Tan Keng Lu, Lee Woo Hyun, Kim Jeong-Whun
Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Department of Otolaryngology, National Police Hospital, Seoul, South Korea.
Eur Arch Otorhinolaryngol. 2017 Jan;274(1):223-229. doi: 10.1007/s00405-016-4201-4. Epub 2016 Jul 16.
The skull base attachment of the second lamella and suprabullar pneumatization are likely to be consistent landmarks if they are systematically classified. This study aimed to classify the pneumatization pattern according to the second lamella skull base attachment. A total of 202 computed tomography sides of 101 patients who underwent endoscopic sinus surgery were studied. Suprabullar pneumatization was defined as air cells present above the ethmoid bulla between the second and third lamellae. Its pattern was classified according to the air cell number and location as in the frontal cell classification. Type 0 suprabullar pneumatization was defined as no air cells between the ethmoid bulla and skull base; type 1, as a single suprabullar cell; and type 2, as multiple suprabullar cells above the ethmoid bulla. In type 3 pneumatization, the second lamella extended into the frontal sinus forming a frontal bullar cell. Type 2 was the most prevalent (40.1 %), followed by types 1, 3, and 0 (24.3, 23.3, and 12.4 %, respectively). The distance between the second lamella and anterior ethmoid artery was 8.93, 8.30, 8.50, and 11.25 mm in types 0, 1, 2, and 3 pneumatization, respectively. No patients had intraoperative injuries in the anterior ethmoid artery or lateral lamella. The second lamella skull base attachment and suprabullar pneumatization pattern could be systematically classified and be a consistent landmark to identify the frontal sinus opening.
如果对第二薄板的颅底附着和泡上气化进行系统分类，它们可能是一致的标志。本研究旨在根据第二薄板的颅底附着对气化模式进行分类。对101例行鼻内镜鼻窦手术患者的202侧计算机断层扫描图像进行了研究。泡上气化定义为位于第二和第三薄板之间筛泡上方的气房。其模式根据气房数量和位置进行分类，类似于额窦气房分类。0型泡上气化定义为筛泡与颅底之间无气房；1型为单个泡上气房；2型为筛泡上方多个泡上气房。在3型气化中，第二薄板延伸至额窦形成额泡气房。2型最为常见（40.1%），其次是1型、3型和0型（分别为24.3%、23.3%和12.4%）。0型、1型、2型和3型气化中，第二薄板与筛前动脉之间的距离分别为8.93、8.30、8.50和11.25mm。所有患者术中筛前动脉或外侧薄板均未发生损伤。第二薄板的颅底附着和泡上气化模式可进行系统分类，是识别额窦开口的一致标志。
