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Indian Journal of Otolaryngology and Head & Neck Surgery logoLink to Indian Journal of Otolaryngology and Head & Neck Surgery
. 2005 Jan;57(1):5–8. doi: 10.1007/BF02907616

Anterior skull base: High risk areas in endoscopic sinus surgery in chronic rhinosinusitis: A computed tomographic analysis

Arif Ali, Mary Kurien 1,, N K Shyamkumar 2, Selvaraj 3
PMCID: PMC3451550  PMID: 23120113

Abstract

Computed Tomography (CT) scan of nose and paranasal sinuses play a key role in preoperative evaluation of patients undergoing endoscopic sinus surgeries (ESS) for chronic rhinosinusitis. The asymmetry of ethmoid fovea olfactory fossa, anatomical variations of lateral lamella and course of anterior ethmoid artery are critical in ESS as it may predispose to dangerous consequences like hemorrhage. CSF leak and intracranial complications. A prospective study was done on 75 patients of clinically and diagnostically proven chronic rhinosimusits. The coronal CT scan was evaluated with special attention to anatomical variations of anterior skull base including ethmoid fovea, olfactory fossa, lateral lamella and course of anterior ethmoid artery. The endoscopic surgeon's awareness of these variations and its role in preventing complications are highlighted.

Key Words: Anterior skull base, Andromical variations, CT scan, Chronic rhinosinusitis

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References

  • 1.Hudgins PA. Complications of Endoscopic Sinus Surgery. The Role of the Radiologist in Prevention. Radiol Clin North Am. 1993;31:21–32. [PubMed] [Google Scholar]
  • 2.Lebowitz RA, Terk A, Jacobs JB, Holliday RA. Asymmetry of the Ethmoid Roof Analysis Using Coronal Computed Tomography. Laryngoscope. 2001;111:2122–4. doi: 10.1097/00005537-200112000-00007. [DOI] [PubMed] [Google Scholar]
  • 3.Basak S, Akdilli A, Karaman CZ, Kunt T. Assessment of some important anatomical variations and dangerous areas of the paranasal sinuses by computed tomography in children. Int J Pediatr Otorhinolaryngol. 2000;55:81–9. doi: 10.1016/S0165-5876(00)00362-1. [DOI] [PubMed] [Google Scholar]
  • 4.Lanza DC, Kennedy DW. Adult rhinosimusitis defined. Otolryngol Head Neck Surg. 1997;117:1–7. doi: 10.1016/S0194-5998(97)70001-9. [DOI] [PubMed] [Google Scholar]
  • 5.Meyers RM, Valvassori G. Interpretation of Anatomic Variations of Computed Tomography Scans of the Sinuses A Surgeon's Perspective. Laryngoscope. 1998;108:422–5. doi: 10.1097/00005537-199803000-00020. [DOI] [PubMed] [Google Scholar]
  • 6.Dessi P, Moulin G, Triglia JM, Zanaret M, Cannoni M. Difference in the height of the right and left ethmoidal roof a possible risk factor for ethmoidal surgery. Prospective study of 150 CT scans. J Laryngol Otol. 1994;108:261–2. doi: 10.1017/s0022215100126477. [DOI] [PubMed] [Google Scholar]
  • 7.Freedmann HM, Kern EB. Complications of intranasal ethmoidectomy a review of 1000 consecutive operations. Laryngoscope. 1979;89:421–34. doi: 10.1288/00005537-197903000-00010. [DOI] [PubMed] [Google Scholar]
  • 8.Ohnishi T, Tachibana T, Kaneko Y, Esaki S. High-Risk Areas in Endoscopic Sinus Surgery and Prevention of Complications. Laryngoscope. 1993;103:1181–5. doi: 10.1288/00005537-199310000-00020. [DOI] [PubMed] [Google Scholar]
  • 9.Stammberger H. Functional Endoscopic Sinus Surgery. Philadelphia: BC Decker; 1991. pp. 27–57. [Google Scholar]
  • 10.Teatini G, Simonetti G, Salvolini U, Masala W, Meloni F, Rovasio S, et al. Computed Tomography of the Ethmoid Labyrinth and adjacent structures. Ann Otol Rhinol Laryngol. 1987;96:239–50. doi: 10.1177/000348948709600301. [DOI] [PubMed] [Google Scholar]

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