D Simmen1, N Veerasigamani1, H R Briner1, N Jones2, B Schuknecht3. 1. Center for Otorhinolaryngology, Head and Neck Surgery, Hirslanden Clinic, Zurich, Switzerland. 2. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Queens Medical Centre, Nottingham, United Kingdom. 3. Medical Radiological Institute MRI, Zurich, Switzerland.
Abstract
BACKGROUND: The distance between the anterior wall of the maxillary sinus and the nasolacrimal duct shows a large individual variation. METHODOLOGY: To evaluate the feasibility of accessing the maxillary sinus through a prelacrimal window access (PLWA), a series of 100 paranasal CT scans from adult patients was analysed retrospectively. The distance between the anterior maxillary wall and the anterior border of the lacrimal duct (= prelacrimal window) were measured in 200 sides. RESULTS: A distance of more the 7 mm was found in 12.5% maxillary sinuses and would enable straight forward PLWA. A distance between smaller than 7mm and larger than 3mm was present in 56.5% of sinuses, and would make surgical access more demanding. In 31.5% of maxillary sinuses the distance was smaller than or equal to 3mm and in these patients this approach would be difficult without transecting the nasolacrimal duct. CONCLUSION: Only in 12.5% of sinuses a prelacrimal endoscopic access is readily feasible, while in 56.5% temporary tear sac dislocation is required and in 31.5% lacrimal sac dislocation is always needed along with a significant amount of bone removal to enable PLWA.
BACKGROUND: The distance between the anterior wall of the maxillary sinus and the nasolacrimal duct shows a large individual variation. METHODOLOGY: To evaluate the feasibility of accessing the maxillary sinus through a prelacrimal window access (PLWA), a series of 100 paranasal CT scans from adult patients was analysed retrospectively. The distance between the anterior maxillary wall and the anterior border of the lacrimal duct (= prelacrimal window) were measured in 200 sides. RESULTS: A distance of more the 7 mm was found in 12.5% maxillary sinuses and would enable straight forward PLWA. A distance between smaller than 7mm and larger than 3mm was present in 56.5% of sinuses, and would make surgical access more demanding. In 31.5% of maxillary sinuses the distance was smaller than or equal to 3mm and in these patients this approach would be difficult without transecting the nasolacrimal duct. CONCLUSION: Only in 12.5% of sinuses a prelacrimal endoscopic access is readily feasible, while in 56.5% temporary tear sac dislocation is required and in 31.5% lacrimal sac dislocation is always needed along with a significant amount of bone removal to enable PLWA.
Authors: Paul Shern Xin Lock; Glenn W Siow; Amit Karandikar; Julian Park Nam Goh; Jin Keat Siow Journal: Eur Arch Otorhinolaryngol Date: 2019-05-02 Impact factor: 2.503
Authors: Florin Lupu; Cătălina-Petruța Iliuță; Ioan Alexandru Bulescu; Mihaly Enyedi; Daniela-Elena Gheoca Mutu; Octavian Enciu; Florin Mihail Filipoiu Journal: J Med Life Date: 2022-06