Presencia de la celdilla supra-órbito-etmoidal: revisión de la literatura a partir de un caso / Presence of supraorbital ethmoid cell: literature review from a case

La celdilla supra-órbito-etmoidal es una variación anatómica que se presenta con diferente frecuencia para las distintas poblaciones. Representa un desafío al realizar cirugía endoscópica funcional del seno frontal debido a que su presencia dificulta el drenaje adecuado del receso del frontal mismo y puede ser confundida con el seno. La celdilla supra-órbito-etmoidal presenta relaciones espaciales constantes con la arteria etmoidal anterior, sirviendo como marcador anatómico confiable para el abordaje quirúrgico. Se destaca la importancia de considerar la presencia de tabiques óseos en el seno frontal en el estudio imagenológico que puedan sugerir la presencia de la celdilla supra-órbito-etmoidal. Se presenta el caso clínico de un paciente que consulta por proptosis del ojo derecho debido a un proceso expansivo por mucocele localizado en dicha variante anatómica.

The supraorbital ethmoid cell its an anatomical variation with different frecuency for diverse populations. It represents a challenge for the endoscopical functional :surgery of the frontal sinus. The supraorbital ethmoid cell presents an estable anatomical relationship with the anterior ethmoidal artery, serving as a dependable anatomical marker for the surgical approach. We stand out the importance to consider the presence of bony septations in the frontal sinus that might suggest the presence of the supraorbital ethmoid cell. We introduce a clinical case from a patient who had an expansive process from a mucocele in the supraorbital ethmoid cell.

Osteoma frontoetmoidal, otras aplicaciones del Draf III, a raíz de un caso clínico / Frontoethmoidal osteoma, other applications of Draf III on the grounds of a clinical case

Presentamos el caso de una mujer de 57 años, que consulta tras notar un aumento de volumen pétreo y de lento crecimiento en el reborde orbitario medial derecho, asociado a obstrucción nasal, anosmia y descarga posterior. La evaluación clínico radiológica evidenció un gran osteoma frontoetmoidal derecho con compromiso orbitario y de la lamela lateral de la lámina cribosa, y además, una rinosinusitis crónica con pólipos. Se realizó una resección endoscópica del tumor por medio de un Draf III y una cirugía endoscópica funcional del resto de las cavidades perinasales para el tratamiento de la rinosinusitis crónica. Describimos el caso y discutimos sus aspectos relevantes.

We report the case of a 57 year-old woman consulting because of a slow growing solid tumor in the right medial orbital rim associated with nasal obstruction, anosmia and posterior nasal drip. Clinical and radiological evaluation evidenced a large right frontoethmoidal osteoma involving the orbit and thelateral lamella of the cribriform plate, and chronic rhinosinusitis with polyps. A Draf III was performed to remove the osteoma and a bilateral functional endoscopic sinus surgery of the remaining sinuses was performed to treat thechronic rhinosinusitis. We described the case and discuss its relevant aspects.

Unilateral ethmoidal polyps

To know the etiology and incidence of unilateral ethmoidal polyps. Descriptive. ENT department Allied Hospital Faisalabad. From Jan 2007 to June 2009. The patients were admitted through ENT out patient department. The data was collected on the basis of history, physical examination, investigations, management and follow up. Out of 200 patients between 05 years to 60 years of age suffering from ethmoidal polyps the incidence of unilateral ethmoidal polyps was 35% and that of bilateral ethmoidal polyps was 65%. The 57% of patients having unilateral ethmoidal polyps were male and 43% female. The highest incidence of unilateral ethmoidal polyps was seen during second decade of life 43%.The incidence of unilateral ethmoidal polyps and bilateral ethmoidal polyps was 1.6 and 03 cases per month respectively. The most common presenting symptom was unilateral nasal obstruction [100%] in cases of unilateral ethmoidal polyps. The most common associated disease in patients with unilateral ethmoidal polyps was deflected nasal septum [71%]. Transantral ethmoidectomy was carried out in majority of patients [43%]. The most common etiology held to be responsible for unilateral ethmoidal polyps was Vasomotor rhinitis [57%]. The unilateral ethmoidal polyps are not uncommon in young adults and the etiological factors are same as that for bilateral ethmoidal polyps

Phaeohyphomycosis.

