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Ahmadzada S, Seresirikachorn K, Png LH, Campbell RG, Kalish L, Harvey RJ. Prelacrimal-Transmaxillary Approach to Lateral Sphenoid Recess Skull Base Defects. Laryngoscope 2024. [PMID: 39087572 DOI: 10.1002/lary.31653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/11/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024]
Abstract
The lateral recess of a well-pneumatized sphenoid sinus is challenging to access surgically. Traditional methods require the use of multiple angled endoscopes and curved instruments which may limit visualization. We describe a prelacrimal-transpterygoid/maxillary approach which offers direct access to this region with a 0° endoscope. Laryngoscope, 2024.
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Affiliation(s)
- Sejad Ahmadzada
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
| | - Kachorn Seresirikachorn
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Lu Hui Png
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
- Department of Otorhinolaryngology-Head and Neck Surgery, Singapore General Hospital, Singapore, Singapore
| | - Raewyn G Campbell
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Larry Kalish
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
- Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia
- Department of Otolaryngology, Head and Neck Surgery, Concord General Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Richard J Harvey
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, New South Wales, Australia
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
- School of Clinical Medicine, St Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, New South Wales, Australia
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Xu M, Wang J, Chen XD, Xue T, Chen FQ. Comparison of two surgical approaches in the management of cerebrospinal fluid rhinorrhea in the lateral recess of sphenoid sinus: A retrospective study. EAR, NOSE & THROAT JOURNAL 2022:1455613221112760. [PMID: 35796349 DOI: 10.1177/01455613221112760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cerebrospinal fluid (CSF) leakage from the lateral recess of the sphenoid sinus (LRSS) is usually repaired using endoscopic endonasal approaches, which can be challenging. Various surgical techniques have been developed for the disease. OBJECTIVE To report our experience with repairing CSF leak from the LRSS via transethmoid sphenoidotomy approach (TESA) and transprelacrimal recess pterygoid root approach (TPLRA), to assess the efficiency of TPLRA by comparing it with TESA. METHODS This retrospective study included patients with LRSS CSF rhinorrhea who underwent TESA (n = 10) or TPLRA (n = 5) from January 2011 to December 2020. Demographic characteristics and operation-related parameters were recorded. RESULTS The mean operation time was 169.5 and 225.0 mins in the TESA and TPLRA groups, respectively, with a mean blood loss of 65 mL and 68 mL, respectively. Histopathological examinations confirmed encephalocele in 11 (73.33%) and 4 (26.67%) cases with meningocele, respectively. CSF rhinorrhea was successfully repaired in the first attempt in both groups during the mean follow-up time of 54 months. Postoperative permanent numbness of the cheek was observed in two patients in the TESA group. No cases of lacrimal overflow or subjective dry eye were observed. CONCLUSIONS The TPLRA, which could be an alternative procedure to treat CSF rhinorrhea in the LRSS, provides a straight-line trajectory and effective maneuverability. We also found that CSF rhinorrhea in the LRSS was accompanied by encephalocele or meningocele, with encephalocele presenting more commonly.
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Affiliation(s)
- Min Xu
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jian Wang
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiao-Dong Chen
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Tao Xue
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Fu-Quan Chen
- Department of Otolaryngology and Head and Neck Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Emerson SN, Aversa A, Al-Mefty O. Sealing the Box: Microsurgical Repair of Skull Base Encephaloceles: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2022; 22:e159-e160. [DOI: 10.1227/ons.0000000000000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/22/2021] [Indexed: 11/19/2022] Open
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