Optic Neuritis following Endoscopic Sinus Surgery

1993 ◽  
Vol 7 (6) ◽  
pp. 247-256
Author(s):  
Perry J. Johnson ◽  
James V. Huerter ◽  
John D. Peters ◽  
Richard H. Legge
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Case Report ◽  
Optic Neuritis ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
High Dose ◽  
Inflammatory Condition ◽  
Rule Out

A case report of optic neuritis, a previously unreported complication following endoscopic sinus surgery, is presented with a review of the diagnosis, postulated pathophysiology, and treatment. Optic neuritis is an inflammatory condition involving the optic nerve and should be considered in the differential diagnosis inpatients who present with ocular complaints following endoscopic sinus surgery. Aggressive evaluation including computed tomography of the orbit and paranasal sinuses to rule out retroorbital hematoma, abscess or bony dehiscence, as well as ophthalmology consultation is essential. Prompt recognition of optic neuritis and institution of high dose corticosteroids and antibiotics may prevent visual loss.

scholarly journals A 16-Year Study on Incidence and Progression of Diseased Sphenoethmoidal (Onodi) Cell

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ethan I. Huang ◽  
Chia-Ling Kuo ◽  
Li-Wen Lee
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Optic Nerve ◽  
Endoscopic Sinus Surgery ◽  
Visual Loss ◽  
Sinus Surgery ◽  
Acute Visual Loss ◽  
Computed Tomography Images ◽  
Onodi Cell

Traumatic operative injury of the optic nerve in an endoscopic sinus surgery may cause immediate or delayed blindness. It should be cautioned when operating in a sphenoethmoidal cell, or known as Onodi cell, with contact or bulge of the optic canal. It remains unclear how frequent progression to visual loss occurs and how long it progresses to visual loss because of a diseased sphenoethmoidal cell. Research to discuss these questions is expected to help decision making to treat diseased sphenoethmoidal cells. From July 2001 to June 2017, 216 patients received conservative endoscopic sinus surgery without opening a diseased sphenoethmoidal cell. We used their computed tomography images of paranasal sinuses to identify diseased sphenoethmoidal cells that could be associated with progression to visual loss. Among the 216 patients, 52.3% had at least one sphenoethmoidal cell, and 14.8% developed at least one diseased sphenoethmoidal cell. One patient developed acute visual loss 4412 days after the first computed tomography. Our results show that over half of the patients have a sphenoethmoidal cell but suggest a rare incidence of a diseased sphenoethmoidal cell progressing to visual loss during the follow-up period.

A Case of Relapsing Visual Loss

2018 ◽  
pp. 149-152
Author(s):  
Aaron E. Miller ◽  
Tracy M. DeAngelis ◽  
Michelle Fabian ◽  
Ilana Katz Sand
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Visual Loss ◽  
Diagnostic Testing ◽  
High Dose ◽  
Inflammatory Condition ◽  
Steroid Dependence ◽  
Eye Pain ◽  
Clinical Stability

Chronic relapsing optic neuritis (CRION) is a rare inflammatory condition that is characterized by repeated episodes of optic neuritis. Diagnostic testing for all other causes of optic neuropathy is negative in CRION, and the diagnosis is made on clinical grounds. At some point in the condition, both optic nerves are commonly affected. Eye pain often precedes the visual symptoms. Visual loss can be more severe than in optic neuritis from multiple sclerosis. Steroid dependence is usual, with a rebound in symptoms upon steroid discontinuation. Treatment involves high-dose steroids followed by a long taper. Most patients require long-term immunosuppression to maintain clinical stability.

Frontal mucocele caused by an ectopic maxillary tooth

2007 ◽  
Vol 122 (12) ◽  
pp. 1384-1385 ◽  
Author(s):  
M A Buchanan ◽  
S E Prince ◽  
P R Prinsley
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Endoscopic Sinus Surgery ◽  
Conventional Treatment ◽  
Maxillary Sinusitis ◽  
Signs And Symptoms ◽  
Sinus Surgery ◽  
Documented Case ◽  
Maxillary Tooth ◽  
Ectopic Tooth

AbstractObjective:To present a previously unreported cause of frontal mucocele.Case report:A patient presented with a frontal mucocele and maxillary sinusitis. Computed tomography revealed an ectopic maxillary tooth as the cause of her signs and symptoms. Removal of the tooth by a Caldwell–Luc procedure facilitated resolution of the mucocele. Conventional treatment of mucoceles by endoscopic sinus surgery, and other rhinological sequelae of ectopic teeth, are considered.Conclusion:This is the first documented case of an ectopic tooth causing a frontal mucocele, and demonstrates how effectively the patient's symptoms resolved on removal of the tooth.

