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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
 

  • References

  • 1 Som PM, Park EE, Naidich TP, Lawson W. Crista Galli Pneumatization Is an Extension of the Adjacent Frontal Sinuses. AJNR Am J Neuroradiol 2009; 30: 31-3
    Search in Google Scholar
  • 2 Hajiioannou J, Owens D, Whittet HB. Evaluation of anatomical variation of the crista galli using computed tomography. Clin Anat 2010; 23 (4) 370-3
    CrossrefSearch in Google Scholar
  • 3 Miranda CMNR, Maranhão COM, Arraes FMNR, Padilha IG, Farias LPG, Jatobá MAS, Andrade ACM, Padilha BG. Variações anatômicas das cavidades paranasais à tomografia computadorizada multislice: o que procurar?. Radiol Bras 2011; 44 (4) 256-62
    Search in Google Scholar
  • 4 Dutra LD, Marchiori E. Tomografia computadorizada helicoidal dos seios paranasais na criança: avalização das sinusopatias inflamatórias. Radiol Bras 2002; 35 (3) 161-9
    CrossrefSearch in Google Scholar
  • 5 Lee JM, Ransom E, Lee JYK, Palmer JN, Chiu AG. Endoscopic Anterior Skull Base Surgery: Intraoperative Considerations of the Crista Galli. Skull Base 2011; 21 (2) 83-6
    Thieme ConnectSearch in Google Scholar