Phaeohyphomycosis, caused by heterogeneous group of phaeoid fungi causes both subcutaneous and systemic infections. The disease is more of a histopathological than a clinical entity. We present a case of phaeohyphomycosis in a 29-year-old male who presented with the complaint of painful swelling of the right eye of 1-year duration. Computed tomography (CT) scan showed an abnormal hyper dense enhancing soft tissue in the extra coronal aspect of the right orbit along the superolateral and superomedial aspect. A provisional clinical diagnosis of lymphoma or fungal infection was entertained. Histopathology revealed granulomas with numerous multinucleated giant cells and fungal hyphae within and in between the giant cells. Per-iodic acid Schiff (PAS stain) was used to confirm the presence of hyphae. Based on the clinical, CT and histopathological features, a diagnosis of Phaeohyphomycosis was given.

[ case report of an ethmoid sinus osteoma with presentation of tension pneumoencephalus]

Osteoid osteoma is a benign tumor, which is mostly seen in the long bones but occasionally originates and grows inside the paranasal sinuses. It rarely may impinge the dura with growing upward inside the ethmoid sinus. As a result, it can cause dural rupture, CSF leak and tension pneumocephalus. This needs complete resection with dural repair as an effective treatment. In this case report, a 72 year old man with osteoid osteoma is reported who had been referred with headache, rhinorrhea, memory loss, mood disorder and mutism. Pneumo-encephalus due to injury of dura of the skull base by a left ethmoid sinus osteoma was later found by CT scan. This tumor was completely resected and dura repaired by a surgical team including neurosurgeon and otorhinolaryngologist. The signs and symptoms were disappeared during the next few days

Fibro-osseous and respiratory epithelial hamartoma of the fronto-ethmoid region

A 31-year-old lady presented to the otorhinolaryngology clinic complaining of right exophtalmus. Imaging studies revealed a right frontal sinus mass, suggestive of a mucocele, and fronto-ethmoidal ground glass opacification. In the operating room, the frontal sinuses were exposed through an osteoplastic flap, and connected to the nasal cavity through a Lothrop-like drainage pathway. The pathologic analysis revealed a frontal sinus mucocele and fibro-osseous and respiratory epithelial hamartoma of the fronto-ethmoid region. In this case report, this rare pathology is discussed, in addition to a thorough elaboration upon the surgical options as dictated by the anatomic complexity of the region

Massa paranasal: dacrioestenose congênita? Relato de caso / Paranasal mass: congenital dacryostenosis? Case report

O objetivo deste é descrever uma criança portadora de massa paranasal, atentando para a importância dos diagnósticos diferenciais. RELATO DO CASO: ACS, 6 meses, sexo feminino, desde o nascimento apresentando abaulamento não inflamatório, no canto medial do olho esquerdo, lacrimejamento e hiperemia no olho direito. Ao exame apresentava fenômeno de Bell negativo bilateral, lagoftalmo à direita, ulceração e opacidade corneana à direita; presença de lesão arredondada, de superfície lisa no canto medial do olho esquerdo, sem sinais inflamatórios, medindo aproximadamente 2 cm de diâmetro, não pulsátil. A palpação, a lesão era elevada, de consistência fibroelástica, imóvel, indolor, irredutível. A propedêutica das vias lacrimais, não havia refluxo à compressão, o teste de Milder foi negativo em ambos olhos e as vias apresentavam-se pérvias à dacriocistografia. O exame tomográfico revelou tratar-se de meningocele fronto-etmoidal. COMENTARIOS: Os autores chamam a atenção para a adequada semiologia para a investigação das massas paranasais, a fim de se instituir o adequado tratamento.

Naso-ethmoid schwannoma with intracranial extension: case report

Intranasal schwannomas are rare lesions, specially when they present with an intracranial extension. The fifth case in the medical literature of a naso-ethmoid schwannoma with extension into the anterior cranial fossa is presented. The magnetic resonance findings and the details of the combined intracranial / transfacial operative approach used are described. The possible origin and the clinical characteristics of this rare lesion are reviewed.

