this structure serves as an additional landmark besides superior turbinate during surgery.

Highlights

In endoscopic sinus and skull base surgeries (ESSBS), anatomical landmarks are useful to ensure proper identification of sinonasal structures, allow precise dissection and avoid complications
In an inflammatory polyposis or sinonasal tumour, when there are excessive bleeding and distortion of the normal anatomy, an additional landmark is a good safeguard for safer surgery
Supreme turbinate (SupT) may serve as an additional landmark besides the superior turbinate (ST) in ESSBS, especially when the ST is destroyed by disease or when it has to be removed due to tumour involvement

Summary

Introduction

In endoscopic sinus and skull base surgeries (ESSBS), anatomical landmarks are useful to ensure proper identification of sinonasal structures, allow precise dissection and avoid complications. Supreme turbinate (SupT) may serve as an additional landmark besides the ST in ESSBS, especially when the ST is destroyed by disease or when it has to be removed due to tumour involvement. In this case presentation, we present our experience in utilizing the SupT as a surgical landmark while performing an endoscopic skull base surgery. The tumour was removed successfully, and no complications were encountered postoperatively

Discussion

Conclusions

Disclosures

Earwaker J