The aim of this study was to delineate the precise relationship between the sphenoid sinus and internal carotid artery and the optic nerve, as well as to assess incidence of the anatomic variations of these structures. A review of 92 paranasal sinus tomographic scans was made for anatomic variations of the sphenoid sinus and related bony and neurovascular structures. Coronal and axial tomographic sections were obtained with 2.5-mm section thickness. We assessed the protrusion of the internal carotid artery (ICA) and the optic nerve (ON) into the sphenoid sinus, bone dehiscence of these structures, and pneumatization of the anterior clinoid process (ACP) and pterygoid recess (PR), as well as the variations of the sphenoid sinus septum. The protrusion of the ICA into the sphenoid sinus was found in 24 (26.1%) patients. An ON protrusion was present in 29 (31.5%) patients. Pneumatization of the PR was encountered in 27 (29.3%) patients. There was not a statistically significant relationship between the pneumatization of the PR and ICA protrusion into the sphenoid sinus (chi2 = 0.258, p = 0.168). A significant relationship between the ACP pneumatization and protrusion of the ON into the sphenoid sinus was found (chi2= 0.481,p = 0.007). Preoperative recognition of the anatomic variations by the radiologist is beneficial for identification of the limits of dissection. This is particularly important in the sphenoid sinus area where extensive pneumatization of the skull base bones may distort the anatomic configuration. Therefore, axial and coronal CT sections should always be obtained prior to any surgery in the sphenoid sinus area.

Incudostapedial rebridging ossiculoplasty with bone cement is a cost-effective and safe procedure that yields good hearing results in selected patients.

The objectives of this study were to investigate the typical clinical presentation, diagnosis and treatment of mycobacterial cervical lymphadenitis (MCL). Medical records of 87 patients who were treated for MCL were retrospectively reviewed. Definitive diagnosis of MCL was made when a neck mass persisted for several weeks or months and one or more of the following was obtained: (1) positive mycobacterial cultures from biopsy material; (2) Positive mycobacterial staining of biopsy material; (3) Granulomatous inflammation and caseating necrosis on histopathological examination of biopsy material. Clinical findings were reviewed prior to treatment. The treatment included standard antituberculous medications followed by surgery in which either total excision or selective nodal dissection of the cervical lump was made. Follow-up results are presented. The chief complaint was a cervical mass that was localized mostly to the posterior cervical or submandibular regions. A fistula formation was encountered in 11.5 per cent. All patients recovered from MCL by combined antituberculous drug and surgical treatments. Clinical presentation of the disease and histopathological assessment are important in the diagnosis of MCL as well as in the differential diagnosis of tuberculous and nontuberculous MCL. Utilizing the combined medical and surgical treatment options, both tuberculous and non-tuberculous cervical adenitis can be treated successfully.

Incudostapedial rebridging ossiculoplasty with ionomeric bone cement is a reliable method for ossicular reconstruction that is cost effective and offers satisfactory hearing results in selected patients.

These results suggest that dexmedetomidine provides analgesia, adequate sedation and surgical comfort without adverse effects for patients undergoing functional endoscopic sinus surgery under local anaesthesia.