Ethmoid Area Research Articles

OSteosarcoma of Ethmoid Sinus-A Rare Entity.

Osteogenic sarcoma of the Craniofacial region are uncommon.They have been mainly reported in the mandible and the maxilla, Primary osteosarcoma arising from ethmoid sinus is an extremely rare condition. We report a case of 34 year old male, presented with gradually increasing swelling over the right medial canthus with history of double vision for one year. Clinically we thought it was a mucous retention cyst in the ethmoid area. After doing Contrast enhanced CT, we proceeded with transnasal endoscopic removal of the cyst. Histopathological examination of the specimen surprisingly turned out to be a low grade Osteogenic sarcoma. Patient was treated with adjuvant chemotherapy.

Assessment of crista galli morphology and morphometry in individuals with cleft lip and palate: A three‐dimensional analysis

AbstractObjectiveThe crista galli (CG), located in the anterior cranial fossa and associated with the cranial structures here, is a bony prominence on the ethmoid bone. In this study, we aimed to examine the anatomical variations and pneumatization status of the CG in individuals with cleft lip and palate (CLP) and to compare them with those of individuals without CLP.Material and methodsData from 16‐ to 25‐year‐old individuals with non‐syndromic cleft lip and palate and control individuals without any syndrome or disease who underwent cone beam computed tomography were used. Measurement of the CG height (superoinferior, on the coronal section), width (laterolateral, on the axial section), and length (anteroposterior, on the axial section) dimensions. In addition, a categorical evaluation of CG morphology, CG pneumatization, olfactory fossa depth, and position of the CG in the ethmoid area (Keros classification) was performed.ResultsAlthough the superoinferior diameter and laterolateral diameter values of the CG did not differ between the groups, the anteroposterior diameter values were found to be significantly (p = 0.047) lower in individuals with CLP (11.95 ± 2.57 mm) compared with control (13.23 ± 2.05 mm). There was no difference in the morphology or pneumatization status of the CG between the groups.ConclusionExcept for the anteroposterior length, there was no difference in CG morphometric measurements between individuals with CLP and control. The anteroposterior length was shorter in individuals with CLP.

Primary mucosal malignant melanoma of the nasal cavity

<p>Primary mucosal melanoma of the nasal cavity and paranasal sinuses is a very aggressive and rare disease with only about 0.5 % of malignant melanoma arising from the nasal cavity. There are only few reports from India. We report a rare case of sino-nasal mucosal malignant melanoma in a 58 years old female who presented with blackish coloured sino-nasal mass involving right nasal cavity, spontaneous and recurrent epistaxis and obliteration of the right naso-labial fold with occasional pain in the past 10 months. Contrast enhanced computed tomography scan showed a heterogenous mass involving right nasal cavity, right maxillary antrum and right ethmoidal area. A positron emission tomography computed tomography was also done which showed increased uptake in the region mentioned above. Initial biopsy, the mass was diagnosed as malignant melanoma. Total maxillectomy was performed with plan of post-operative radiotherapy.</p>

An Infrasellar Craniopharyngioma Involving the Sphenoid Sinus and Clivus

An Infrasellar Craniopharyngioma Involving the Sphenoid Sinus and Clivus

Polyostotic Fibrous Dysplasia Related to Mccune Albright Syndrome: Case Report

McCune Albright syndrome is a rare disorder characterized by polyostotic fibrous dysplasia, café-au-lait spots, and some endocrinopathies. Girl, 10, was brought to the oral medicine clinic for evaluation of jaw deformity. Facial asymmetry was observed on the lower left side of the face. Intraoral examination revealed a tumor on the lower alveolar ridge that had a smooth surface, was of normal mucosal color, and was firm and asymptomatic. The diagnostic images showed a “ground glass” expansive lesion located on the jaw, maxillary sinus, zygomatic bone, ethmoid area, and skull base associated with precocious puberty, which was suggestive of McCune Albright syndrome. The patient was referred to the National Institute of Traumatology and Orthopedics to perform jaw osteoplasty and for follow-up. This case reports a rare syndrome in a female child as classified in the literature.

The expression of caspase-3, caspase-7, caspase-9 and cytokeratin AE1/AE3 in goats with enzootic nasal adenocarcinoma: an immunohistochemical study

The aim of this study was to examine the expression of caspase-3, caspase-7, caspase-9 and cytokeratin AE-1/AE-3 using the avidin-biotin complex (ABC) immunoperoxidase technique in 20 goats with enzootic nasal adenocarcinoma (ENA). Clinically, dyspnoea and nasal discharge were observed in all cases. Macroscopically, polypoid and sessile masses were seen in the ethmoidal area. At the histopathological examination, tubular, papillary and mixed patterns of ENA were diagnosed. Immunohistochemically, strong positive reactions were generally seen for caspase-3, while strong to moderate and slight reactions were observed for caspase-7 and caspase-9 in the cytoplasm of the tumour cells. Positive reactions for cytokeratin AE-1/AE-3 were only seen in epithelial cells. In addition, the causative agent of ENA, retrovirus, was detected immunohistochemically in tumour cells.  

