Abducens Nerve Paralysis Induced by a Primary Solitary Sphenoid Sinus Mucocele with Broad Osseous Thinning at the Cranial Base

Figure 4

Surgical findings. (a) Remedial surgery is performed on the nasal septum with exfoliation of the vomer bone. (b) Approximately one-third of the lower middle nasal concha is removed on both sides. (c) The rear end of the membranous septa is removed on both sides. (d) The vomer bone is removed by drilling, and (e) the frontal cystic wall is resected with the pituitary scalpel. (f) Bones of the cranial base showed thinning, with pulsations and dura mater observed through them (black arrow). r IC, right internal carotid artery and l IC, left internal carotid artery. (g), (h) Cranial base reinforcement using fat and fascia collected from the femur, and (i) hemostatic packing.

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