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Radiological relationship of the ethmoid slit with the frontal sinus and the anterior ethmoidal artery and applications to the frontal sinus drillout

  • Rhinology
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To compare two types of CT acquisition parameters: CT scan of the facial bone and CT scan of the sinuses, for studying the ethmoidal slit and its relationship with the frontal sinus and anterior ethmoidal artery.

Materials and methods

Retrospective study of 145 scans of the sinuses and 79 of the facial bones performed between 2012 and 2016. On each scan, the visibility of the ethmoidal slits, their length, their distance from the ethmoidal artery, and their relationship with the anterior and posterior wall of the frontal sinus were studied.

Results

The ethmoidal slit was better visualized on CT scans of the facial bone (58.2%) than on those of the sinuses (43.1%) (p = 0.02). The distance between the anterior ethmoidal artery and the anterior part of the cribriform plate was 9.3 mm for CT scans of the facial bone and 8.4 mm for CT scans of the sinuses. The theoretical risk of damaging the glabellar soft tissue and that of damaging the meninges during a frontal sinusotomy was evaluated, respectively, at 9.6% and 26.1% for CT scans of the facial bone, and at 6.2% and 21.5% for sinus scans.

Conclusions

CT scans of the facial bone are better than CT scans of the sinuses for identifying ethmoidal slits and their distance from the canal of the anterior ethmoidal artery. The identification of these elements is relevant for the surgeon during frontal sinus surgery and makes it possible to assess the risk of damaging the glabellar soft tissue or meninges. Performing a CT scan of the facial bone seems preferable to that of a CT scan of the sinuses in certain pathological situations, such as cerebrospinal rhinorrhea or revision surgeries of the frontal sinus.

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References

  1. Castelnuovo P, Dallan I, Battaglia P, Bignami M (2010) Endoscopic endonasal skull base surgery: past, present and future. Eur Arch Otorhinolaryngol 267:649–663

    Article  Google Scholar 

  2. Patron V, Hitier M (2021) Chirurgie endoscopique endonasale. Elsevier Health Sciences

  3. Seyedhadi S, Mojtaba MA, Shahin B, Hoseinali K (2013) The Draf III septal flap technique: a preliminary report. Am J Otolaryngol 34:399–402

    Article  Google Scholar 

  4. Schuknecht B, Simmen D, Briner HR, Holzmann D (2008) Nontraumatic skull base defects with spontaneous CSF rhinorrhea and arachnoid herniation: imaging findings and correlation with endoscopic sinus surgery in 27 patients. Am J Neuroradiol 29:542–549

    Article  CAS  Google Scholar 

  5. Rouvière H (1911) Précis d’anatomie et de dissection, 1st edn. Masson, Paris

    Google Scholar 

  6. Gray H (1858) Anatomy, descriptive and surgical, 1st edn. Blanchard and Lea, Philadelphia

    Google Scholar 

  7. Patron V, Berkaoui J, Jankowski R et al (2015) The forgotten foramina: a study of the anterior cribriform plate. Surg Radiol Anat 37:835–840

    Article  Google Scholar 

  8. Roussel L-M, Patron V, Maubert E et al (2019) New landmarks in endonasal surgery: from nasal bone to anterior cribriform plate including branches of anterior ethmoidal artery and nerve and terminal nerve. Int Forum Allergy Rhinol 10:395

    Article  Google Scholar 

  9. Patron V, Roussel L-M, Moreau S, Hitier M (2020) How to identify the anterior cribriform plate in the medial approach to the frontal sinus. Eur Ann Otorhinolaryngol Head Neck Dis 138:201

    Article  Google Scholar 

  10. Jankowski R (2007) Endoscopic resection of the olfactory cavity. Fr ORL 93:341–346

    Google Scholar 

  11. Escalard C, Roussel L-M, Hamon M et al (2019) New detailed description of the anterior part of the cribriform plate using anatomic specimens and computed tomography. Surg Radiol Anat 41:801–808

    Article  Google Scholar 

  12. Hooper AC (1982) The cribriform plate and cerebrospinal fluid rhinorrhoea. Ir J Med Sci 151:31–35

    Article  CAS  Google Scholar 

  13. Lang J (1989) Clinical anatomy of the nose, nasal cavity and paranasal sinuses. Thieme

  14. Upadhyay S, Buohliqah L, Vieira Junior G et al (2016) First olfactory fiber as an anatomical landmark for frontal sinus surgery. Laryngoscope 126:1039–1045

    Article  Google Scholar 

  15. Chang C-M, Jaw F-S, Lo W-C et al (2016) Three-dimensional analysis of the accuracy of optic and electromagnetic navigation systems using surface registration in live endoscopic sinus surgery. Rhinology 54:88–94

    Article  Google Scholar 

  16. Citardi MJ, Yao W, Luong A (2017) Next-generation surgical navigation systems in sinus and skull base surgery. Otolaryngol Clin North Am 50:617–632

    Article  Google Scholar 

  17. Kalmey JK, Thewissen JGM, Dluzen DE (1998) Age-related size reduction of foramina in the cribriform plate. Anat Rec 251:326–329

    Article  CAS  Google Scholar 

  18. Ganjaei KG, Soler ZM, Mappus ED et al (2019) Radiologic changes in the aging nasal cavity. Rhinology 57:117–124

    Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Radiology, CHU de Caen, 14000, Caen, France

    Laurie Begaud, Clément Escalard & Michèle Hamon

  2. Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Caen, Avenue de La Côte de Nacre, 14000, Caen, France

    Vincent Patron, Martin Hitier & Maxime Humbert

  3. Department Anatomy, UNICAEN, 14032, Caen, France

    Martin Hitier

Authors
  1. Laurie Begaud
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  2. Vincent Patron
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  3. Clément Escalard
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  4. Martin Hitier
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  5. Michèle Hamon
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  6. Maxime Humbert
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Correspondence to Vincent Patron.

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Begaud, L., Patron, V., Escalard, C. et al. Radiological relationship of the ethmoid slit with the frontal sinus and the anterior ethmoidal artery and applications to the frontal sinus drillout. Eur Arch Otorhinolaryngol 280, 227–233 (2023). https://doi.org/10.1007/s00405-022-07527-z

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  • DOI: https://doi.org/10.1007/s00405-022-07527-z

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