Asymmetry of the Ethmoid Roof: Analysis Using Coronal Computed Tomography

Abstract

In a patient population with sinus and nasal symptoms, the height and contour of the right and left fovea ethmoidalis were symmetric in less than 50% of individuals. The asymmetry was most often the result of a difference in contour with flattening of the fovea on one side. This underscores the importance of careful preoperative and intraoperative review of paranasal sinus CT scans in patients undergoing endoscopic sinus surgery.

Incidence of sinonasal anatomical variations associated with chronic sinusitis by CT scan in Karaikal, South India

“…Since anatomical variations are common in any population and this variation is often ethnic based on genetic and environmental factors. 8,9 An anatomic variation study reviewing the CT scans of 100 Caucasian and 100 Chinese patients found statistically significant difference in the occurrence of concha bullosa, pneumatised middle turbinate, Haller and Onodi cells between the two groups. 10 Literature review showed no such published data in this geographical region.…”

Importance of Ethmoidal Roof in Endoscopic Sinus Surgery

“…[16,17] Injury to surrounding structures during endoscopic ethmoid surgery can lead to cerebrospinal fluid leak, damage to orbital structures and bleeding. In serious injuries, direct penetration trauma to the dura, serious intracranial and intracerebral complications can occur [10,18]. The commonest sites of injury in anterior cranial fossa is the cribriform plate and roof of the ethmoid sinus [19].…”

A computerized tomographic study of height of ethmoidal skull base

“…2 The thin lateral lamella of cribriform plate and low Ethmoid Skull Base (ESB) are potential anatomical variants that can lead to iatrogenic injuries in the form of direct penetration trauma to the Dura, serious intracranial and intra-cerebral complications during ESS. [3][4][5][6][7][8][9] ESB is defined as the orbital plate of the frontal bone, which extends from the superior attachment of Lateral Lamella of Cribriform Plate (LCP) medially to the junction of the Lamina Papyracea (LP) laterally ( Figure 1). 10 Previous studies have classified ESB as Keros I, II, III, based on the length of lateral lamella of cribriform plate or depth of olfactory fossa.…”

“…11,12 Another study quantified ESB into high (>7 mm), moderate (4 to 7 mm) and low ESB (1 to 4 mm) depending upon the height of the ESB measured from a reference plane. 13 Even though many studies reporting occurrence of low ESB causing complications during ESS exist [3][4][5][6][7][8][9] only limited studies have evaluated low ESB till date. 13,14 So the present study aims to evaluate and classify ESB preoperatively using coronal paranasal sinus CT scan images in Indian population and to deduce the relationship of ESB between side and gender.…”