PubMed · 2594629
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S Kershaw, C Hood. 1989-03-22. Ethmoidal polypi.. https://pubmed.ncbi.nlm.nih.gov/2594629/
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Many surgical procedures in the field of ENT take place in close proximity to vital structures like the orbit, the skull base, the internal carotid artery etc. In our clinic we have decided to study two different computer-assisted navigation systems to reduce the risk of trauma to these structures during endonasal endoscopic procedures. Such systems should be able to correlate the position of the surgical instrument, ideally in the submillimeter range, to CT- or MR-images. The ARTMA Virtual Patient finds the position of the instrument by permanently measuring magnetic fields. The ISG-system uses a mechanical arm to localize the probe in the patient. Using Computer-Assisted-Surgery (CAS) does not significantly extend the time needed for surgery. We found that it prevents the surgeon from inadvertently injuring structures. Other groups have shown (1) that CAS-systems minimize the risk of complications of surgical procedures in the frontobasis arising from mishaps in the usage of the endoscope or the surgical tool. If properly used, CAS-systems can be a very helpful tool in the hand of an experienced surgeon but will never replace his expertise and knowledge.
A consensus on the preferred modern usage of potentially confusing or ambiguous terms in sinus anatomy and nomenclature is described. These terms are intended to provide clear communication among otorhinolaryngologists and serve as a basis for discussion among anatomists. Terminology is in English and based on Latin nomenclature. An attempt has been made to reconcile or eliminate duplication, redundancy, and overlap in terminology that have arisen over the past century. A key concept is that the ethmoid complex is divided into anterior and posterior sections by the basal lamella of the middle turbinate.
Traditionally, frontal mucoceles were treated with open obliterative procedures such as collapse of the forehead soft tissues into the sinus or the more cosmetically appealing osteoplastic flap technique. When a frontal mucocele expands intracranially, these surgical procedures become difficult and with higher risk of cerebrospinal fluid leak and/or meningitis. In cases of a mucocele that extends both intracranially and anteriorly into the soft tissues, osteoplastic flap procedure may not be possible. We present our experience with telescopic intranasal surgery for the treatment of frontal mucocele with intracranial extension. The technique, which is based on intranasal marsupialization and stenting, was used in four patients with large mucoceles eroding into the cranium and the anterior soft tissues. The results were excellent and the patients are free of disease 1 to 4 1/2 years after surgery.