Incidence of SVT is significantly underreported and may predispose patients to increase risk for CSF leak. Staged and translabyrinthine approaches demonstrate an increased trend toward thrombosis risk. Our findings suggest it may not be necessary to treat asymptomatic SVT.
Anatomical variation of the lateral nasal wall, including the pathway from the frontal, ethmoidal, and maxillary sinuses may affect the communication between the paranasal sinuses and the nasal cavity. The middle meatus and hiatus semilunaris are areas where variations can occur which predispose patients to recurring sinusitis. Endoscopy allows for visualization of the entire nasal cavity, for both diagnostic and therapeutic uses. The purpose of this study was to provide an accurate characterization of the middle meatus and hiatus semilunaris for the purposes of endoscopic procedures. Ninety seven cadaveric lateral nasal walls were observed. The middle meatus was measured at three distinct points. Cranial length was also recorded. A 3D digitizer was used to record spatial relationships for the openings of the paranasal sinuses and the morphology of the hiatus semilunaris. The average widths for the middle meatus were 1.69-mm anteriorly, 2.83 mm at the transition angle, and 4.74-mm posteriorly. The posterior width was significantly larger than either of the two other measurements. The length of the hiatus semilunaris was found to be shorter on both left-sides and in females. The hiatus semilunaris was categorized into five types according to the varying morphologies. Given that the middle meatus was significantly wider posteriorly, our findings support the recommendation that entering the middle meatus posteriorly may allow an endoscopic surgeon easier access to the structures of the lateral nasal wall. Knowing the discrepancy of hiatus semilunaris lengths between right and left sides and males versus females may guide advancement of endoscopic instruments into the nasal cavity. Describing the five distinct types of the hiatus semilunaris allows the distinction of normal variation in this anatomic space versus pathologic condition.
The kidneys are the most commonly injured genitourinary organ in children following blunt abdominal trauma. Though the retroperitoneal location affords the kidneys some protection from the forces experienced in blunt abdominal trauma, the kidneys are at greater risk of injury when a disease process exposes them from their normal shielded location. In such cases, the injuries may appear to be disproportionate in relation to the severity of the trauma history, confusing the imaging findings. Recognition of both the underlying disease process as well as the manifestations of acute trauma is important; therefore, we present a pictorial essay of traumatized kidneys in children with pre-existing renal abnormalities.
Anatomical variation of the lateral nasal wall, including the pathway from the frontal, ethmoidal and maxillary sinuses may affect the communication between the paranasal sinuses and the nasal cavity. The middle meatus and hiatus semilunaris are areas where variations can occur which predispose patients to recurring sinusitis. Endoscopy allows for visualization of the entire nasal cavity, for both diagnostic and therapeutic uses. The purpose of this study was to provide an accurate characterization of the middle meatus and hiatus semilunaris for the purposes of endoscopic procedures. 116 cadaveric lateral nasal walls were observed. The middle meatus was measured at three distinct points. Cranial length was also recorded. A 3D digitizer was used to record spatial relationships between the openings of the paranasal sinuses and the hiatus semilunaris. The average widths for the middle meatus were 1.69mm anteriorly, 2.83mm at the transition angle and 4.74mm posteriorly. The posterior width was significantly larger than either of the two other measurements. The hiatus semilunaris was categorized according to the varying morphologies. Given that the middle meatus was significantly wider posteriorly, our findings support the recommendation that entering the middle meatus posteriorly may allow an endoscopic surgeon easier access to the structures of the lateral nasal wall.
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