On the olfactory apparatus in the Miocene odontocete Squalodon sp. (Squalodontidae)

Most extant odontocetes appear to be anosmatic. However, some Miocene odontocetes, including a broken skull attributed to Squalodon sp. (Calvert Formation, Calvert Cliffs, Maryland, USA) preserve the osteological components associated with a well-developed sense of smell: dorsal nasal meatuses, ethmoturbinates within olfactory recesses, a perforate cribriform plate, and an olfactory bulb chamber. In Squalodon sp., the area within the olfactory recesses (i.e., covered in life by olfactory sensory epithelia) is 5367mm2 and the area occupied by the olfactory bulbs (i.e., the ethmoid area) is 769.8mm2. In most mammals, the area of the olfactory epithelium is typically circa 16 times larger than the ethmoid area. The area covered by olfactory epithelium in CMM-V-2287 is only about seven times larger than its ethmoid area, less than half the area in typical mammals. During the Miocene, most odontocetes variously lost the osteological proxies indicative of osmatic ability. Perhaps biosonar surpassed the efficiency of olfactory cues during predation and social/parental/sexual interactions rendering the latter redundant/obsolete in odontocete analysis of, and interactions with and within their aquatic environments.

Riechvermögen nach Medialisierung der mittleren Nasenmuschel bei der endonasalen Siebbeinoperation

Endoscopic sinus surgery usually requires a move of the middle nasal turbinate into the midline to achieve a better sight into the ethmoidal sinuses. In this procedure damages of the turbinate are possible, which later can lead to a scarred fixation of the turbinate. Fixing of the turbinate to the septum can avoid this effect, but could reduce smell ability by blocking of the upper nasal duct. In a prospective study with 83 patients with chronic sinusitis (55% CRS with polyps, 45% CRS without polyps) at the end of the operation the middle nasal turbinates were fixed at the nasal septum with a 4 × 0 stitch. Before the operation and 6 weeks, 3 and 5 months after operation the smell was tested using the "sniffin'sticks" threshold test. After operation the ethmoidal area remained open without developing of relevant synechiae or scars. The smell ability decreased after surgery due to the obstruction of the upper nasal duct, but improved again later. After 5 months the average threshold of smell was better than before operation. Testing of the threshold values with the t-test showed a significant difference (p<0.001) between the pre- and postoperative status. The method of medialization and temporary septal fixation of the middle nasal turbinate allows a sufficient ventilation and drainage of the paranasal sinuses after sinus surgery. Due to only temporary fixation of the turbinate at the septum, a permanent obstruction of the upper nasal duct and the olfactory area is prevented. Thus the threshold of smell is not reduced.

The nasal and paranasal architecture of the Middle Miocene ape Pierolapithecus catalaunicus (primates: Hominidae): Phylogenetic implications

The internal (nasal and paranasal) cranial anatomy of the Middle Miocene (11.9 Ma [millions of years ago]) great ape Pierolapithecus catalaunicus (Hominidae: Dryopithecini) is described on the basis of computed-tomography scans of the holotype specimen (IPS21350), with particular emphasis on its phylogenetic implications. Pierolapithecus displays the following characters: an anteriorly-restricted maxillary sinus that posteriorly spreads towards the ethmoidal area (thus resembling the pongine condition), although being situated well above the molar roots (as in kenyapithecins, other dryopithecins and pongines); lack of frontal sinus (a synapomorphy of derived pongines, independently acquired by both cercopithecoids and hylobatids); posteriorly-situated turbinals (as in Pongo); anteriorly-projecting nasolacrimal canal (as in Pongo); and probably stepped nasal floor with non-overlapping premaxillary–maxillary contact (as in dryopithecines and stem hominoids, although it cannot be conclusively shown due to bone damage). Overall, Pierolapithecus displays a mosaic of primitive hominid and derived pongine features that are inconsistent with this taxon being a hominine (as previously suggested). Two alternative phylogenetic interpretations are possible: Pierolapithecus may be a stem member of the Hominidae as previously suggested in its original description, or alternatively this taxon may be a stem member of the Ponginae s.l. (with the European dryopithecines being the sister taxon to the Asian pongines).

