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2018 | 77 | 1 |

Tytuł artykułu

The supreme turbinate and the drainage of the posterior ethmoids: a computed tomographic study

Warianty tytułu

Języki publikacji

EN

Abstrakty

EN
Background: It is generally acknowledged that the posterior ethmoidal cells drain under the superior nasal turbinate (SorNT) or, rarely, under the supreme nasal turbinate (SmeNT), and the sphenoid ostium (SO) opens to the sphenoethmoidal recess. However, detailed relations between these structures are variable, complex and still not clear. There is no reliable data on the prevalence of SmeNT and drainage of the posterior ethmoidal cells under this structure. The aim of this study was to re-evaluate the anatomy of the aforementioned region. Materials and methods: Multiplanar and three-dimensional reconstruction analysis of 100 thin slice paranasal sinus computed tomography scans. Results: SmeNT was identified in 77 subjects (136 sides). It formed the ostium to the posterior ethmoidal cell adjacent to the skull base or orbit in 58 subjects (91 sides). This cell drained independently from the remaining posterior ethmoidal cells. The sphenoethmoidal (Onodi) cell drained to supreme meatus in 41 subjects (54 sides), and to superior meatus in 37 subjects (49 sides). SO was always located medial to the posteroinferior attachment of SmeNT, or SorNT (in absence of SmeNT). Conclusions: Patients with divergent drainage of the posterior ethmoids (with posterior ethmoidal cell draining to the supreme meatus) may require more extensive surgery to avoid persistence or recurrence of inflammatory disease. SmeNT is more common than thought, but due to its posterior and superior location to SorNT, it is rarely seen intraoperatively. If SmeNT is present, SO is always located medial to its posteroinferior attachment. (Folia Morphol 2018; 77, 1: 110–115)

Słowa kluczowe

Wydawca

-

Czasopismo

Rocznik

Tom

77

Numer

1

Opis fizyczny

p.110-115,fig.,ref.

Twórcy

autor
  • Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
autor
  • Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
  • Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland
autor
  • Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland
autor
  • Department of Otolaryngology, Medical University of Warsaw, Warsaw, Poland

Bibliografia

  • 1. Bolger WE, Keyes AS, Lanza DC. Use of the superior meatus and superior turbinate in the endoscopic approach to the sphenoid sinus. Otolaryngol Head Neck Surg. 1999; 120(3): 308–313, doi: 10.1016/S0194-5998(99)70267-6, indexed in Pubmed: 10064630.
  • 2. Christmas DA, Mirante JP, Yanagisawa E. Supreme nasal turbinate as a landmark during endoscopic sphenoid sinus surgery. Ear Nose Throat J. 2004; 83(2): 84–85, indexed in Pubmed: 15008437.
  • 3. Eweiss AZ, Ibrahim AA, Khalil HS. The safe gate to the posterior paranasal sinuses: reassessing the role of the superior turbinate. Eur Arch Otorhinolaryngol. 2012; 269(5): 1451–1456, doi: 10.1007/s00405-011-1832-3, indexed in Pubmed: 22086607.
  • 4. Fokkens WJ, Lund VJ, Mullol J, et al. EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology. 2012; 50(1): 1–12, doi: 10.4193/Rhino50E2, indexed in Pubmed: 22469599.
  • 5. Hopkins C. Nose, Nasal Cavity and Paranasal Sinuses. In: Susan Standring ed. Gray’s Anatomy. 561.The Anatomical Basis and Clinical Practice. Forty-first edition, Elsevier 2016.
  • 6. Kim HU, Kim SS, Kang SS, et al. Surgical anatomy of the natural ostium of the sphenoid sinus. Laryngoscope. 2001; 111(9): 1599–1602, doi: 10.1097/00005537-200109000-00020, indexed in Pubmed: 11568612.
  • 7. Kim SS, Lee JG, Kim KS, et al. Computed tomographic and anatomical analysis of the basal lamellas in the ethmoid sinus. Laryngoscope. 2001; 111(3): 424–429, doi: 10.1097/00005537-200103000-00009, indexed in Pubmed: 11224770.
  • 8. Millar DA, Orlandi RR. The sphenoid sinus natural ostium is consistently medial to the superior turbinate. Am J Rhinol. 2006; 20(2): 180–181, indexed in Pubmed: 16686384.
  • 9. Orhan M, Govsa F, Saylam C. A surgical view of the superior nasal turbinate: anatomical study. Eur Arch Otorhinolaryngol. 2010; 267(6): 909–916, doi: 10.1007/s00405-009-1169-3, indexed in Pubmed: 20012078.
  • 10. Orlandi RR, Lanza DC, Bolger WE, et al. The forgotten turbinate: the role of the superior turbinate in endoscopic sinus surgery. Am J Rhinol. 1999; 13(4): 251–259, indexed in Pubmed: 10485010.
  • 11. Stammberger H. Functional Endoscopic Sinus Surgery. The Messerklinger technique 1991.

Typ dokumentu

Bibliografia

Identyfikatory

Identyfikator YADDA

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