Frontal Sinus “Hump”: An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out)
Skull base injuries caused by the outside-in frontal drill-out technique have not been reported. In this report, we chose an outside-in approach to open the frontal sinus for olfactory neuroblastoma resection. Although we identified the first olfactory fibre, the anterior skull base was damaged whil...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Case Reports in Otolaryngology |
| Online Access: | http://dx.doi.org/10.1155/2021/3402496 |
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| author | Teppei Takeda Kazuhiro Omura Haw Torng Teru Ebihara Satoshi Aoki Kosuke Tochigi Hiromi Kojima Nobuyoshi Otori |
| author_facet | Teppei Takeda Kazuhiro Omura Haw Torng Teru Ebihara Satoshi Aoki Kosuke Tochigi Hiromi Kojima Nobuyoshi Otori |
| author_sort | Teppei Takeda |
| collection | DOAJ |
| description | Skull base injuries caused by the outside-in frontal drill-out technique have not been reported. In this report, we chose an outside-in approach to open the frontal sinus for olfactory neuroblastoma resection. Although we identified the first olfactory fibre, the anterior skull base was damaged while drilling into the frontal sinus on the tumour side. We reconstructed the skull base in multiple layers using fascia and cartilage. Postoperative cerebrospinal fluid leakage or intracranial haemorrhage was not observed. In this case, a morphological difference existed in the posterior wall of the frontal sinus between the right and left sides, like a “hump” in the posterior wall of the frontal sinus. This case of damage to the anterior skull base that could not be avoided by identifying the first olfactory fibre alone is the first published case of skull base injury caused by the outside-in approach due to morphological variations of the frontal sinus and skull base. In this approach, the posterior wall of the frontal sinus cannot be observed because the intraoperative landmark is limited to the first olfactory fibre. Therefore, morphological variations of the posterior wall of the frontal sinus should be analysed in advance to prevent cranial base injury. |
| format | Article |
| id | doaj-art-d751dc1930b34e03aa23445eaa34c55f |
| institution | Kabale University |
| issn | 2090-6765 2090-6773 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Otolaryngology |
| spelling | doaj-art-d751dc1930b34e03aa23445eaa34c55f2025-02-03T05:44:45ZengWileyCase Reports in Otolaryngology2090-67652090-67732021-01-01202110.1155/2021/34024963402496Frontal Sinus “Hump”: An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out)Teppei Takeda0Kazuhiro Omura1Haw Torng2Teru Ebihara3Satoshi Aoki4Kosuke Tochigi5Hiromi Kojima6Nobuyoshi Otori7Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, JapanDepartment of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, JapanDepartment of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, JapanDepartment of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, JapanDepartment of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-koshigaya, Koshigaya-Shi, Saitama 350-8550, JapanDepartment of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, 2-1-50 Minami-koshigaya, Koshigaya-Shi, Saitama 350-8550, JapanDepartment of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, JapanDepartment of Otorhinolaryngology, The Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, JapanSkull base injuries caused by the outside-in frontal drill-out technique have not been reported. In this report, we chose an outside-in approach to open the frontal sinus for olfactory neuroblastoma resection. Although we identified the first olfactory fibre, the anterior skull base was damaged while drilling into the frontal sinus on the tumour side. We reconstructed the skull base in multiple layers using fascia and cartilage. Postoperative cerebrospinal fluid leakage or intracranial haemorrhage was not observed. In this case, a morphological difference existed in the posterior wall of the frontal sinus between the right and left sides, like a “hump” in the posterior wall of the frontal sinus. This case of damage to the anterior skull base that could not be avoided by identifying the first olfactory fibre alone is the first published case of skull base injury caused by the outside-in approach due to morphological variations of the frontal sinus and skull base. In this approach, the posterior wall of the frontal sinus cannot be observed because the intraoperative landmark is limited to the first olfactory fibre. Therefore, morphological variations of the posterior wall of the frontal sinus should be analysed in advance to prevent cranial base injury.http://dx.doi.org/10.1155/2021/3402496 |
| spellingShingle | Teppei Takeda Kazuhiro Omura Haw Torng Teru Ebihara Satoshi Aoki Kosuke Tochigi Hiromi Kojima Nobuyoshi Otori Frontal Sinus “Hump”: An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out) Case Reports in Otolaryngology |
| title | Frontal Sinus “Hump”: An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out) |
| title_full | Frontal Sinus “Hump”: An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out) |
| title_fullStr | Frontal Sinus “Hump”: An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out) |
| title_full_unstemmed | Frontal Sinus “Hump”: An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out) |
| title_short | Frontal Sinus “Hump”: An Anatomical Risk Factor for Anterior Skull Base Injury in the Endoscopic Modified Lothrop Approach (Outside-In Frontal Drill-Out) |
| title_sort | frontal sinus hump an anatomical risk factor for anterior skull base injury in the endoscopic modified lothrop approach outside in frontal drill out |
| url | http://dx.doi.org/10.1155/2021/3402496 |
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