Computed Tomographic and Anatomical Analysis of the Basal Lamellas in the Ethmoid Sinus

Kim, Sung-Shik; Lee, Jeung‐Gweon; Kim, Kyung Soo; Kim, Hyun Ung; Chung, In Hyuk; Yoon, Joo‐Heon

doi:10.1097/00005537-200103000-00009

Cited by 11 publications

(14 citation statements)

References 8 publications

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“…Similar to the middle turbinate basal lamella, these are an anterior coronally oriented part, and a posterior axially oriented part. This observation had been previously reported in cadaveric and radiological studies [5], but had not been commented upon in actual operative studies. Both the coronal and axial parts were attached laterally to the lamina papyracea.…”

Section: Surgical Techniquementioning

confidence: 53%

“…In a detailed cadaveric and radiological study, Kim et al [5] found that the coronal part of the superior turbinate basal lamella was only present in 69% of the specimens. In the remaining specimens, the axial part of the superior turbinate basal lamella fused with the middle turbinate basal lamella and inserted to the skull base as one structure.…”

Section: Discussionmentioning

confidence: 99%

“…Kim et al [5] identiWed the axial part of the superior turbinate basal lamella in 100% of their specimens. In our operative study, this structure was identiWed only in 88% of the operated sides.…”

Section: Discussionmentioning

confidence: 99%

“…There have been, however, several articles presenting cadaveric and/or radiological studies of the superior turbinate [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

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The safe gate to the posterior paranasal sinuses: reassessing the role of the superior turbinate

Eweiss

Ibrahim

Khalil

2011

Eur Arch Otorhinolaryngol

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Surgery of the posterior ethmoid and sphenoid sinuses can be challenging. In 1999, a technique was described for identification of the superior turbinate and utilizing it as a landmark in endoscopic posterior ethmoidectomy and sphenoidotomy. Although this was more than a decade ago, it has not been supported by further studies. In our practice, we have routinely adopted this technique, and have modified it to allow further orientation during endoscopic surgery of the posterior sinuses. To describe a review of our technique, and to prospectively assess the value of the superior turbinate as a useful landmark during endoscopic posterior ethmoidectomy and sphenoidotomy. Fifty patients listed for endoscopic posterior ethmoidectomy with or without sphenoidotomy were included in a prospective study utilising our surgical technique. Data were collated for the success or failure of identification of the landmarks, and for any complications during the surgery. A total of 93 sides of endoscopic posterior ethmoidectomy and 73 sides of endoscopic sphenoidotomy were performed. The superior turbinate was identified in 100% of the cases. The coronal part of the superior turbinate basal lamella was identified in 60.22% of the cases, and the axial part in 88.17% of the cases. The natural sphenoid ostium was identified medial to the posterior part of the superior turbinate in 98.63% of the cases. The axial part of the superior turbinate basal lamella was a constant landmark for the level of the sphenoid ostium. The number of transverse septae between the axial part of the superior turbinate basal lamella and the skull base was studied, and was found never to exceed one septum. No major complications were recorded. One case of small posterior septal perforation was detected with no post-operative effects. Our study represents the first report of identifying the two parts of the superior turbinate basal lamella intra-operatively. It also represents the first report of using the axial basal lamella of the superior turbinate as a landmark for the level of the sphenoid sinus ostium, as well as a landmark for the level of the skull base. The superior turbinate represents a constant landmark for performing a safe posterior ethmoidectomy and sphenoidotomy.

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Section: Surgical Techniquementioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…There have been, however, several articles presenting cadaveric and/or radiological studies of the superior turbinate [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The safe gate to the posterior paranasal sinuses: reassessing the role of the superior turbinate

Eweiss

Ibrahim

Khalil

2011

Eur Arch Otorhinolaryngol

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“…Kim identified the structure of this connection as the suprainfundibular plate (SIP). 2 The cleft between the basal lamella of the uncinate process and the middle turbinate is known as the groove of the meatus.…”

Section: Methodsmentioning

confidence: 99%

Frontal Sinus Surgery Anterior to the Ethmoid Bulla

Zhou

et al. 2013

International Surgery

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The frontal sinus surgery is difficult to perform but the ethmoid bulla is a relative, constant landmark in the middle turbinate that can improve the surgery. The purpose of this study was to evaluate the validity, security, and predominance of approaches to the frontal sinus via the route anterior to the ethmoid bulla. The data from 370 endoscopic frontal sinus surgery cases from our center were integrated and retrospectively analyzed. Three hundred twenty-nine patients underwent frontal sinus surgery via the route anterior to the ethmoid bulla. An additional 27 patients underwent frontal sinus surgery with mini-trephination, 13 patients with the Draf II procedure, and 1 patient had applied MELP (modified endoscopic Lothrop procedure). No serious complications occurred; however, there were 3 cases of eyelid ecchymosis and 1 case of anterior ethmoid artery bleeding. In all, 319 patients (86.2%) were cured, an improvement was noted in 36 of the patients (9.7%), and there was no improvement in 15 patients (4.1%). Frontal sinus surgery via the route anterior to the ethmoid bulla is valid, relatively safe, and can be applied in most cases involving frontal disease.

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CT and MR Anatomy of Paranasal Sinuses: Key Elements

Maroldi

Borghesi

Maculotti

Imaging in Treatment Planning for Sinonasal Diseases

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Computed Tomographic and Anatomical Analysis of the Basal Lamellas in the Ethmoid Sinus

Cited by 11 publications

References 8 publications

The safe gate to the posterior paranasal sinuses: reassessing the role of the superior turbinate

The safe gate to the posterior paranasal sinuses: reassessing the role of the superior turbinate

Frontal Sinus Surgery Anterior to the Ethmoid Bulla

CT and MR Anatomy of Paranasal Sinuses: Key Elements

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