Foreign Body in Paranasal Sinus: A Unique Accident and a Miraculous Escape for the Patient

An 18month old male child presented with the complaint of foreign body-one and half inch broken piece of quilt sewing needle fully impacted between nasal bridge and medial angle of left eye. The needle was safely removed endonasaly using 4mm 0° Karl stroz telescope avoiding external scar from anterior ethmoid area under general anaesthesia. Minimal exploration of lateral wall of nose, keeping anterior 1/3 of middle turbinate as the landmark, helped in safe removal of foreign body, as no CT scan was there and since the patient was poor. This is rare and unusual location of foreign body removed safely without any complications.

Don't sue the surgeon: remineralisation of the skull base or a defect that never existed?

Intracranial complications are recognised as rare, but serious, sequelae of endoscopic sinus surgery. A 56-year-old woman was referred after developing meningitis following elective functional endoscopic sinus surgery. Computed tomography demonstrated a significant defect of the skull base in the right posterior ethmoid, clearly visible on both coronal and sagittal sections. Operative exploration demonstrated the skull base to be intact in the posterior ethmoid area identified on the scan, and the overlying mucosa appeared undisturbed. Scans were reviewed in the light of operative findings; coronal and sagittal images were found to be reconstructions. Directly acquired coronal computed tomography, undertaken three weeks after surgery, demonstrated a complete bony plate in the right posterior ethmoid at the site previously identified as dehiscent. We speculate that the posterior ethmoid defect was actually an artefact of reconstruction. We cannot exclude the alternative possibility of remineralisation, but given the time frame this seems unlikely. This case highlights the need for caution when interpreting reconstructed images of the thin bony plates of the skull base and lamina papyracea, as regards both clinical significance and medicolegal reporting. While virtual defects have been reported in the superior semicircular canals as a result of reconstructed images, we believe this to be the first reported case demonstrating a similar problem in the anterior skull base.

Descriptive Study of Enzootic Nasal Adenocarcinoma in Goats in Southwestern China

This is the first report on enzootic nasal adenocarcinoma (ENA) in goats (Nanjiang Yellow goats and Jianyang Big-ear Black goats) in southwestern China. The clinical, histological and ultrastructural features of ENA in goats were described. From July 2007 to May 2009, 21 cases of ENA in goats, from 6 months to 8 years old, were diagnosed solely in one big herd. Clinically, the affected goats showed nasal discharge, facial swelling, sneezing, stertorous breathing and weight loss. Tumours that originated from the ethmoid area of the nasal cavity were unilateral (18/21) or bilateral (3/21). All tumours were classified as low grade adenocarcinomas by histopathological examination and were displayed a combination of tubular and papillary growth. No metastases were detected in regional lymph nodes, brain or other organs. Ultrastructurally, virus-like particles with an average diameter between 80 and 110 nm were observed in 5/7 examined tumours.

Enzootic Nasal Adenocarcinoma of Sheep in Slovenia

SUMMARY Clinicopathological and electron microscopical findings of eight cases of enzootic nasal adenocarcinoma of sheep, diagnosed solely in one big flock in Slovenia between years 2001 and 2003 are described. All affected sheep were female, their mean age was 4.5 +/- 1.5 years and they either belonged to the Istrian pramenka breed (five sheep) or were crossbreeds (three sheep). Tumours that arose from the ethmoid area of the nasal cavity were unilateral in six cases (75%) and bilateral in two cases (25%). All tumours were classified as adenocarcinomas by histopathological examination and they displayed either a combination of tubular and papillary growth or less often solely tubular proliferation. No metastases were detected in regional lymph nodes, brain or other organs. Electron microscopical studies performed on the reprocessed paraffin-embedded tissues revealed the presence of the virus-like particles with an average diameter between 70 and 90 nm.

し骨眼か板（紙様板）のし骨洞内突出例の検討

The frequency, location and gender difference of the medial protrusion of the lamina papyracea toward the ethmoid sinus were evaluated in 522 patients who underwent CT of the paranasal sinus region at our institution between January 1999 and January 2002. The area of interest was the nose and paranasal sinuses in 295 patients, auditory organ in 190 patients and maxillofacial area in 37 patients. The lamina papyracea was clearly identified in all the patients. Patients with a past history of paranasal sinus surgery and those with injuries in the lamina papyracea were excluded from the study. The patients consisted of 283 males and 239 females aged between 6 and 94 years. Twenty-nine patients were younger than 20 years old. Axial slices were taken in most cases. Medial protrusion was judged to be positive in cases where the lamina papyracea evidently deviated toward the ethmoid sinus on CT and the CT value of the protruded area was identical to that of the orbital fat.Medial protrusion of the lamina papyracea was positive in 4 males and 2 females with a frequency of 1.15%. All the 6 patients were older than 20 years old. The protrusion was located in the anterior ethmoid in 2 patients, middle ethmoid in 3 patients and entire ethmoid area in 1 patient whose ethmoid sinuses were poorly developed. The protrusion was also located on the right side in 4 patients and on the left side in 2. Bilateral protrusion was not observed.It has been reported that the frequency of medial protrusion of the lamina papyracea is about 1%. CT is an essential examination before surgery of the nose and paranasal sinuses. It is important to preoperatively evaluate the anatomical relation of critical structures including the lamina papyracea.

