PubMed Health⌕ Search

Biomedical subjects

D A Kirkpatrick

Publications and source records attributed to D A Kirkpatrick.

4 recordsLinked to original sources
PubMed1993

An anatomic and CT scan study of the lateral wall of the sphenoid sinus as related to the transnasal transethmoid endoscopic approach.

Interest in endoscopic sinus surgery has expanded to include the sphenoid sinus. While the transnasal transethmoid approach is an established route to the sphenoid sinus, instrumentation is brought close to the lateral wall. This study organizes the lateral wall of the sphenoid sinus into three distinct areas. Fifteen fixed cadaver specimens, 15 fresh specimens and 25 axial as well as coronal CT scans are used to examine each area of the lateral wall. The orbital apex, spongy vascular tissue of the cavernous sinus and the internal carotid artery are found in tandem sequence adjacent to the lateral wall of the sphenoid sinus. A highly pneumatized sphenoid sinus may attenuate the bone over the lateral wall placing the optic nerve and carotid artery at greater risk. Anatomic variations, as examined in this study, and limitations imposed by endoscopic vision via the transnasal transethmoid approach dictates a need to understand the anatomy as well as familiarity with endoscopic surgery. Axial CT scans of the sphenoid sinus can image anatomic variations which may compromise safety of the lateral sphenoid sinus wall.

Cadaver↗
PubMed1992

Intranasal Xylocaine: a prognostic aid for pre-operative assessment of facial pain of nasal origin.

Many people with facial pain suggestive of sinus disease are ultimately proved, through extensive investigations, to have intranasal pathology without sinusitis. The middle turbinates in close proximity to other mucosal surfaces have been implicated as a possible cause of the rhinogenic pain. Surgical removal appears to provide relief in appropriately selected patient population. Pre-operative assessment to date has been mostly exclusional. Inference has been made to the efficacy of topical vasoconstrictive and combined vasoconstrictor-anesthetic agents as a diagnostic and prognostic aid for postoperative pain relief. Thirteen patients with middle turbinate hypertrophy, and symptoms suggestive of chronic rhinosinusitis were fully assessed clinically and radiographically. Significant sinus disease was ruled out. They were selected for middle turbinectomy with or without septoplasty. Topical Xylocaine was applied intranasally when patients were symptomatic. Postoperative follow-up suggests that the Xylocaine test may be a good prognostic aid for surgical outcome for craniofacial pain of apparent middle turbinate origin.

Administration, Intranasal↗
PubMed1986

Ligation of the external carotid and anterior ethmoidal arteries for severe or unusual epistaxis resulting from facial fractures.

From July 1980 to December 1983, 16 patients with severe posterior epistaxis were treated by arterial ligation. The procedure was successful in all. Two cases of life-threatening and unusual epistaxis resulting from maxillary fractures are presented in detail. The authors conclude that ligation of the external carotid and anterior ethmoidal arteries is a speedy, safe and highly successful method of dealing with posterior epistaxis.

Adolescent↗