An Analysis of Anatomic Variations of the Sphenoid Sinus and Its Relationship to the Internal Carotid Artery.

Introduction The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the internal carotid artery (ICA). Objective To evaluate the anatomic variations of the SS and its relationship to the ICA using computed tomography (CT). Methods Cross-sectional retrospective study. Analysis of 90 patients' CT scans on axial, coronal and sagittal planes with 1 mm slices, evaluating lateral and posterior extensions of pneumatization of the SS, deviation of the sphenoid septum, presence of septations and their relationship to the parasellar and paraclival segments of the internal carotid artery (psICA and pcICA, respectively). Results The association between the protrusions of the psICA and the pcICA was statistically significant ( p < 0.001), as was the association between the lateral extension of pneumatization of the SS and the protrusion of the psICA ( p = 0.014). The presence of the posterior extension of pneumatization of the SS and protrusion of the pcICA occurred in 46% of the cases. Deviation of the sphenoid septum in the direction of the pcICA was present in 14% and dehiscence of the pcICA was seen in 3.6% of the cases. Conclusion Using the CT scan to recognize the type of extensions of pneumatization of the SS, the deviation of the sphenoid septum, and the presence of septations is beneficial to identify accurately the ICA and to reduce the risk of injury to it.

Síndrome de Treacher Collins / Treacher Collins` syndrome

É descrito um caso de síndrome de Treacher Collins, ou disostose mandíbulo-facial, também denominada síndrome de Franceschetti Zwahlen. Trata-se de uma herança autossômica dominante, com penetrância incompleta e expressividade variável. É descrito um caso de paciente com má-formaçäo do ouvido médio e presença de hipoacusia de conduçäo bilateral e zumbidos graves. Foi realizada uma timpanotomia exploradora no ouvido esquerdo e contatada má formaçäo dos três ossículos. Foi interposta ima prótese de aço e gordura entre o martelo e a janela oval. O ouvido direito foi operado com a mesma técnia e os resulados satisfatórios

Fibroma ossificante de seio maxilar e fossa nasal: apresentaçäo de um caso / Ossifyng fibroma of maxillary sinus and nasal fossa: a case report

Os autores apresentam um caso de fibroma ossificante de seio maxilar e fossa nasal, discutindo os aspectos clínicos radiológicos e anatomopatológicos. O diagnóstico é difícil, devido às características clínicas diversas e a eventuais controvérsias na classificaçäo anatomopatológica. O tratamento é cirúrgico, e neste caso foi realizada sinusectomia maxilar com técnica de Caldwell-Luc e micro-cirurgia endonasal e transmaxilar