Removal of frontal sinus keratoma solely via endoscopic sinus surgery

2010 ◽  
Vol 124 (10) ◽  
pp. 1116-1119
Author(s):  
J-C Lai ◽  
C-K Liu ◽  
M-L Chen ◽  
M-K Chen
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Magnetic Resonance ◽  
Endoscopic Sinus Surgery ◽  
Frontal Sinus ◽  
English Language ◽  
Current Knowledge ◽  
Magnetic Resonance Images ◽  
Sinus Surgery ◽  
Postnasal Drip

AbstractObjectives:To present a patient with a frontal sinus keratoma removed solely via endoscopic sinus surgery, including presentation of characteristic computed tomography and magnetic resonance images; to discuss the differential diagnosis of this condition; and to report the current knowledge on and treatment of frontal sinus keratoma.Case report:A 53-year-old man presented to our department with a 10-month history of rhinorrhoea and postnasal drip. After computed tomography and magnetic resonance imaging studies, the patient underwent surgery utilising a modified Lothrop procedure. An extensive soft tissue lesion was removed from the frontal sinus. Histological examination revealed a lamellated cluster of keratinous material. The pathological diagnosis was keratoma of the frontal sinus. There was no recurrence of keratoma over a two-year follow-up period.Conclusions:Following review of the English language literature, we believe this case report to represent the first successful application of a modified endoscopic Lothrop procedure for resection of an extensive frontal sinus keratoma. Thus, the applications of endoscopic sinus surgery may be expanded to include frontal sinus keratoma removal.

scholarly journals Ethmoid Pneumocele Presenting with Exophthalmos 15 Years after Endoscopic Sinus Surgery

2015 ◽  
Vol 6 (2) ◽  
pp. ar.2015.6.0123
Author(s):  
Michelle Song ◽  
Sun M. Ahn ◽  
Douglas R. Reh ◽  
Josef Shargorodsky
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Endoscopic Sinus Surgery ◽  
Surgical Decompression ◽  
Operative Approach ◽  
Diagnostic Workup ◽  
Sinus Surgery ◽  
Postoperative Results ◽  
Natural Position ◽  
History Of

Introduction A pneumocele is an abnormal dilation of an air-containing sinus beyond the normal margins of bone, with associated bony thinning. A delayed ethmoid pneumocele after sinus surgery has not previously been reported. Methods A case report of a patient with a delayed ethmoid pneumocele after sinus surgery. The diagnostic workup, operative approach, and postoperative results were evaluated. Results A 57-year-old female with a history of endoscopic sinus surgery 15 years prior presented with right eye proptosis and severe orbital and facial pressure. A maxillofacial computed tomography showed a markedly expanded air-filled right anterior ethmoid space with a dehiscent lamina papyracea, consistent with a pneumocele. Marsupialization of the pneumocele as well as a revision ethmoidectomy were performed, with a visible return of the orbital contents to a more natural position. The patient experienced worsened diplopia immediately postoperatively that resolved within two weeks. Conclusions This case demonstrates that a pneumocele can present even years after endoscopic sinus surgery, and acute but temporary development or worsening of diplopia can result from surgical decompression of the pneumocele as the eye returns to its natural position.

scholarly journals Endoscopic Visualization of the True Maxillary Ostium Following Uncinectomy

2019 ◽  
Vol 99 (6) ◽  
pp. 384-387 ◽  
Author(s):  
Omar H. Ahmed ◽  
Marissa P. Lafer ◽  
Ilana Bandler ◽  
Elcin Zan ◽  
Binhuan Wang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Chronic Rhinosinusitis ◽  
Study Design ◽  
Endoscopic Sinus Surgery ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Academic Hospital ◽  
Preoperative Ct

Objectives: To examine the frequency in which angled endoscopes are necessary to visualize the true maxillary ostium (TMO) following uncinectomy and prior to maxillary antrostomy. Additionally, to identify preoperative computed tomography (CT) measures that predict need for an angled endoscope to visualize the TMO. Study Design: Retrospective study. Setting: Tertiary academic hospital. Patients and Methods: Patients who underwent endoscopic sinus surgery (ESS) between December of 2017 and August of 2018 were retrospectively identified. Cases were reviewed if they were primary ESS cases for chronic rhinosinusitis without polyposis and if they were at least 18 years of age. Results: Sixty-three maxillary antrostomies were reviewed (82.5% were from bilateral cases). Thirty-five cases (55.6%) required an angled endoscope in order to visualize the TMO. Of the preoperative CT measures examined, a smaller sphenoid keel-caudal septum-nasolacrimal duct (SK-CS-NL) angle was significantly associated with need for an angled endoscope intraoperatively to visualize the TMO (17.1° SD ± 3.2 vs 15.0° SD ± 2.9; P = .010). Conclusion: Angled endoscopes are likely required in the majority of maxillary antrostomies to visualize the TMO. This is important to recognize in order to prevent iatrogenic recirculation. The SK-CS-NL angle may help to identify cases preoperatively which require an angled endoscope to identify the TMO during surgery.

scholarly journals Cone beam-computed tomography as an indispensable tool in the management of radiculous premolar: a case report

2016 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Shristhi Sharma ◽  
Ananth Raghav Sharma ◽  
Vivek Kumar Rai ◽  
Ronak Choudhary
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Cone Beam Computed Tomography ◽  
Anatomical Variations ◽  
Endodontic Treatment ◽  
Cone Beam ◽  
Internal Anatomy ◽  
Indispensable Tool ◽  
Rule Out

Background: Internal anatomy of maxillary first premolars is particularly multifaceted on account of the variation in number of roots and canal configuration. Maxillary first premolars with 3 roots are called as small molar or “radiculous” because of their similar anatomy to the maxillary first molars. The most demanding step in endodontic treatment is identification and proper access to pulp canals of certain teeth with atypical canal configurations. Methods of identification of such premolars can be by various aides.Case Presentation: The present case describes the application of Cone Beam-Computed Tomography in the diagnosis of extra root with extra canal in a three rooted maxillary right first premolar.Conclusions: Proper knowledge of the anatomical variations is a must for an endodontist to make a treatment successful. Utilizing the latest technology along with the traditional concepts can surely rule out the inaccuracy in the treatment involved in such cases.

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