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Int Arch Otorhinolaryngol 2013; 17(03): 246-250
DOI: 10.7162/S1809-97772013000300003
Original Article
Thieme Publicações Ltda Rio de Janeiro, Brazil

Endoscopic surgery in the treatment of crista galli pneumatization evolving with localizated frontal headaches

Jan Alessandro Socher
1   Doctor of Otolaryngology Faculty of Medicine, University of Sao Paulo. Professor of Otorhinolaryngology in FURB - Regional University of Blumenau.
,
Pedro Geisel Santos
2   Otolaryngologist.
,
Vinicius Cidral Correa
3   Student of Medicine in FURB - Regional University of Blumenau.
,
Leandro Caetano de Barros e Silva
3   Student of Medicine in FURB - Regional University of Blumenau.
› Author Affiliations
Further Information

Publication History

19 November 2012

19 March 2013

Publication Date:
21 January 2014 (online)

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Summary

Introduction: The crista galli is part of the ethmoid bone and thus may suffer from the process of pneumatization. Pneumatization occurs in between 3% and 14% of patients, resulting from air cells in the frontal or ethmoid sinuses.

Aim: To describe 3 cases of crista galli pneumatization in which the patients developed infection and were treated surgically by endoscopic techniques.

Method: We present 3 case studies of patients complaining of severe frontal headaches. The patients underwent ENT evaluation, examination by video-endoscopy, and computed tomography, which identified crista galli pneumatization with mucosal thickening and the presence of fluid. Patients underwent treatment with antibiotics and corticosteroids; however, they showed no symptomatic improvement, displayed recurrence of symptoms, and maintained radiographic changes. Thus, patients then underwent drainage through the crista galli via an endoscopic procedure.

Discussion: During surgery, mucopurulence and/or mucosal thickening and edema were identified in the pneumatized crista galli. There were no complications during or after surgery. Postoperatively, headache was improved in patients after a minimum follow-up of 6 months.

Conclusion: Crista galli pneumatization can result in infection, simulating rhinosinusitis. When there is little response to drug therapy, endoscopic surgical treatment is required; the current cases demonstrate that this technique is safe and effective.

Keywords

Natural Orifice Endoscopic Surgery - Video-Assisted Surgery - Headache
 

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