We also compared IFI versus all other situations of T4 including intracranial involvement, cranial nerves and/or orbit involvement.
The extensive spectrum of the neural and the vascular structures within the reach of the pterional approach includes insula, basal ganglia, lateral ventricle, middle cerebral artery, temporal operculum, frontal and parietal opercula, uncus, orbit, anterior cranial fossa, optic nerve, internal carotid artery and branches, lamina terminalis, and interpeduncular fossa.
In the most severely affected snake, swelling extended to the cranial aspect of the orbit and maxillary fang.
Open image in new window Fig. 1 Sinus anatomy: a) Coronal CT image in bone window showing the right ethmoid sinus (E); the left maxillary sinus (M); the lamina papyracea (short white arrow); the left orbit ; the orbital plate (long white arrow); the anterior cranial fossa.
They are commonly located within the superior nasal cavity, ethmoid air cells with occasional extension into other paranasal sinuses, orbits, anterior cranial fossa, and cavernous sinuses.
Then, the diagnosis of primary central nervous system lymphoma (PCNSL) was strongly support according to neuroimaging work-up, because the vast majority of PCNS tumors arise in the deep hemispheric periventricular white matter, the corpus callosum, cerebellum, orbits, and cranial nerves [ 21].
The optic nerve, which carries about one million nerve fibres, leaves the globe from the back of the eye and passes through the apex of the orbit into the cranial cavity.
The orbit and anterior cranial fossa were the most common adjacent anatomic spaces to exhibit disease extension.
From a practical point of view, the technique described in our study might be of particular interest, if a patient in a medical-emergency situation underwent a cranial MRI examination including the orbit for other reasons, so that the same image taken for information about the brain or head can simultaneously serve to find an estimation of the ICP.
MRI is generally regarded as the technique of choice for morphologic imaging after sinonasal surgery of malignant neoplasms because of its superb contrast resolution, particularly valuable for the assessment of crucial areas such as the anterior skull base, the pterygopalatine fossa, the foramina and fissures that connect it to the orbit and middle cranial fossa.
The dura was freed from the orbits and anterior cranial vault, and LeFort III osteotomies were performed from above with the aid of IGS registered osteotomes to track our position relative to the patient's anatomic landmarks (Fig. 4).
