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Assessment of the prelacrimal recess in different maxillary sinus pneumatizations in relation to endoscopic prelacrimal recess approaches: a computed tomography study

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A Correction to this article was published on 03 July 2023

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Abstract

Purpose

To assist in planning before the endoscopic prelacrimal recess (PLR) approach, we aimed to investigate the relationship between morphometry and variations of PLR in maxillary sinus (MS) pneumatizations.

Methods

Retrospective analysis of the paranasal sinus computed tomography images of 150 patients was conducted to determine the pneumatization patterns of the MS, PLR variations, and the applicability of the PLR approach. The results were compared based on lateralization, gender, and age groups.

Results

The PLRwidth, the anteroposterior diameter of the nasolacrimal duct (NLD), the vertical and horizontal diameters of the MS were the highest in hyperplasic MS, and decreased significantly with increasing age (p = 0.005, p = 0.017, p = 0.000), respectively. Most of the morphometric measurements were higher in hyperplasic MS, while the medial wall thickness of PLR was higher in hypoplasic MS. The PLRwidth for feasibility of the PLR approach were Type I (48%) in hypoplasic MS and Type III (80%) in hyperplasic MS (p < 0.001), respectively. The PLR medial wall thickness was higher in Type I, while the piriform aperture angle (PAA), MS volume, length, and slope of the NLD were higher in Type III PLRwidth (p = 0.000), respectively. The highest anterior and separation-type variations of the PLR were observed in hyperplasic MS, whereas 31.0% of hypoplasic MS had no PLR (p < 0.001).

Conclusion

This study revealed that PLRwidth and PAA were the highest in hyperplasic MS, which allows the endoscopic PLR approach to be performed more easily. For safer and uncomplicated surgery, surgeon should be aware of the PLR anatomy in different MS pneumatization patterns.

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Data availability

The data supporting this study's findings are available from the corresponding author upon reasonable request.

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References

  1. Aktuna Belgin C, Colak M, Adiguzel O, Akkus Z, Orhan K (2019) Three-dimensional evaluation of maxillary sinus volume in different age and sex groups using CBCT. Eur Arch Otorhinolaryngol 276:1493–1499. https://doi.org/10.1007/s00405-019-05383-y

    Article  PubMed  Google Scholar 

  2. Andrianakis A, Moser U, Wolf A, Kiss P, Holzmeister C, Andrianakis D, Tomazic PV (2021) Gender-specific differences in feasibility of pre-lacrimal window approach. Sci Rep 11:7791. https://doi.org/10.1038/s41598-021-87447-w

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Arosio AD, Valentini M, Canevari FR, Volpi L, Karligkiotis A, Terzakis D, Battaglia P, Georgalas C, Bignami M, Castelnuovo P, Turri-Zanoni M (2021) Endoscopic endonasal prelacrimal approach: radiological considerations, morbidity, and outcomes. Laryngoscope 131:1715–1721. https://doi.org/10.1002/lary.29330

    Article  PubMed  Google Scholar 

  4. Chen Z, Wang J, Wang Q, Lu Q, Zheng Z (2020) Assessment of the prelacrimal recess in maxillary sinus in different sex and age groups using cone beam computed tomography (CBCT). Eur Arch Otorhinolaryngol 277:777–783. https://doi.org/10.1007/s00405-019-05749-2

    Article  PubMed  Google Scholar 

  5. Chen Z, Wang Q, Wang P (2021) Prevalence of the prelacrimal recess in maxillary sinus and its medial bony wall dimensions. Eur Arch Otorhinolaryngol 278:1099–1105. https://doi.org/10.1007/s00405-020-06400-1

    Article  PubMed  Google Scholar 

  6. Craiu C, Rusu MC, Hostiuc S, Săndulescu M, Derjac-Aramă AI (2017) Anatomic variation in the pterygopalatine angle of the maxillary sinus and the maxillary bulla. Anat Sci Int 92:98–106. https://doi.org/10.1007/s12565-015-0320-z

    Article  CAS  PubMed  Google Scholar 

  7. Duman SB, Gumussoy İ (2021) Assesment of prelacrimal recess in patients with maxillary sinus hypoplasia using cone beam computed tomography. Am J Rhinol Allergy 35:361–367. https://doi.org/10.1177/1945892420959592

    Article  PubMed  Google Scholar 

  8. Iwanaga J, Wilson C, Lachkar S, Tomaszewski KA, Walocha JA, Tubbs RS (2019) Clinical anatomy of the maxillary sinus: application to sinus floor augmentation. Anat Cell Biol 52:17–24. https://doi.org/10.5115/acb.2019.52.1.17

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kashlan K, Craig J (2018) Dimensions of the medial wall of the prelacrimal recess. Int Forum Allergy Rhinol 8:751–755. https://doi.org/10.1002/alr.22090

    Article  PubMed  Google Scholar 

  10. Khong GC, Medikeri G, Tierney C, Leong SC (2020) Adjunctive techniques to improve access of the endoscopic prelacrimal recess approach. Laryngoscope 130:1857–1863. https://doi.org/10.1002/lary.28259

    Article  PubMed  Google Scholar 

  11. Kim H, Jung T, Park JY, Lee J, Cho JH, Kim JK (2022) A retrospective CT analysis for prelacrimal window access to maxillary sinus. J Rhinol 29:38–42. https://doi.org/10.18787/jr.2021.00394

