The Endoscopic Endonasal Dacryocystorhinostomy (eDCR) in the Immunocompromised Patient.

We present the clinical case of a 51-year-old male patient, affected by common variable immunodeficiency (CVID). In his history recurrent orbital cellulitis, exacerbation of chronic right dacryocystitis, lacrimal sac empyema with periodic episodes of dacryocutaneous fistolization. The coexistence of these particular immunological defects and the lack of literature about similar cases required an accurate evaluation of each step of the diagnostic and therapeutic approach.

Anatomical Variations of Anterior Ethmoidal Foramen and Cribriform Plate: Relations With Sex.

Position of anterior ethmoidal artery and height of lateral lamella of cribriform plate (LLCP) represent critical variants in endoscopy.In 200 maxillofacial computed tomography scans of patients the position of anterior ethmoidal foramen (AEF) in relation to ethmoid roof was recorded. The height of LLCP was measured and classified according to Keros classification.

Temporal Bone Pneumatization: Relationship With Sex and Variants of the Ethmoid and Sphenoid Bone.

Pneumatization variants of the temporal bone have a crucial importance in several surgical interventions. However, very few data are known about possible correlation with other pneumatization variants.Pneumatization of glenoid fossa, petrous apex, and infralabyrinthine portion of temporal bone was assessed in 200 computed tomography scans, equally divided between males and females (18-92 years).

Relationship between lateral angle and shape of internal acoustic canal: cautionary note for diagnosis of sex.

Lateral angle (LA) of the internal acoustic canal (IAC) at its opening at the surface of the petrous portion of the temporal bone is known in literature as a dimorphic measurement useful for sex assessment. However, its reliability is still debated. Moreover, no information is available about the possible relationship between LA and shape and size of the IAC.

Prevalence of accessory septations of sphenoid sinus in pediatric population: Applications to endoscopic sinus surgery.

Sphenoid sinus accessory septations and their possible insertion on internal carotid artery (ICA) may represent a risk for endoscopic sinus surgical procedures. However, scarce data on this variant for children are available so far. This retrospective study included 220 maxillofacial CT-scans equally divided among males (13.

Are coding systems of frontal sinuses anatomically reliable? A study of correlation among morphological and metrical features.

Frontal sinuses are of special interest for personal identification thanks to their high variability. A common procedure for comparing ante-mortem and post-mortem material is based on coding systems classifying frontal sinuses according to their morphological and metrical characteristics. However, the calculation of possible combinations is performed on the hypothesis that all the classified features are independent one from each other.

Three-Dimensional Assessment of Pharyngeal Volume on Computed Tomography Scans: Applications to Anesthesiology and Endoscopy.

Pharyngeal volume is important in anesthesiology for correctly assessing intubation procedures. However, most of studies are based on patients in upright position and do not assess possible relationships between pharyngeal volume and cranial size. This study aims at measuring pharyngeal volume in CT-scans and to assess possible statistically significant differences according to sex.

Relation between volume of sphenoid sinuses and protrusion of Vidian nerve: possible applications to Vidian neurectomy.

Purpose: Vidian neurectomy is a surgical procedure applied to different pathological conditions, including chronic rhinitis and sphenopalatine neuralgia. The choice of the correct surgical approach depends upon the possible protrusion of Vidian nerve into the sphenoid sinuses. The present study analyzes the possible relationship between protrusion of Vidian nerve and volume of sphenoid sinuses.

Relationship between sphenoid sinus volume and accessory septations: A 3D assessment of risky anatomical variants for endoscopic surgery.

Sphenoid sinus accessory septations involve serious complications during their removal for the injury of the internal carotid artery (ICA) and the optic nerve (ON). The relationships of this anatomical variant with sphenoid size still remain unclear. In the present study, 260 patients (equally divided among sexes, aged between 18 and 92 years) were retrospectively assessed.

Relationship between sphenoid sinus volume and protrusion of internal carotid artery and optic nerve: a 3D segmentation study on maxillofacial CT-scans.

