BackgroundThe orbital floor is considered as an important intraoperative reference point in endoscopic sinonasal surgery. The aim of this review is to evaluate its reliability and usefulness as a surgical landmark in endoscopic endonasal surgery.MethodsA literature search was performed on electronic databases, namely PUBMED. The following keywords were used either individually or in combination: orbital floor; maxillary sinus roof; endoscopic skull base surgery; endoscopic sinus surgery. Studies that used orbital floor as a landmark for endoscopic endonasal surgery were included in the analysis. In addition, relevant articles were identified from the references of articles that had been retrieved. The search was conducted over a period of 6 months between 1st June 2017 and 16th December 2017.ResultsOne thousand seven hundred forty-three articles were retrieved from the electronic databases. Only 5 articles that met the review criteria were selected. Five studies of the orbital floor (or the maxillary sinus roof) were reviewed, one was a cadaveric study while another 4 were computed tomographic study of the paranasal sinuses. All studies were of level III evidence and consists of a total number of 948 nostrils. All studies showed the orbital floor was below the anterior skull base irrespective of the populations. The orbital floor serves as a guide for safe entry into posterior ethmoids and sphenoid sinus.ConclusionsThe orbital floor is a reliable and useful surgical landmark in endoscopic endonasal surgery. In revision cases or advanced disease, the normal landmarks can be distorted or absent and the orbital floor serves as a reference point for surgeons to avoid any unintentional injury to the skull base, the internal carotid artery and other critical structures.
Paediatric patient with a foreign body in the ear may be present primarily to primary care physician or being referred to the otorhinolaryngology (ORL) clinic. The foreign bodies vary from organic to inorganic material with different sizes and shapes. Removal of foreign body in the ear canal requires adequate clinical experience as well as proper clinical instruments and cooperative clinical staff. Throughout the years, many clinical instruments and devices have been designed and proven to able to facilitate a smooth procedure with high success rates. However, an agitated child may be uncooperative and the increase in the number of attempts will result in injury of the ear canal or displacement of foreign body to the middle ear. Thus, clinical experience is essential and the doubtful cases are preferably to be performed under general anaesthesia to prevent complications.
Constitutional symptoms are the most common clinical manifestation of the systemic disease. When there is the presence of cervical lymphadenopathy concurrently, systemic infection or malignancy has to be taken into consideration. At the paediatric or adolescent age group, tuberculosis and lymphoma are the common diseases that associated with these symptoms. We should consider patient’s age group, risk factors and the disease presentation for the diagnosis. With the guidance of the imaging studies, laboratory and histopathological studies, the precise final diagnosis is made. Bangladesh Journal of Medical Science Vol.18(1) 2019 p.149-152
Tongue abscess is rare but can be life-threatening especially if the cause of it is not removed promptly. It usually results from trauma, foreign body, lingual tonsils pathology, thyroglossal duct remnants or dental diseases. The etiology of the disease can be found out by obtaining a detailed history from the patient and physical examination with the assistance of lab investigation, laryngoscope, imaging tools such as Computed tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasonography (US). The main principles of the management of tongue abscess are maintaining the patency of the airway, draining the abscess, antibiotics therapy or even surgical approach. We present a tongue abscess case which the etiology was a fish bone sits deeply in the tongue.
In Otorhinolaryngology (ORL) practice, we commonly received cases of foreign bodies in the nose. Among these referrals, the pediatric group is the most common, others could involve the mentally challenged patients. These foreign bodies may vary from different materials and consistencies and removal them requires good clinical experience as well as proper clinical instruments and cooperative clinical staff and the patient. On rare occasion, penetrating foreign body at the nasal bridge was presented to us; and, we are reporting a case of penetrating fishhook at the nasal bridge and its management.
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