    Article  CAS  Google Scholar 

  12. Lee JJ, Ahmad ZAM, Kim D, Ryu G, Kim HY, Dhong HJ, Chung SK, Hong SD (2019) Comparison between endoscopic prelacrimal medial maxillectomy and caldwell-luc approach for benign maxillary sinus tumors. Clin Exp Otorhinolaryngol 12:287–293. https://doi.org/10.21053/ceo.2018.01165

    Article  CAS  PubMed  Google Scholar 

  13. Lessa AMG, Oliveira VS, Costa RBA, Meneses ATR, Crusoé-Rebello I, Costa FWG, Neves FS (2023) Anatomical study of the maxillary sinus: which characteristics can influence its volume? Surg Radiol Anat 45:81–87. https://doi.org/10.1007/s00276-022-03055-x

    Article  PubMed  Google Scholar 

  14. Lin Z, Kamath N, Malik A (2021) Morphometric differences in normal bony nasolacrimal anatomy: comparison between four ethnic groups. Surg Radiol Anat 43(2):179–185. https://doi.org/10.1007/s00276-020-02614-4

    Article  PubMed  Google Scholar 

  15. Lock PSX, Siow GW, Karandikar A, Goh JPN, Siow JK (2019) Anterior maxillary wall and lacrimal duct relationship in Orientals: CT analysis for prelacrimal access to the maxillary sinus. Eur Arch Otorhinolaryngol 276:2237–2241. https://doi.org/10.1007/s00405-019-05446-0

    Article  PubMed  Google Scholar 

  16. Sieskiewicz A, Buczko K, Janica J, Lukasiewicz A, Lebkowska U, Piszczatowski B, Olszewska E (2017) Minimally invasive medial maxillectomy and the position of nasolacrimal duct: the CT study. Eur Arch Otorhinolaryngol 274:1515–1519. https://doi.org/10.1007/s00405-016-4376-8

    Article  PubMed  Google Scholar 

  17. Simmen D, Veerasigamani N, Briner HR, Jones N, Schuknecht B (2017) Anterior maxillary wall and lacrimal duct relationship - CT analysis for prelacrimal access to the maxillary sinus. Rhinology 55:170–174. https://doi.org/10.4193/Rhino16.318

    Article  CAS  PubMed  Google Scholar 

  18. Sirikçi A, Bayazit Y, Gümüsburun E, Bayram M, Kanlikana M (2000) A new approach to the classification of maxillary sinus hypoplasia with relevant clinical implications. Surg Radiol Anat 22:243–247. https://doi.org/10.1007/s00276-000-0243-8

    Article  PubMed  Google Scholar 

  19. Tatlisumak E, Aslan A, Cömert A, Ozlugedik S, Acar HI, Tekdemir I (2010) Surgical anatomy of the nasolacrimal duct on the lateral nasal wall as revealed by serial dissections. Anat Sci Int 85:8–12. https://doi.org/10.1007/s12565-009-0044-z

    Article  PubMed  Google Scholar 

  20. Wang X, Chen X, Zheng M, Liu C, Wang C, Zhang L (2019) The Relationships between the nasolacrimal duct and the anterior wall of the maxillary sinus. Laryngoscope 129:1030–1034. https://doi.org/10.1002/lary.27420

    Article  PubMed  Google Scholar 

  21. Whyte A, Boeddinghaus R (2019) The maxillary sinus: physiology, development and imaging anatomy. Dentomaxillofac Radiol 48:20190205. https://doi.org/10.1259/dmfr.20190205

    Article  PubMed  PubMed Central  Google Scholar 

  22. Yu QQ, Guan G, Zhang NK, Zhang XW, Jiang Y, Lian YY, Liu TT, Jiang XD, Li N (2018) Intranasal endoscopic prelacrimal recess approach for maxillary sinus inverted papilloma. Eur Arch Otorhinolaryngol 275:2297–2302. https://doi.org/10.1007/s00405-018-5078-1

    Article  PubMed  PubMed Central  Google Scholar 

  23. Zhou B, Han DM, Cui SJ, Huang Q, Wei YX, Liu HC, Liu M (2007) Endoscopic nasal lateral wall dissection approach to maxillary sinus [inChinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 42:743–748

    PubMed  Google Scholar 

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Funding

No funds, grants, or other support were received. The authors have no relevant financial relationships to disclose.

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Authors and Affiliations

  1. Department of Anatomy, Meram Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey

    Rukiye Soyal, Gülay Açar, Aynur Emine Çiçekcibaşı & Ahmet Safa Gökşan

  2. Department of Radiology, Meram Faculty of Medicine, Necmettin Erbakan University, 42090, Meram, Konya, Turkey

    Demet Aydoğdu

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  1. Rukiye Soyal
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  2. Gülay Açar
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Contributions

SR, AG, GAS: Methodology, Software. SR, AG, AD: Visualization, Investigation. SR, GAS, AD: Data curation, Original draft preparation. AG, ÇAE: Validation, Supervision. SR, AG: Figures and tables preparation. SR, AG, ÇAE, GAS, AD: Writing and Reviewing.

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Correspondence to Gülay Açar.

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Ethical approval was given by the Ethics Committee of Necmettin Erbakan University, approval number 2022/3703.

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Soyal, R., Açar, G., Çiçekcibaşı, A.E. et al. Assessment of the prelacrimal recess in different maxillary sinus pneumatizations in relation to endoscopic prelacrimal recess approaches: a computed tomography study. Surg Radiol Anat 45, 963–972 (2023). https://doi.org/10.1007/s00276-023-03181-0

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