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Posterior ethmoid cell expansion towards the inferolateral region of the sphenoid sinus: a computed tomography study

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Abstract

Objective

The aim of this study was to investigate the anatomical imaging characteristics of posterior ethmoid cells (PEs) expanding towards the inferolateral region of the sphenoid sinus (SS).

Methods

This study included a total of 278 inpatients (556 sides) whose paranasal sinus computed tomography (CT) scans were reviewed and collected from May 2018 to February 2019. The anatomical imaging characteristics of PEs expanding towards the inferolateral region of the SS were observed.

Results

PEs expanding towards the inferolateral region of the SS formed an inferolateral spheno-ethmoid cell (ISEC). ISECs were observed on three sides (0.54%; 3/556) in three cases (1.08%; 3/278). All of the ISECs were present unilaterally on the right side of the SS. The ISECs originated from the most posterior ethmoid cell; they were first located at the medial aspect of the orbital apex, pneumatized continually backward to the inferomedial wall of the orbital apex, and then extended into the lateral region of the SS. The ISECs further extended laterally, inferiorly and posteriorly beyond the sphenoid body into the greater wing and/or pterygoid process.

Conclusion

An ISEC is a rare variation of ethmoid air cells. Preoperative recognition of ISECs is essential to achieve safe and effective endoscopic sinus surgery because of the important anatomical location.

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Abbreviations

EMS:

Ethmoid maxillary sinus

ESS:

Endoscopic sinus surgery

ICA:

Internal carotid artery

ISEC:

Inferolateral spheno-ethmoid cell

LRS:

Lateral recess of the sphenoid sinus

MS:

Maxillary sinus

OA:

Orbital apex

PE:

Posterior ethmoid cell

RMPE:

Retromaxillary posterior ethmoid cell

SS:

Sphenoid sinus

SOEC:

Supraorbital ethmoid cell

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Acknowledgements

The general work was supported by the Beijing Natural Science Foundation (7162066) and the National Natural Science Foundation of China (no. 81271090/H1304).

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Authors and Affiliations

  1. Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China

    Jinfeng Liu & Ningyu Wang

  2. Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China

    Qitong Liu

Authors
  1. Jinfeng Liu
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  2. Qitong Liu
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  3. Ningyu Wang
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Contributions

JL discovered and identified this anatomical variation, analysed the clinical significance of this variation, and wrote the manuscript. NW and JL reconfirmed this anatomical variation together. QL completed the image editing.

Corresponding authors

Correspondence to Jinfeng Liu or Ningyu Wang.

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The authors have no relevant competing interests to declare in relation to this manuscript.

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Liu, J., Liu, Q. & Wang, N. Posterior ethmoid cell expansion towards the inferolateral region of the sphenoid sinus: a computed tomography study. Surg Radiol Anat 41, 1011–1018 (2019). https://doi.org/10.1007/s00276-019-02277-w

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  • DOI: https://doi.org/10.1007/s00276-019-02277-w

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