Graphical Abstract
Three-dimensional anatomy of the junction between the posterior ethmoidal region and the sphenoid sinus
Volume: 0 - Issue: 0
First page: 0 - Last page: 0
M. Eördögh - A.A. Menabbawy - L. Bárány - M. Kirsch - R. Reisch - G. Baksa - H.W.S. Schroeder - W. Hosemann - H.R. Briner
DOI: 10.4193/Rhin24.565
BACKGROUND: The anatomy of the sphenoethmoidal recess is of clinical importance, however, the literature focuses on the superior turbinate and the sphenoid ostium. We analyzed the entire junction of the posterior ethmoidal region and the sphenoid sinus (SEJ) to define possible regularities. METHODS: We analyzed the junction between the posterior ethmoidal region and the sphenoid sinus on CT scans of 100 paranasal sinuses from 50 individuals using the 3D Slicer software. RESULTS: The SEJ had two components: medially the sphenoethmoidal recess, laterally the wall between these aeriated regions, the latter built by the basal lamella of the superior turbinate (4BL) in 92.0%. The 4BL was a constant structure (100.0%), its most frequent phenotype was a frontally oriented pentangular wall without dehiscences (44.0%). There were no bony walls between the 3BL and the anterior wall of the sphenoid sinus in 49.0% and there was one wall in 42.0%. The 4BL had three complicating factors: firstly, it shifted to anterior, if the supreme turbinate was present (43.0%). Secondly, the pneumatization of the 4BL and the superior turbinate (25.0%) was related to an incomplete-dehiscent anterior 4BL wall. Thirdly, sphenoethmoidal cells (36.0%) led to a bony contact of the optic canal and the 4BL (33.0%). CONCLUSIONS: The 4BL is an important landmark for endoscopic sinus and skull base surgery with highly constant morphology and a typical phenotype. Surgeons should be aware that after dissection of the 3BL the next wall is likely the 4BL which mostly merges to the ASW. This study can help surgeons to detect anatomical variations and improve their intraoperative orientation.
Rhinology 0-0: 0-0, 0000
