Cigdem Kalaycik Ertugay1, Ela Araz Server2,3, Yesim Karagoz4, Ozgur Yigit1, Ahmet Volkan Sunter1, Ahmet Gorkem Yasak1. 1. Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey. 2. Department of Otorhinolaryngology/Head and Neck Surgery, Istanbul Training and Research Hospital, Istanbul, Turkey. serverela@hotmail.com. 3. İstanbul Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniği, Kasap İlyas Mah., Org. Abdurrahman Nafiz Gürman Cad., Fatih, 34098, Istanbul, Turkey. serverela@hotmail.com. 4. Department of Radiology, Istanbul Training and Research Hospital, Istanbul, Turkey.
Abstract
PURPOSE: Pediatric population may be more prone to complications in comparison to adults because of the variability of developmental changes of paranasal sinuses and skull base. Knowledge of standard columellar distances regarding age in addition to anatomical landmarks is an important guide during functional endoscopic sinus surgery. We aimed to identify standard distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid sinus ostiums and provide an objective reference graph in regard to age in children. METHODS: Subjects who are older than 1 year and younger than 18 years who had undergone a head-and-neck, maxillofacial or temporal bone region high resolution computed tomography scan during the last 3 years were obtained from radiological database. The distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid sinus ostiums were measured and nasofrontal and nasosphenoid angles were calculated. RESULTS: A total number of 119 children (73 boys, 46 girls) were reviewed. The average age was 7.7 ± 5.0 years. All subjects had normal sinonasal anatomy. We found statistically significantly positive correlation between age and all distances (p < 0.001). Although all measured distances of boys were greater than girls, this difference did not reach statistical significance. Additionally, nasosphenoidal angles were significantly obtuse in boys (p < 0.05). CONCLUSIONS: Our columellar distance graphic can provide further improvement of surgeon confidence while performing endoscopic sinus surgery or skull base surgery.
PURPOSE: Pediatric population may be more prone to complications in comparison to adults because of the variability of developmental changes of paranasal sinuses and skull base. Knowledge of standard columellar distances regarding age in addition to anatomical landmarks is an important guide during functional endoscopic sinus surgery. We aimed to identify standard distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid sinus ostiums and provide an objective reference graph in regard to age in children. METHODS: Subjects who are older than 1 year and younger than 18 years who had undergone a head-and-neck, maxillofacial or temporal bone region high resolution computed tomography scan during the last 3 years were obtained from radiological database. The distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid sinus ostiums were measured and nasofrontal and nasosphenoid angles were calculated. RESULTS: A total number of 119 children (73 boys, 46 girls) were reviewed. The average age was 7.7 ± 5.0 years. All subjects had normal sinonasal anatomy. We found statistically significantly positive correlation between age and all distances (p < 0.001). Although all measured distances of boys were greater than girls, this difference did not reach statistical significance. Additionally, nasosphenoidal angles were significantly obtuse in boys (p < 0.05). CONCLUSIONS: Our columellar distance graphic can provide further improvement of surgeon confidence while performing endoscopic sinus surgery or skull base surgery.
Authors: Jean Anderson Eloy; David M Neskey; Richard J Vivero; Jose W Ruiz; Osamah J Choudhry; Roy R Casiano Journal: Am J Otolaryngol Date: 2012-10-23 Impact factor: 1.808