Calculation of an Optic Nerve Injury Risk Profile Before Sphenoid Sinus Surgery
| Autor: | Mehmet Fatih Kucuk, Nuray Bayar Muluk, Erdem Atalay Cetinkaya, Pınar Koç, Koray Koç, Cemal Cingi |
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| Přispěvatelé: | Kırıkkale Üniversitesi |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty Adolescent Sphenoid Sinus Dehiscence Preoperative care Risk Assessment optic nerve Anterior clinoid process 03 medical and health sciences Young Adult 0302 clinical medicine sphenoidal sinus Paranasal Sinuses Preoperative Care Medicine Humans Intraoperative Complications Sinus (anatomy) Aged Retrospective Studies Sphenoidal sinus business.industry Retrospective cohort study endoscopic sphenoid surgery General Medicine Middle Aged Surgery medicine.anatomical_structure Paranasal sinuses Otorhinolaryngology Optic Nerve Injuries Optic nerve Female 030101 anatomy & morphology business 030217 neurology & neurosurgery |
| Popis: | Kucuk, Mehmet Fatih/0000-0002-2548-7869 WOS: 000405399600003 PubMed: 27906848 Objectives: Our objective was to analyze variations in the optic nerve (ON) course and surrounding structures in an effort to construct an optic nerve injury risk profile before endoscopic intranasal sphenoidal, or endoscopic endonasal transphenoidal, skull-base surgery, and eventually to construct and formulate a common classification by combining the known classes. The authors used computed tomography (CT) toward this end. Methods: The authors retrospectively reviewed 200 consecutive CT scans (400 sides) of the paranasal sinuses. The pneumatization of the anterior clinoid process, the relationships of the ONs to the sphenoidal sinuses, and ON dehiscence were evaluated. The authors then created a formula by which risk profiles can be constructed for patients for whom sphenoid or parasellar surgery is planned. Results: Pneumatization of the anterior clinoid process was evident in 28.25%. Dehiscence of the bony wall of the ON was evident in 9.5%. The ON course lay adjacent to the sphenoidal sinus, causing sinus wall indentation, in 23%. Cumulative optic nerve injury risk scoring showed that, radiologically, surgery on 8.5% and 1.5% of sphenoid sinuses described here carried severe or critical risk of ON injury, respectively. Conclusions: Head-and-neck surgeons and neurosurgeons should be aware of variations in ON course. The authors composed an optic nerve injury risk classification category based on the sum of individual weights of each of these classes. Reductions in ON injuries require careful evaluation of potential variant anatomies. Preoperative CT scans must be meticulously reviewed to avoid ON injury. |
| Databáze: | OpenAIRE |
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