Rakesh Kumar Singh

Abstract

Background: Endoscopic skull base surgery is an emerging surgical technique that recolonized the resection of skull base lesions. The present study analyzed the outcome of the endoscopic endonasal anterior skull base. Materials and Methods: A retrospective data review ofendoscopic endonasal anterior skull base surgeries performed from 2017 to 2022. Minimum follow-up was done 6 months postoperatively. Results: 63 cases of anterior skull base pathologies have been operated out of which 2 cases of meningioma, 3 cases of meningoencephalocele, 5 olfactory neuroblastoma, 18 angiofibroma extending till anterior skull base, 8 CSF rhinorrhea repair, 12 pituitary macroadenoma, 8 cerebral Mucormycosis and 7 sino-nasal mass with intracranial extension have been operated. Residual disease was left in 10 cases, the rest all the masses were completely removed. The overall complication rate was 28.6 percent. Three mortalities occur a few months post-operatively of which 2 were cerebral mucormycosis and one was sino-nasal malignancy with intracranial extension. Conclusion: Endoscopic endonasal anterior skull base surgeries are safe surgical procedure that provides a high degree of disease clearance and negligible complications. Keywords: Endonasal, Endoscopic, Anterior skull base, Outcome

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Abstract

Background: The pathophysiology of Chronic Rhino-Sinusitis with Nasal Polyposis (CRSwNP) showed distinct ethnic and geographic differences whereas the Western Caucasian population revealed Th2 eosinophilic inflammation in contrary to the Asian Mongolian population with Th1-Th17 non-eosinophilic inflammatory pattern. Materials and Methods: Prospective Observational study was undertaken from December 2019 to December 2021 on 50 patients who were diagnosed to have sinonasal polyposis. The collected polyp tissue was sent to the histopathological department for further microscopic evaluation. The types of inflammatory cell infiltrate studied in the tissue specimens obtained during surgery included lymphocytes, eosinophils, neutrophils, mast cells, and plasma cells. Results: The age of patients ranged from 11 to 70 years with a mean age of 31.80±17.69 years. The male to female ratio was 1.3:1. The 62% of patients showed the predominance of eosinophil which was of grade III and grade IV category, Lymphocyte infiltrate of grades III and IV was present in 46% of cases, Mast cell was 30% and 10% of grade III and Grade IV respectively, and the Neutrophils were found only in 22% and 105 of cases of grade III & Grade IV, respectively which was the least of all inflammatory cells found in polyp tissue. Conclusion: The cellular predominance was shifted toward the Th2 type of inflammation with the predominance of Eosinophil, Lymphocytes, Plasma cells, and mast cells in the Asian Aryan sub origin population contrary to the Th17 type of inflammation as indicated by the least infiltration of Neutrophils as reported in Asian Mongolian Populations.   Keywords: Sinonasal polyposis, Lymphocytes, Eosinophils, Neutrophils, Mast cells, and Plasma cells

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