Sanat Bhatkar1, Manoj Kumar Goyal1, Aastha Takkar1, Manish Modi1, Kanchan K Mukherjee2, Paramjeet Singh3, Bishan Das Radotra4, Ramandeep Singh5, Vivek Lal1. 1. Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 2. Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 3. Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 4. Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. 5. Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
INTRODUCTION: Ishikawa and Jefferson are the two most commonly used systems used for the classification of cavernous sinus syndrome (CSS). However, relative utilities of these two classification systems have not been evaluated in detail in developing countries. In this study, we compared relative utilities of these two classification schemes in the evaluation of CSS. OBJECTIVE: To compare the utility of Jefferson and Ishikawa classifications in the evaluation of CSS. PATIENTS AND METHODS: A total of 73 consecutive patients of CSS were prospectively classified using either Ishikawa or Jefferson classification and relative utility of these two classification schemes in determining etiology of CSS was compared. RESULTS: While only 46.6% of patients could be classified using Jefferson classification, 95.5% of patients could be classified using Ishikawa scheme. CSS was classified as anterior, middle, and posterior in 17.8%, 21.9%, and 8.2% of patients, respectively, as per the Jefferson classification. As per the Ishikawa classification, 37% of patients each showed anterior and posterior CSS, 16.4% showed middle CSS, whereas 4.1% had whole CSS. Middle CSS was significantly associated with the presence of fungal infections (P = 0.045) as per Jefferson classifications, and anterior CSS was significantly associated with a vascular etiology (P = 0.005) as per Ishikawa classification. Overall, inflammatory causes were the most common cause for anterior CSS, while tumors accounted for maximum cases of posterior CSS. CONCLUSION: Although more number of patients could be classified using Ishikawa classification, there was no advantage of Ishikawa classification over Jefferson with regard to determination of etiology of CSS.
INTRODUCTION: Ishikawa and Jefferson are the two most commonly used systems used for the classification of cavernous sinus syndrome (CSS). However, relative utilities of these two classification systems have not been evaluated in detail in developing countries. In this study, we compared relative utilities of these two classification schemes in the evaluation of CSS. OBJECTIVE: To compare the utility of Jefferson and Ishikawa classifications in the evaluation of CSS. PATIENTS AND METHODS: A total of 73 consecutive patients of CSS were prospectively classified using either Ishikawa or Jefferson classification and relative utility of these two classification schemes in determining etiology of CSS was compared. RESULTS: While only 46.6% of patients could be classified using Jefferson classification, 95.5% of patients could be classified using Ishikawa scheme. CSS was classified as anterior, middle, and posterior in 17.8%, 21.9%, and 8.2% of patients, respectively, as per the Jefferson classification. As per the Ishikawa classification, 37% of patients each showed anterior and posterior CSS, 16.4% showed middle CSS, whereas 4.1% had whole CSS. Middle CSS was significantly associated with the presence of fungal infections (P = 0.045) as per Jefferson classifications, and anterior CSS was significantly associated with a vascular etiology (P = 0.005) as per Ishikawa classification. Overall, inflammatory causes were the most common cause for anterior CSS, while tumors accounted for maximum cases of posterior CSS. CONCLUSION: Although more number of patients could be classified using Ishikawa classification, there was no advantage of Ishikawa classification over Jefferson with regard to determination of etiology of CSS.
Entities:
Keywords:
Cavernous sinus syndrome; Ishikawa; Jefferson
Authors: Susana Fernández; Oscar Godino; Sergio Martínez-Yélamos; Edilia Mesa; Jordi Arruga; José María Ramón; Juan José Acebes; Francisco Rubio Journal: Medicine (Baltimore) Date: 2007-09 Impact factor: 1.889