Purpose: Anatomy of sphenoid sinuses has acquired a growing importance with the diffusion of transsphenoidal surgical procedures. A common risk in these practices is the damage of internal carotid artery (ICA) and optic nerve (ON), which may protrude into the sphenoid air cavities. This study aims at analysing the relationships between sphenoid sinuses volume and protrusion of ICA and ON.

Anatomy of the pterygopalatine fossa: an innovative metrical assessment based on 3D segmentation on head CT-scan.

Purpose: The pterygopalatine fossa is an important anatomical structure for several surgical and anaesthesiologic procedures; yet, very few data are available about its size. This study aims at providing a metrical assessment of pterygopalatine fossa through an innovative 3D segmentation procedure on head CT-scans.

Methods: CT-scans from 100 patients (50 males and 50 females) aged between 18 and 85 years were chosen for the study.

Can Volumetric and Morphological Variants of Sphenoid Sinuses Influence Sinuses Opacification?

Improvements in computed tomography and in functional endoscopic sinus surgery have recently increased interest toward paranasal sinus anatomy and anatomic variations that can be observed in patients affected by sinusitis. Isolated sphenoid sinusitis is a relatively rare pathology, often related to nonspecific symptoms, therefore making diagnosis difficult. The correlation between this type of sinusitis and anatomical variants remains unclear.

Anatomic Characteristics of Intrapetrous Carotid Artery: A 3-Dimensional Segmentation Study on Head Computed Tomography Scan.

Background: The intrapetrous carotid artery (IPCA) is one of the most unexplored anatomic regions, and its 3-dimensional reconstruction in living subjects is still missing. This study aims to describe the IPCA on 3D models extracted from head computed tomography (CT) scans.

Methods: The intrapetrous carotid artery was manually segmented on head CT scans of 100 healthy patients free from vascular and neurologic pathologies (50 men and 50 women; age range, 18-91 years).

An innovative 3D-3D superimposition for assessing anatomical uniqueness of frontal sinuses through segmentation on CT scans.

Anatomical uniqueness plays a significant role in the personal identification process of unknown deceased. Frontal sinuses have been widely used in the past decades for this purpose, mostly using 2D X-ray techniques. However, the modern 3D CT-based segmentation methods may help in developing novel and more reliable methods of identification.

Anatomical variants of ethmoid bone on multidetector CT.

Anatomical variants of the ethmoid bone have a special importance in several fields, especially in otolaryngology; a precise understanding of the complex anatomy and anatomic variations of the ethmoid bone is crucial for radiological diagnosis of paranasal pathology and for surgical work-up in order to avoid potential complications. The present study aims at helping general radiologists to become familiar with the most common forms of ethmoid anatomical variants and their clinical relevance.

Assessing symmetry of zygomatic bone through three-dimensional segmentation on computed tomography scan and "mirroring" procedure: A contribution for reconstructive maxillofacial surgery.

Purpose: Surgical reconstruction of zygomatic bones in cases of traumatic injuries is a frequent event: assessment of symmetry is mandatory for a correct restoration of zygomatic shape, but the literature is discordant about its quantification. The purpose of this study is to show a novel method for assessing symmetry of zygomatic bone through mirroring of 3D models segmented on CT-scan.

Materials And Methods: A total of 100 patients (50 male and 50 female), divided into two age groups (18-49 years and 50-92 years) were selected from the computed tomography (CT) scan database of a hospital in northern Italy.

Uric Acid, Metabolic Syndrome and Atherosclerosis: The Chicken or the Egg, Which Comes First?

Background: A great debate in literature exists nowadays on the role of uric acid as a marker of cardiovascular and metabolic organ damage or a risk factor for cardiovascular and metabolic disease.

Methods: The study aimed to determine the relationship among serum uric acid and metabolic syndrome and atherosclerosis, by means of carotid intima media-thickness, in a cohort of 811 otherwise healthy overweight/obese subjects, without overt atherosclerosis not using any kind of drug.

