Dimensions of the medial wall of the prelacrimal recess

Kashlan, Khaled N.; Craig, John R.

doi:10.1002/alr.22090

Cited by 17 publications

(16 citation statements)

References 15 publications

(17 reference statements)

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“…Thus, EPLAs may save more time than MMAs without additional complications, especially when treating cases in which inflammatory polyps full of maxillary sinus. In these cases, stripping lesions arising from the anterior and/or medial aspect of maxillary sinus (e.g., alveolar or PLR) present an obstacle for standard MMA approach (Turri-Zanoni et al, 2017;Kashlan & Craig, 2018). Nonetheless, further studies are needed to elucidate whether patients with inflammatory maxillary disease undergoing EPLAs have results comparable with those treated with conventional MMAs.…”

Section: Discussionmentioning

confidence: 99%

“…Antero-posterior (AP) diameter was first defined as the distance from pyriform aperture to the nasolacrimal duct (NLD) by identifying the inferior-most aspect of NLD on coronal view and then transposing that to axial view. The height of medial PLR was measured starting at the level of the superior-most aspect of the NLD to the nasal floor, as described in Kashlan & Craig (2018). Other demographic data including age, gender, initial symptoms and their durations, image findings and known surgical history of each patient were also collected from each patient prior to surgery.…”

Section: Study Design and Patient Eligibilitymentioning

confidence: 99%

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Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Lin

Chen

2020

PeerJ

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Background The aim of the study was to evaluate the treatment outcomes of endoscopic prelacrimal recess approaches (EPLAs) in managing different sinus pathologies, analyzing associated adverse events and post-treatment quality-of-life. Methods We enrolled 21 consecutive patients (22 lesions) who received endoscopic sinus surgical procedures with EPLAs in two tertiary medical institutes between 2015 and 2018. Quality-of-life and self-rated symptom severity data were collected using the 22-item Sino-Nasal Outcomes Test (SNOT-22) and 10-point visual analog scales (VAS), respectively. Results A total of 21 patients (mean age (standard deviation) 51.7 (14.5) years; 16(76.2%) male) were followed up for 12.7 months. The most common symptoms were nasal discharge and nasal airway obstructions. Nine lesions (40.9%) were sinonasal papilloma’s, seven lesions were other types of neoplasms (31.8%; five benign and two malignant), two were trauma-related (9.1%), and four inflammatory diseases (18.2%). Patients with non-papilloma lesions had higher presurgical SNOT-22 than those with papillomas (P-value = 0.021). After EPLAs, non-papilloma patients had significant improvements in SNOT-22 and VAS (P-values = 0.012 and 0.012, respectively), while those with papillomas had only marginally significant improvements in VAS (P-value = 0.061). The most common adverse events was temporary cheek/tooth numbness (n = 11), and patients with sinonasal papillomas were more likely to have post-treatment complications than those with other disease entities. Conclusions EPLAs were found to effectively manage various sinus diseases. Short-term life-quality improvements were promising. Future large-scale studies with longer follow-up periods are recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Study Design and Patient Eligibilitymentioning

confidence: 99%

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Lin

Chen

2020

PeerJ

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“…The anteroposterior and superoinferior dimensions of the medial wall of the prelacrimal recess vary, 19,20 and we should evaluate its dimensions preoperatively in order to avoid the NLD injury. Our previous and other studies reported that NLD is preserved in the PLRA, 9,10,12,14–16 a finding that was echoed in our results of the present study as well.…”

Section: Discussionmentioning

confidence: 99%

Resection of Inverted Papilloma of the Maxillary Sinus via a Prelacrimal Recess Approach: A Multicenter Retrospective Analysis of Surgical Efficacy

