Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Measures can help save frontal sinuses

01.07.2005


A few X-ray measurements can help determine whether chronic problems with the hard-to-reach frontal sinuses can be corrected with surgery, according to a new study.



“The frontal sinus is behind the forehead and it has a very tortuous drainage,” says Dr. Stil E. Kountakis, vice chair of the Medical College of Georgia Department of Otolaryngology-Head and Neck Surgery. “It’s the most difficult sinus to work with.”

The good news is the frontal sinuses, which run parallel to the eyebrows, are not the most common site for infection. The bad news is the sinuses between the eyes – the ethmoids, into which the frontal sinuses drain – are, says Dr. Kountakis.


“The general recommendation is to avoid frontal sinus surgery as much as possible,” he says, citing potential hazards that come with their proximity to the skull base and the orbits.

But when chronic symptoms such as headache, cough, sore throat, nasal congestion and drip don’t respond to medical therapy, miserable patients may opt for surgery that effectively obliterates their frontal sinuses. Surgeons crack open the skull, open the frontal sinuses, remove the lining and fill the empty cavity with abdominal fat. “A better solution is to perform functional endoscopic surgery that provides a large area for the sinuses to drain while preserving sinus function,” says Dr. Kountakis, who directs the Georgia Sinus and Allergy Center.

He is corresponding author on a study published in the May/June issue of the American Journal of Rhinology that should help surgeons determine if patients are instead candidates for a sinus-saving modified Lothrop procedure.

The procedure enables sinus surgeons to work through the nose to create a larger drainage pathway for the frontal sinuses by removing the floor of the sinuses between the eyes and creating a hole in the septum that separates the nose. “This opens up the sinuses so they drain without obstruction,” says Dr. Kountakis. ‘This is a last-ditch effort to try and fix chronically obstructed frontal sinuses.

“By doing the surgery over and over again, I’ve learned to look at the (computerized tomography) scan and check to see if I had room for my instruments to go through,” says Dr. Kountakis, senior author of the recently released first textbook on the frontal sinuses.

He wondered if guidelines could be developed to help others do the same.

He and colleagues Dr. Ramon E. Figueroa, MCG neuroradiologist, and Dr. Firas T. Farhat, MCG sinus fellow who is now the first fellowship-trained rhinologist practicing in Lebanon, determined those measurements by studying the CT scans and anatomy of seven cadavers.

They identified the critical measurements as the thickness of the nasal beak, the boney structure between the eyes where the nose and forehead meet, as well as the “accessible dimension,” a term Dr. Kountakis coined for available working space inside the frontal drainage area.

“Even with the smallest instruments that are available today, this dimension should be at least 5 mm (about .2 inches) to allow for safe drill insertion,” the study authors write of the accessible dimension.

“The smaller it is, the harder it is,” says Dr. Kountakis. “You need to have some space that will admit all these instruments going up into the forehead.”

Researchers also measured the distance between the nasal beak and the front of the nearby skull base as well as the widest front-to-back depth of the frontal sinuses.

By their new measurements, four of the seven cadavers qualified for the sinus-saving modified Lothrop procedure. The researchers suggest long-term clinical studies to further assess the efficacy of the measurements.

Toni Baker | EurekAlert!
Further information:
http://www.mcg.edu

More articles from Studies and Analyses:

nachricht The importance of biodiversity in forests could increase due to climate change
17.11.2017 | Deutsches Zentrum für integrative Biodiversitätsforschung (iDiv) Halle-Jena-Leipzig

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

Im Focus: Wrinkles give heat a jolt in pillared graphene

Rice University researchers test 3-D carbon nanostructures' thermal transport abilities

Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

NASA detects solar flare pulses at Sun and Earth

17.11.2017 | Physics and Astronomy

NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

17.11.2017 | Health and Medicine

The importance of biodiversity in forests could increase due to climate change

17.11.2017 | Studies and Analyses

VideoLinks
B2B-VideoLinks
More VideoLinks >>>