The Ethmoid Labyrinth, Point of Entry to Diseases of the Nasal Cavity, Paranasal Sinuses, the Orbit and Skull Base

Abstract

Abstract: Endoscopic endonasal surgery developed as a logical consequence of more sophisticated knowledge of the pathophysiology of the paranasal sinuses. Also endoscopic treatment of various diseases of the nasal cavity and paranasal sinuses proved to be as effective as clas-sical methods. Ethmoidal bone is a basic anatomic area, where pathologic activities are formed or the natural extension for a minimally invasive approach from the natural nasal opening to the brain, so the knowledge of its anatomy and development is of the para-mount significance. Ethmoid labyrinth starts to develop in the third week of gestation from the pharyngeal apparatus, and reach its full size only at age 12. From a surgical point of view, the most interesting are the medial turbinates, the roof of the nasal cavity, the uncinate process and the bulla ethmoidalis. Through the transethmoidal approach we can access all the cells in the ethmoid sinuses, the frontal sinus, the anterior skull base, the orbital walls and its contents. The awareness that there might be anatomical variations also carries great importance. The central location of the ethmoid bone is actually an in-tersection inside the nasal cavity and the basic component for understanding the anatom-ical relationships and the physiology of the paranasal sinuses. Keywords: ethmoid labyrinth, embryology, anatomy, endoscopic endonasal surgery