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Anatomical variation of the pneumatized superior turbinate and its impact on endoscopic sinus surgery in chronic rhinosinusitis

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Abstract

Purpose

The posterior ethmoid sinus is adjacent to important structures, such as the orbit, optic nerve, skull base, and ostium of the sphenoid sinus. The purpose of this study was to examine the effect of pneumatization of the superior turbinate (ST) and its basal lamella, and of the position of the anterior wall of the sphenoid sinus, on opening of the posterior ethmoid and sphenoid sinuses.

Methods

On axial, coronal, and sagittal computed tomography images, 394 sinuses of 197 patients who underwent endoscopic sinus surgery at Toho University Omori Medical Center in Tokyo, Japan, were classified according to the presence or absence of pneumatization of the ST and its basal lamella. The basal lamella of the ST was classified separately into the vertical and horizontal portions. We examined whether the classification of the anterior wall of the sphenoid sinus was associated with the structure of the ST.

Results

Pneumatization was observed in the ST in 28 sinuses (7.1%), in the vertical portion of the basal lamella in 127 (32.2%), and in the horizontal portion of the basal lamella in 90 (22.8%). Pneumatization in the horizontal portion of the basal lamella was significantly more common in the anterior sphenoidal wall classified as optic-canal type.

Conclusion

Consideration should be given to the pneumatization of the ST and its basal lamella and optic-canal-type anterior sphenoidal wall, because these reduce the volume of the posterior-most ethmoid cell and may increase the risk of damaging the skull base and optic nerve.

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Funding

None declared.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Toho University Omori Medical Center, Tokyo, Japan

    Riko Kajiwara, Teppei Takeda, Shinya Ohira, Kentaro Matsuura, Hanae Furuya, Hidehito Matsui & Kota Wada

  2. Department of Otorhinolaryngology, The Jikei University School of Medicine, 3-19-18 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan

    Kazuhiro Omura & Teppei Takeda

  3. Department of Otorhinolaryngology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan

    Kazuhiro Omura & Yasuhiro Tanaka

  4. Department of Otorhinolaryngology, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan

    Yuichiro Yaguchi

Authors
  1. Riko Kajiwara
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  2. Kazuhiro Omura
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  3. Teppei Takeda
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  4. Shinya Ohira
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  5. Kentaro Matsuura
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  6. Hanae Furuya
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  7. Hidehito Matsui
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  8. Yuichiro Yaguchi
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  9. Yasuhiro Tanaka
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  10. Kota Wada
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Contributions

RK: protocol development, data collection and management, data analysis, and manuscript writing. KO: protocol development, data analysis, manuscript editing. TT: protocol development, data collection. SO: data collection. KM: data collection. HF: data collection. HM: data collection. YY: data collection. YT: manuscript editing. KW: manuscript editing.

Corresponding author

Correspondence to Kazuhiro Omura.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kajiwara, R., Omura, K., Takeda, T. et al. Anatomical variation of the pneumatized superior turbinate and its impact on endoscopic sinus surgery in chronic rhinosinusitis. Surg Radiol Anat 42, 81–86 (2020). https://doi.org/10.1007/s00276-019-02313-9

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  • DOI: https://doi.org/10.1007/s00276-019-02313-9

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