By Dr. André Felippu, from the Felippu Institute
La surgical training app SurgSchool is proud to present the latest video uploaded to our platform. On this occasion, we have the privilege of having an intervention from the Dr. André Felippu from the prestigious Felippu Institute in São Paulo, Brazil. This meticulously documented surgery addresses the resection of an osteoma in the right ethmoid sinus using a centripetal approach.
Introduction to the Case: Right Ethmoidal Osteoma
In this intervention, we treat the case of a fifty-year-old patient with a history of frequent headaches. After a thorough diagnosis, it was decided to remove the osteoma, although the relationship between this type of injury and headaches is not fully established in the current medical literature.
Surgical Technique: Centripetal Approach and Ethmoidectomy
Dr. Felippu performs a precise and safe surgical approach. The centripetal technique used includes an ethmoidectomy with an incision anterior to the uncinate. Dissection of the lamina papyracea and skull base is then carried out, using an osteotome to ensure safe resection of the osteoma endoscopically, without complications.
Step by Step
1. Identification and Preparation: The surgery begins with partial resection of the middle cornet, preserving the tail and making an incision anterior to the uncinate bone. The maxillary sinus and the frontal sinus are located.
2. Access to the Frontal Sinus: With the use of a curved chisel and a knife, the frontal sinus is accessed directly. Partial resection of the uncinate allows drainage of the frontal sinus, exposing the lesion.
3. Exposure and Resection of the Lesion: The orbit and central lesion are adequately exposed. Using the osteotome, fractures are made parallel to the orbit to carefully move the lesion. The lesion is detached from the base of the skull and removed en bloc.
4. Results and Conclusions: The centripetal technique used by Dr. Felippu allows for efficient and safe removal of the osteoma. The surgery concludes with a clear exposure of the frontal sinus and the anterior ethmoidal artery, achieving an optimal result without complications.
