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4 results

  • Isolated pituitary fossa metastasis from a primary tonsillar squamous cell carcinoma: case report

  • H Merchant, D S Rye, J A Smith
  • Journal:
    The Journal of Laryngology & Otology / Volume 134 / Issue 4 / April 2020
    Published online by Cambridge University Press:
    01 April 2020, pp. 369-371
    Print publication:
    April 2020
  • Objective

    This paper presents a case of an isolated pituitary fossa metastasis on a background of a previously treated tonsillar squamous cell carcinoma.

    Case report

    A 64-year-old male, diagnosed with a primary p16-negative squamous cell carcinoma in the right tonsil, was treated with a course of chemoradiotherapy with curative intent. Positron emission tomography/computed tomography, performed at six months post-treatment, revealed a good local response and no distant metastases. The patient was placed on routine follow up at two-monthly intervals. Two months into follow up, he presented with a right-sided oculomotor nerve palsy and partial Horner's syndrome. Imaging and biopsy revealed a pituitary fossa metastasis (p16-negative squamous cell carcinoma), and a further positron emission tomography/computed tomography visualised this lesion. He was deemed unsuitable for further intervention and underwent palliative radiotherapy for symptom control.

    Conclusion

    This case represents the first reported isolated pituitary fossa metastasis from a tonsillar squamous cell carcinoma. A high degree of clinical suspicion is recommended, along with a low threshold for biopsy and a cautioned use of positron emission tomography/computed tomography, when investigating such patients.

  • Anatomical variation of the sphenoid sinus in paediatric patients and its association with age and chronic rhinosinusitis

  • H Odat, D Almardeeni, M Tanash, M Al-Qudah
  • Journal:
    The Journal of Laryngology & Otology / Volume 133 / Issue 6 / June 2019
    Published online by Cambridge University Press:
    10 April 2019, pp. 482-486
    Print publication:
    June 2019
  • Objective

    To report the prevalence of different anatomical variations of the sphenoid sinus and its related structures among paediatric patients with or without chronic rhinosinusitis.

    Methods

    Computed tomography scans of 50 paediatric patients with chronic rhinosinusitis were reviewed and compared to 50 scans of paediatric patients without chronic rhinosinusitis. The type of sphenoid sinus pneumatisation and the surrounding structures were thoroughly analysed. The patients were divided into three groups according to age.

    Results

    Mean age was 10.9 years (range, 4–16 years). The sellar configuration was the commonest in all groups, while the conchal type was the least common. There were significant differences between paediatric patients with or without sinusitis in: sphenoid sinus pneumatisation type, vidian canal type and Onodi cell presence. In addition, there were significant differences between age groups in: sphenoid sinus pneumatisation type, single sinus septum and multiple septa presence, and internal carotid artery bulging.

    Conclusion

    Age and sinusitis have a significant impact on sphenoid pneumatisation type and surrounding structure variation. Recognition of these variations can be useful for mapping this region, and enables a safer and more efficient endoscopic surgical procedure.

  • The Morphology of the Sella Turcica in Monozygotic Twins

  • Mette T. Brock-Jacobsen, Carsten Pallisgaard, Inger Kjær
  • Journal:
    Twin Research and Human Genetics / Volume 12 / Issue 6 / 01 December 2009
    Published online by Cambridge University Press:
    21 February 2012, pp. 598-604
    • Article
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  • The purpose was to compare the sella turcica morphology of individuals within pairs of monozygotic twins with normal karyotype and to analyze the similarity between the observed morphology and the morphology of non-twins at the same age with normal karyotype. Profile radiographs from 84 individuals of 42 twin pairs (18 male and 24 female pairs, aged 18–23 years) comprised the material. Sella turcica measurements from non-twins aged 6–21 years were used as normal reference. Length, depth and diameter of the sella turcica were measured and controlled by re-measurements. Pearson's correlation coefficient was used for comparison of individuals within twin pairs. For comparison of twins and non-twins, normal standard values for length, depth and diameter were subtracted from the twin values. For the mean values of these differences, confidence limits p values and t values were calculated. The study showed that the size of the sella turcica may be partly similar and partly dissimilar within the pair of monozygotic twins. Statistical evaluation of the data showed correlations between length, depth and diameter of the sella turcica between the two twin individuals in the same twin pair. Differences in sizes are observed between individuals in the twin material and individuals in the non-twin material. As a conclusion, the twin males were more similar within the twin pair, but deviated more from the non-twin material than the females. Female twins had more discrepancy within the twin pair, but deviated less from the non-twin material than the males.

  • Endoscopic anatomy of the sphenoid sinus and sella turcica

  • Dharambir S. Sethi, Ralph E. Stanley, Prem Kumar Pillay
  • Journal:
    The Journal of Laryngology & Otology / Volume 109 / Issue 10 / October 1995
    Published online by Cambridge University Press:
    29 June 2007, pp. 951-955
    Print publication:
    October 1995

  • An endoscopic study of the sphenoid sinus was carried out, on 30 cadavers, to understand the important anatomical relationships of the sphenoid sinus, and the sella turcica. The aim was to study the endoscopic anatomy and the variants, and to determine if endoscopic instrumentation and techniques, could play a beneficial role in endoscopic management of sellar lesions.

    The results of this study are discussed, with particular reference to the important surgical anatomical features of the sphenoid sinus. A surgical technique for the endoscopic transsphenoid approach to the sella turcica was developed.

    Anatomical variants can be identified endoscopically, and endoscopic techniques have the advantages of improved visualization, magnification, angled vision, and a panoramic perspective of the intrasphenoid anatomy, compared to currently employed methods of pituitary/sellar surgery, using the operating microscope/.