INVESTIGATIONS OF THE CORRELATION BETWEEN THE ROOF OF THE MAXILLARY SINUS, THE POSTERIOR ETHMOID SINUSES, AND THE SPHENOID SINUS ON CT SCAN OF THE PARANASAL SINUSES
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Abstract
Background: The posterior ethmoid sinuses and sphenoid sinus have a complex anatomy, adjacent to many critical structures. Endoscopic sinus surgery in this region requires reliable anatomical landmarks to minimize the risk of complications, among which the maxillary sinus roof is an effective and easily identifiable landmark on sinus endoscopy and CT scan.
In Vietnam, there are still few authors who have evaluated the role of the maxillary sinus roof in guiding the surgical approach to the posterior ethmoid sinuses and sphenoid sinus.
Objective: To investigate the correlation between the roof of the maxillary sinus, the posterior ethmoid sinuses, and the sphenoid sinus on multi-slice CT scan of the paranasal sinuses.
Methods: This is a descriptive cross-sectional study that included 125 patients who underwent multi-slice CT (MSCT) scan of the paranasal sinuses at the Ho Chi Minh City ENT Hospital from January 2020 to October 2020. Results: The average height of the maxillary sinus roof relative to the nasal floor was 34,43 ± 3,46 mm. There is a positive linear correlation between the maxillary sinus roof and the posterior ethmoid sinuses roof (Pearson’s r = 0.620, p <0.001). The distance ratio from the maxillary sinus roof to the posterior ethmoid roof to the height of the maxillary sinus roof was predominantly within the range of one-third to one-half of the maxillary sinus roof height. (76.8%). Furthermore, 82,46% of sphenoid sinus ostia were positioned lower than the maxillary sinus roof, with a positive linear correlation between the maxillary sinus roof height, and the position of the sphenoid sinus ostium (Pearson's r=0.307, p<0.001). Conclusion: There is a strong correlation between the roof of the maxillary sinus, the posterior ethmoid sinuses, and the sphenoid sinus on CT scan. The maxillary sinus roof serves as an important anatomical landmark, providing a reliable guide for safe navigation during endoscopic sinus surgery, particularly in sphenoid sinus and revision surgery. With its stable and easily identifiable characteristics, the maxillary sinus roof can help minimize the risk of complications in endoscopic sinus surgery, thereby contributing to improved surgical outcomes.
Keywords
maxillary sinus roof, posterior ethmoid sinuses, sphenoid sinus, computed tomography, endoscopic sinus surgery
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References
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