Department of Otolaryngology, Head and Neck Surgery, Whipps Cross Hospital, Whipps Cross Road, London E11 1NR, United Kingdom.
Int J Surg. 2013;11(2):188-90. doi: 10.1016/j.ijsu.2013.01.001. Epub 2013 Jan 9.
Endoscopic sinus surgery is a common and generally safe ENT procedure. Orbital injury is a rare but devastating complication. The distance between the uncinate process and the lamina papyracea is the safety margin to avoid entering the orbital cavity and has not been measured previously.
The authors reviewed 330 consecutive coronal CT scans of the paranasal sinuses to measure this distance and identify variation.
The distance can be as narrow as 0.1 mm and varies between sides. An air cell lateral to the uncinate is not uncommon; it increases the distance considerably p < 0.001 but is frequently unilateral (22%). Gender does not have an effect on this distance p = 0.90.
It is essential to carefully examine the area on a CT scan especially when performing front-to-back uncinectomy during endoscopic sinus surgery. The variation between the right and left sides should be considered to avoid unsafe assumptions.
内窥镜鼻窦手术是一种常见且通常安全的耳鼻喉科手术。眼眶损伤是一种罕见但严重的并发症。钩突和纸样板之间的距离是避免进入眶腔的安全界限，但之前尚未进行测量。
作者回顾了 330 例连续的鼻窦冠状 CT 扫描，以测量这个距离并确定其变异。
这个距离可以小到 0.1 毫米，并且两侧之间存在差异。钩突旁的气房并不少见，它会显著增加这个距离（p<0.001），但通常是单侧的（22%）。性别对这个距离没有影响（p=0.90）。
在进行内窥镜鼻窦手术时，特别是进行前后向钩突切除术时，务必仔细检查 CT 扫描上的这个区域。应该考虑左右两侧之间的差异，以避免不安全的假设。
