PubMed · 507652
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J Bouche. 1979. [The De Lima operation].. https://pubmed.ncbi.nlm.nih.gov/507652/
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The present study was performed on axial and coronal CT scans of 100 patients, most of whom were affected by nasal polyposis. Five observers had to analyse the radiograms and answer a questionnaire including the following items: presence of a supraorbital recess; identification of anterior and posterior ethmoidal canals; dehiscences in the lamina papyracea; pneumatized middle turbinate; presence of a sphenomaxillary plate; presence of Haller's cells; presence of Onodi's cells; relationships of the optic canal; relationships of the internal carotid artery; relationships of the maxillary nerve; relationships of the vidian nerve; level difference between the ethmoid roof and nasal vault; depth of the sphenoethmoidal recess. The data obtained were compared with those drawn from anatomical studies. The fair agreement between them proves the value of CT as an alternative method for studying paranasal sinuses anatomy.
A case of iatrogenic perforation of the lamina cribrosa, followed by intracranial placement of a nasogastric tube in a preterm neonate is described. By routine ultrasound examination of the brain an echogenic structure was seen, which was radiographically diagnosed as a nasogastric tube. The tube was manually removed under antibiotic prophylaxis. No complications were observed. The false route disappeared and long-term follow-up showed no neurological side effects.
The medial canthal tendon and the fragment of bone on which it inserts ("central" fragment) are the critical factors in the diagnosis and treatment of nasoethmoid orbital fractures. The status of the tendon, the tendon-bearing bone segment, and the fracture pattern define a clinically useful classification system. Three patterns of fracture are appreciated: type I--single-segment central fragment; type II--comminuted central fragment with fractures remaining external to the medial canthal tendon insertion; and type III--comminuted central fragment with fractures extending into bone bearing the canthal insertion. Injuries are further classified as unilateral and bilateral and by their extension into other anatomic areas. The fracture pattern determines exposure and fixation. Inferior approaches alone are advised for unilateral single-segment injuries that are nondisplaced superiorly. Superior and inferior approaches are required for displaced unilateral single-segment injuries, for bilateral single-segment injuries, and for all comminuted fractures. Complete interfragment wiring of all segments is stabilized by junctional rigid fixation. All comminuted fractures require transnasal wiring of the bones of the medial orbital rim (medial canthal tendon-bearing or "central" bone fragment). If the fracture does not extend through the canthal insertion, the canthus should not be detached to accomplish the reduction.