Infrasellar craniopharyngioma: case report

We report a case of infrasellar craniopharyngioma in a 34 year-old woman who presented with progressive headache and diplopia. Computed tomographic and magnetic resonance images showed a heterogeneous tumor originating from the sphenoid bone with ethmoid sinus and sella turcica extension. A sublabial rhinoseptal transsphenoidal surgery was performed. Craniopharyngiomas with infrasellar development are very rare. Infrasellar craniopharyngioma is uncommon, thirty-five cases has been reported in literature. The embryology, clinical features and radiographic investigation of these tumors are discussed

Tumor pardo fronto-ethmoidal e hiperparatiroidismo secundario: presentación de caso / Fronto-ethmoidal brown tumor: case report

Los tumores pardos son lesiones óseas focales secundarias a hiperparatiroidismo. Se han descrito en la literatura 7 casos asociados a hiperparatiroidismo secundario localizados en hueso frontal, maxilar y etmoidal que involucran la órbita. Se presenta un caso clínico, en una mujer de 58 años de edad con insuficiencia crónica de 18 años de evolución; en diálisis peritoneal crónica ambulatoria y en programa de transplante renal. Seis meses antes inicia aumento de volumen inter ciliar de predominio izquierdo. presenta desplazamiento ocular izquierdo por tumor de aproximadamente 10 x 7 cm, fijo, no doloroso y sin cambios tróficos en la piel supra yacente. Se extirpó el tumor que fue diagnosticado como "tumor pardo"

Rhinogenic trigger zones for migraine: evaluation and surgical treatment

Many theories were proposed for the explanation of migraine. In this study, an attempt to locate and treat rhinogenic trigger zone responsible for triggering migraine attack was done. Fifty patients with resistant migraine were studied. Thirty-five patients were due to nasal abnormalities in the area of middle meatus, posterior part of the septum, middle turbinate, ethmoid and sphenoid sinuses. Endoscopic correction of these restrictive pathomorphological changes resulted in 80% permanent improvement, 11.5% substantial improvement and 8.5% little or no improvement

Sino-nasal fibromatosis - an unusual cause of fronto-ethmoid mucocoele

A patients with a fronto-ethmoidal mucocele secondary to fibromatosis of the nose and paranasal air sinuses is presented. The case was operated upon for first time in 1980 to remove a right fronto-ethmoidal mucocele, when a fibrous firm tissue mass was excised from the right side of his nasal cavity at the frontonasal opening. This mass was incorrectly diagnosed as fibrosarcoma. Fortunately radiotherapy was not given for fear of affecting vision. Frequent recurrences of the mucocoele with infection was treated medically and surgically. The closure of the frontonasal duct and the right upper part of nasal cavity with new bone and fibrous tissue, and the long standing condition of the patient aroused suspicion regarding the pathological diagnosis. Review of previous histopathology and fresh specimen proved that this is a case of fibromatosis of the paranasal sinuses

Posterior ethmoid sinsus mucocele presenting with unilateral blindness

A case of mucocele of posterior ethmoid sinus presneting with unilateral painful blindness without proptosis is presented. CT of the orbits and paranasal sinuses demonstrated the lesion well and showed its relationship to the optic foramen. A combined cranial excision and a transnasal drainage dealt with the problem effectively

Adenocarcinoma del seno etmoidal que simula carcinoma de colon / Ethmoidal carcinoma resembling colon carcinoma

Algunos carcinomas de nariz y senos paranasales tienen similitud histológica con los carcinomas colónicos, lo que deberá tenerse presente para no confundirlos con metástasis de un tumor primario de colon. Se presenta un caso de un adenocarcinoma con esas características que surgió del seno etmoidal, invadiendo la órbita y el antro maxilar y que protruía al exterior a través de la fosa nasal. Se comentan su diagnóstico, las características histopatológicas, el tipo de tratamiento empleado y el pronóstico