Surgical causes of failure in endoscopic sinus surgery.

Evaluate causes of surgical failure at time of revision endoscopic sinus surgery. Prospective review of 682 cases that had endoscopic sinus surgery performed between 1991 and 1995. In all cases, variables of age, sex, asthma, allergy, computed tomography stage, associated procedures, complications, and operative findings were collected. Those cases that had a failure after a previous endoscopic sinus procedure and not an intranasal procedure or an external procedure were evaluated. Fifty-two patients (7.6%) were identified. The age range was 24 to 70 years. The most common cause of failure was residual air cells and adhesions in the ethmoid area (30.7%), followed by maxillary sinus ostium stenosis in 27%, frontal sinus ostium stenosis in 25%, and a separate maxillary sinus ostium stenosis in 15% of the cases. Review of surgical causes of failure in endoscopic sinus surgery patients revealed that residual air cells and stenotic maxillary or frontal sinus ostium were the most common causes of failures.

The macroscopic vascular anatomy of the equine ethmoidal area.

The vascular anatomy of the ethmoidal area in six normal horses and two normal ponies was studied using vascular-corrosion casts. The major arterial supply to the ethmoidal area stems from an intracranial source. The internal and external ethmoidal arteries anastomose on the rostral intracranial surface of the cribriform plate to form the arterial ethmoidal rete which arborizes and passes through the perforations of the cribriform plate to supply the ethmoid labyrinth. A minor arterial supply to the ventral portion of the ethmoid labyrinth stems from a small caudal nasal branch of the sphenopalatine artery. Multiple parallel venules drain the ethmoid labyrinth rostrally to its apex then join the venous drainage from the surrounding sinuses.

만성 부비동염 환자에서 임상증상 및 전산화단층촬영 소견에 의한 부비동 내시경수술의 술후 결과분석

Endoscopic sinus surgery is based on principle that the mucosal abnormalities can be reversed into normal mucosa by relieving the obstruction of the anterior ethmoidal area. This study is aimed to evaluate postoperative mucosal changes and symptomatic improvement in the patients who have underwent endoscopic sinus surgery from September 1991 through August 1992. The total number of patients were 76, who were divided into 2, 4, and 6 months postoperative groups. The thickness of maxillary sinus mucosa measured at three different sites on follow-up ostiomeatal unit(OMU) computed tomogram was compared with that on preoperative OMU CT. Changes of preoperative symptoms such as nasal discharge, nasal obstruction, facial pain, headache, anosmia and epiphora were analysed. It is suggested that removal of obstructive lesion in the ostiomeatal area might be beneficial in symptomatic improvement, however, healing of the maxillary sinus mucosa might take longer than 6 months after operation.

Microsurgery in nasal polyposis transnasal ethmoidectomy.

Transnasal ethmoidectomy is a current treatment in selected cases of nasal polyposis, and with its complicated anatomy offers a proper opportunity for microsurgery. Ten years' experience of microsurgical ethmoidectomy in 155 patients with nasal polyposis is reported. The surgical anatomy of the ethmoid sinus is reviewed with attention to the requirements of the microsurgical approach, and the operative procedure is described. The microsurgical approach is discussed both as a part of the treatment of nasal polyposis and as a new development in rhinologic surgery. Advantages of the technique are the objective safety against risks of the ethmoid area and enhanced sense of security for the surgeon.

The role of ethmoid and middle turbinate surgery in patients with chronic headache

Otolaryngologists and Rhinologists are frequently consulted by patients with headaches. A careful history and thorough examination of the nose and adjacent areas can determine if the cause of headache is secondary to the pathology in the middle turbinate and ethmoid area. In these selected cases ethmoidectomy and middle turbinate surgery have given some excellent results. No serious after-effects of middle turbinate resection were seen. A study of fifty-five (55) patients over a three (3) year period is presented and results discussed.

Transcranial--facial approach for tumours of superior paranasal sinuses and orbit.

A monobloc resection of the fronto-ethmoid sphenoid area may be performed through a combined cranial and facial approach. Osmotic cerebral dehydration increases the exposure of the anterior cranial fossa. The results of treatment in 26 patients (24 with malignant disease of the ethmoid area who had disease recurrence after previous radiotherapy with or without surgery) and the complications encountered are described. The clinical details of 9 of these patients have been included in an earlier report (Clifford 1977).