Results: Uric acid levels were positively related to male gender, waist circumference, BMI, systolic and diastolic pressure levels, fasting insulin, fasting glucose, HOMA-IR, triglycerides, total cholesterol, LDL cholesterol, the presence of metabolic syndrome and the number of the components of metabolic syndrome and negatively related to HDL cholesterol levels.

Sella turcica bridging and ossified carotico-clinoid ligament: Correlation with sex and age.

Aim Sella turcica bridging and ossified carotico-clinoid ligament are two variants of the sella turcica, the origin of which is partially unknown. These variations should be properly recognised, as they may hamper the removal of the anterior clinoid process in surgical procedures. Therefore, our aim was to determine the prevalence of these two anatomical variants and to investigate their prevalence according to patient sex and age in a series of maxilla computed tomography scans.

Volumetric assessment of sphenoid sinuses through segmentation on CT scan.

Purpose: Computed tomography represents the gold standard for the assessment of morphological characteristics of sphenoid sinuses, whose anatomy has acquired a novel interest because of the recent introduction of transsphenoidal surgery and robot-assisted procedures. One of the most relevant parameters for planning surgical intervention is the volume of sphenoid sinuses, and with time few population studies have been published. However, at present, no data are available concerning the relation between volume and anatomical variants of sphenoid sinuses.

Anatomical variants of sphenoid sinuses pneumatisation: a CT scan study on a Northern Italian population.

Sphenoid bone may be affected by different variants of pneumatisation, which have a relevant importance from a clinical and surgical point of view. The description of such variants in different populations may give useful information. However, few articles describe the variability of sphenoid pneumatised structures and none of them focuses on Northern Italian population.

Risk factors for postoperative delirium after colorectal surgery for carcinoma.

Background And Aim: Data regarding the incidence and risk factors for postoperative delirium (PD) after gastrointestinal surgery are heterogeneous because they include both benign and malignant disease. The aim of this study was to investigate the incidence and risk factors for PD in 100 consecutive patients over 65 years who underwent colorectal surgery for carcinoma.

Methods: Pre-operative cognitive function was assessed using the Mini Mental State Examination.

[Carcinoid of the appendix. A case report].

A case of a young male operated on for acute appendicitis due to a carcinoid of the base is reported. Since the tumor was infiltrating the resection margin of the appendix, the patient was later treated with a right hemicolectomy. Carcinoid tumor is unusual, but can be encountered several times during the career of a surgeon (1/200-300 appendicectomy).

[Tension-free hernioplasty in the treatment of inguinal hernia in the adult: our experience with local anesthesia and a review of the literature].

Background: In the last years the real innovation in the treatment of groin hernia is represented by tension-free hernioplasty under local anaesthesia, based on the techniques of Lichtenstein and Trabucco, which use synthetic prosthesis (polypropylene) to restore the floor of inguinal tract and enable an early deambulation and return to work.

Methods: In 21 months the authors have treated, only under local anaesthesia, 100 patients, 95 men and 5 women; the age ranged from 18 to 82 years; some of them suffer from systemic pathology (7 patients with cardiovascular diseases, 1 with epilepsy, 3 with pulmonary diseases, 1 with liver cirrhosis). All patients underwent short-term antibiotic prophylaxis.

Hemophagocytic syndrome in a case of splenic large B-cell lymphoma.

A case of splenic large B-cell lymphoma with hemophagocytic syndrome is reported. The difficulties of diagnosis are emphasized especially when peripheral lymph nodes or bone marrow lymphomatous infiltration are not present. Diagnostic criteria for hemophagocytic syndrome and their relationship with the pathogenesis of the disease are also stressed.

[Clinical usefulness of the immunophenotypic study of circulating lymphocytes in leukemic lymphoproliferative diseases].

The immunophenotypes (IF) on peripheral lymphocytes of 24 B-CLL in different stage, 2 PLL and 14 leukemic B-non Hodgkin lymphomas were investigated. As regard to B-CLL and PLL, the results are similar to those reported so far. In stage A and B of B-CLL the IF appear less variable than in advanced stages where a decrease of CD21+ and an increase of both CD25+ and CD38+ lymphocytes were observed.