Zhou

Huang

Sun

et al. 2018

Am J Rhinol�Allergy

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Background The intranasal endoscopic prelacrimal recess approach (PLRA) access to all aspects of the maxillary sinus while preserving the inferior turbinate and nasolacrimal duct and its use have been reported in the treatment of many maxillary sinus and lateral skull base diseases. Objective To retrospectively assess the effectiveness of a 10-year multicenter follow-up for the resection of inverted papilloma of the maxillary sinus (IPMS) via a PLRA. Methods A total of 71 patients were admitted and underwent IPMS excision via an intranasal endoscopic PLRA from 2003 to 2013. All patients underwent high-resolution computed tomography scanning of the nasal sinus, and some also underwent magnetic resonance imaging examination. Results Based on the Krouse staging system, all 71 patients belong to T3 staging. The PLRA was employed to remove IPMS in 71 patients. The postoperative pathological examination of the excised tissue revealed inverted papilloma, and cancerization was identified in 3 patients. The median follow-up time was 37.3 months (range: 13–134 months). Of the 71 patients, reoccurrence was seen in 5 patients (7.04%); 5 patients (7.04%) experienced numbness of the upper lid and the ala of the nose and 4 (5.63%) experienced mild collapse of the ala of the nose. Conclusions These multicenter follow-up results demonstrated that the PLRA is a safe and effective method for the excision of primary or recurrent IPMS with lower postoperative complications and recurrent rate.

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“…Some studies have reported that the distance between the pyriform aperture and nasolacrimal duct is variable and most cases require skeletonizing of the lacrimal system before entering the maxillary sinus anterolateral to it . The need to skeletonize the lacrimal system allows it to be mobilized together with the inferior turbinate flap but also provides access for the management of lacrimal system pathology; the senior author has utilized the prelacrimal recess technique in the resection of juvenile nasopharyngeal angiofibroma and lacrimal tumors which has previously been reported by other surgical teams .…”

Section: Discussionmentioning

confidence: 99%

Adjunctive techniques to improve access of the endoscopic prelacrimal recess approach

et al. 2019

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Objectives To determine whether adjunctive surgical techniques could improve access of instruments provided by the endoscopic prelacrimal recess approach to the anatomical boundaries of the maxillary sinus, and pterygopalatine and infratemporal fossa. Methods Ten fresh‐frozen adult cadaver heads were utilized. The anatomical areas of interest were fixed, bony boundaries of the maxillary sinus, infratemporal fossa, and pterygopalatine fossa: alveolar recess (AR), zygomatic recess (ZR), perpendicular plate of the palatine bone (PB), ascending ramus of mandible (RM), floor of the orbit medial and lateral to infraorbital nerve (M‐ION and L‐ION, respectively). Access to the areas were compared using standard sinus surgery instruments (straight and 45° forceps) introduced via the prelacrimal recess approach, trans‐septal window and canine fossa puncture. Results The prelacrimal recess approach successfully provided access to the PB and M‐ION in >90% of dissections when using both the straight and 45° forceps. With the straight forceps, the ability to successfully access to the AR and ZR was the lowest at 50% and 35% respectively, although improving to 75% and 60% respectively with the 45° forceps. Access to the AR, ZR, and L‐ION improved significantly when the 45° forceps was introduced through the trans‐septal window. Frequency of access to the RM when either instruments when introduced through the canine fossa puncture was no greater than 60% of the dissections. Conclusions The addition of a small trans‐septal window for instruments significantly improved access of the prelacrimal recess approach especially to the orbital floor, lateral margins of the maxillary sinus, and retromaxillary space. Level of Evidence 4 Laryngoscope, 130: 1857–1863, 2020

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Dimensions of the medial wall of the prelacrimal recess

Abstract: The anteroposterior and superoinferior dimensions of the medial wall of the PLR are variable, with the anteroposterior dimension being widest inferiorly. Its dimensions should be evaluated preoperatively when considering endoscopic approaches to or through the anterior maxillary sinus.

Cited by 17 publications

References 15 publications

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Clinical outcome of endonasal endoscopic prelacrimal approach in managing different maxillary pathologies

Resection of Inverted Papilloma of the Maxillary Sinus via a Prelacrimal Recess Approach: A Multicenter Retrospective Analysis of Surgical Efficacy

Adjunctive techniques to improve access of the endoscopic prelacrimal recess approach

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