Approach to frontal sinus via five frontal sinus drainage pathways.

IF 1.9 3区医学 Q2 OTORHINOLARYNGOLOGY

European Archives of Oto-Rhino-Laryngology Pub Date : 2024-10-20 DOI:10.1007/s00405-024-09041-w

Toru Kikawada, Yasutomo Araki, Kenji Kondo

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引用次数: 0

Abstract

Purpose: This study aimed to validate a method for successful frontal sinus surgery. The method classifies the frontal sinus drainage pathway (FSDP) into five categories based on three bony walls of the anterior ethmoid sinus, including the uncinate process (UP), accessory uncinate process (UPa), and basal lamella of the ethmoid bulla (BLEB), which was tested in actual surgical procedures.

Methods: This study analyzed 53 sides of 48 patients who underwent frontal sinus surgery between October 2022 and March 2023. We classified the FSDPs using preoperative computed tomography (CT) and multiplanar reconstruction (MPR). During surgeries for FSDPs located anterior to the BLEB, we used a two-step method involving resection of the turbinal UP, followed by upward resection from the lower edge of the ethmoidal UP. For FSDPs located posterior to the BLEB, we resected the BLEB at the superior semilunar recess.

Results: We confirmed the origin of each of the five types of FSDP during surgery. These origins, which were located at the lowest part of the anterior ethmoid, could be identified in the early stages of ethmoid sinus surgery before proceeding to the frontal recess area.

Conclusion: The origins of the five types of FSDP, classified based on the bony walls, can be clearly and accurately identified during surgery. This provides a reliable method for preoperatively predicting and locating the inferior end of the FSDP (origin), without extensive manipulation of the cells formed in the frontal fossa.

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通过五条额窦引流路径进入额窦。

目的：本研究旨在验证一种成功实施额窦手术的方法。该方法根据乙状窦前窦的三个骨壁，包括钩突（UP）、附属钩突（UPa）和乙状鼓室基底层（BLEB），将额窦引流路径（FSDP）分为五类，并在实际手术过程中进行了测试：本研究分析了在 2022 年 10 月至 2023 年 3 月期间接受额窦手术的 48 名患者的 53 个侧面。我们使用术前计算机断层扫描（CT）和多平面重建（MPR）对 FSDPs 进行了分类。在对位于BLEB前方的FSDP进行手术时，我们采用了两步法，先切除鼻甲UP，然后从乙状窦UP的下缘向上切除。对于位于 BLEB 后方的 FSDP，我们在上半月凹处切除了 BLEB：结果：我们在手术中确认了五种FSDP的起源。结果：我们在手术中确认了五种类型的前鼻窦内膜增生症的起源，这些起源位于前乙状窦的最低部位，可以在乙状窦手术的早期阶段确定，然后再进入额凹区域：结论：根据骨壁分类的五种 FSDP 的起源可在手术中清晰准确地识别。这为术前预测和定位 FSDP 下端（起源）提供了一种可靠的方法，而无需对额窝形成的细胞进行大量操作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Archives of Oto-Rhino-Laryngology 医学-耳鼻喉科学

CiteScore

5.30

自引率

7.70%

发文量

537

审稿时长

2-4 weeks

期刊介绍： Official Journal of European Union of Medical Specialists – ORL Section and Board Official Journal of Confederation of European Oto-Rhino-Laryngology Head and Neck Surgery "European Archives of Oto-Rhino-Laryngology" publishes original clinical reports and clinically relevant experimental studies, as well as short communications presenting new results of special interest. With peer review by a respected international editorial board and prompt English-language publication, the journal provides rapid dissemination of information by authors from around the world. This particular feature makes it the journal of choice for readers who want to be informed about the continuing state of the art concerning basic sciences and the diagnosis and management of diseases of the head and neck on an international level. European Archives of Oto-Rhino-Laryngology was founded in 1864 as "Archiv für Ohrenheilkunde" by A. von Tröltsch, A. Politzer and H. Schwartze.