Careful preoperative study of the paranasal sinus CT scans in patients undergoing sinus surgery seems to be the most important thing needed to prevent severe intraoperative complications. A thorough anatomic knowledge of the anterior skull base is needed for a safe surgery, either endoscopic sinus surgery or external rhinoplasty to avoid possible major complications that may occur during the operation. Coronal CT scan has contributed not only to the evaluation of sinonasal diseases, but also to the characterization of the paranasal sinuses anatomy.
The Keros classification is a method of classifying the depth of the olfactory fossa-ethmoid roof.
The ethmoid labyrinth is covered by the fovea ethmoidalis of the frontal bone and separates the ethmoidal cells from the anterior cranial fossa. The very thin, horizontal cribriform plate (lamina cribrosa) of the ethmoid bone is bounded laterally by the vertical lateral lamella. The lateral lamella joins the cribriform plate to the fovea ethmoidalis.
The depth of the olfactory fossa is determined by the height of the lateral lamella of the cribriform plate. Keros in 1962, classified the depth into three categories.
Type 1: has a depth of 1-3 mm (26.3% of population)
Type 2: has a depth of 4-7mm (73.3% of population)
Type 3: has a depth of 8-16mm (0.5% of population)
The type 3 essentially exposes more of the very thin cribriform plate to potential damage from trauma, tumor erosion, CSF erosion (in benign intracranial hypertension) and local nasal surgery or orbital decompression.
Thin bone in the skull base, especially the cribriform plate, is susceptible to erosion, encephalomeningocoele herniation and CSF leaks.
Currently, endoscopic frontal sinuses surgery is considered as the treatment of choice for chronic rhino sinusitis resistant to clinical management, as well as for approaching a number of conditions such as mucocele, choanal atresia, nasal polyposis, sellar and parasellar tumors, optic nerve decompression, management of epistaxis and epiphora caused by lower lacrimal ducts obstruction.
Superior osteotomies are routinely performed in external rhinoplasty in hump reduction procedures.
Although the incidence of intraoperative complications is low, severe complications such as intraorbital hematomas with visual loss and intracranial penetration with CSF leak may occur. Most of major complications are related to surgical manipulation of the ethmoidal and frontal sinuses.
The knowledge about the complex skull base anatomy and anatomical relations, including the fovea ethmoidalis and lateral lamella of the cribriform plate, is essential in the prevention of complications in endoscopic nasal surgeries and external rhinoplasty where superior bony osteotomies are being performed.
Third Eye-Pineal Gland
The pineal gland is an important endocrine gland. It is a small, oval structure descending from the roof of the diencephalon, a section of the brain that relays sensory information between the brain’s different regions. Although it’s very tiny-only about six millimeters long-the pineal gland produces several important hormones. The most significant of these is melatonin, a hormone which regulates the circadian rhythm, or sleep cycle. In some of the lower vertebrates this. gland grows into an eyelike structure; in others, although it isn’t a fully developed eye, it is still able to act as a light receptor. Because of this, the pineal gland is also known as the third eye.
Along with secreting melatonin, the pineal gland also regulates other endocrine functions and converts signals from the nervous system into endocrine signals. Melatonin production (or the lack of it) can contribute to a person feeling awake or becoming sleepy, and the pineal gland’s endocrine function regulation can also influence sexual development.
The pineal gland, the most enigmatic of endocrine organs, has long been of interest to anatomists. The 17th-century French philosopher René Descartes concluded that the pineal gland was the seat of the soul. A corollary notion was that calcification of the pineal caused psychiatric disease, but modern imaging techniques revealed that the pineal gland becomes more or less calcified in most people.
Yoga Science- Kundalini yoga acknowledged the role of the pineal gland in the spiritual process. In the Kundalini system, which has seven distinct energy centers, the pineal gland has been variously identified with the Ä€jÅˆÄ Chakra .
