Jolly Karan, Kontogiannis Theodoros, Pankhania Miran, Hussain Khalid, Naik Paresh Pramod, Ahmed Shahzada K
Department of Otolaryngology, Queen Elizabeth Hospital University Hospitals Birmingham NHS Foundation Trust Birmingham UK.
Department of Otolaryngology Birmingham Children's Hospital Birmingham UK.
Laryngoscope Investig Otolaryngol. 2020 Sep 19;5(5):791-795. doi: 10.1002/lio2.440. eCollection 2020 Oct.
Frontal sinus surgery is considered one of the more challenging aspects of Functional Endoscopic Sinus Surgery, due to the complex variations in normal sinus anatomy but also increased morbidity due to the close proximity of critical structures such as the anterior cranial fossa and orbits. We aim to investigate the medial canthal point (MCP) as an anatomical landmark for safe frontal sinus access.
The MCP intranasally is identified during surgery with non-tooth forceps, with one limb just anterior to the medial canthus and the other intranasally in the same coronal plane along the skull base. This point was identified on 100 paranasal sinus computed tomography (CT) scan reconstructions. The distance between the anterior cranial fossa and MCP was measured on imaging-medial canthal point distance (MCPD). The maximal anterior-posterior (AP) distance was measured on all scans.
The average MCPD for males was 13.0 mm (8.7-20.4 mm) and for females 12.0 mm (6.8-22.8 mm). Mean AP distance for males was 12.0 mm (4.5-20.2 mm) and for females 10.4 mm (3.8-15.9 mm). Mean distance for all 100 patients was 12.6 mm (range 7.5-22.8 mm). In all cases, the MCP was anterior to the cranial fossa. Mixed effects modelling analysis showed a significant correlation between the MCPD and AP distance ( = .006).
The MCP is a consistent anatomical landmark that can serve as an adjunct to safe frontal sinus access alongside the first olfactory fiber and CT navigation systems. However, patient selection continues to be very important, with larger well pneumatized frontal sinuses being ideal to tackle earlier in a surgeon's career.
NA.
由于正常鼻窦解剖结构复杂多变，且因前颅窝和眼眶等关键结构距离较近导致发病率增加，额窦手术被认为是功能性内窥镜鼻窦手术中更具挑战性的方面之一。我们旨在研究内眦点（MCP）作为安全进入额窦的解剖标志。
在手术中用无齿镊确定鼻内的MCP，镊的一肢位于内眦前方，另一肢沿颅底在同一冠状面内位于鼻内。在100例鼻窦计算机断层扫描（CT）扫描重建图像上确定该点。在前颅窝与MCP之间的距离在影像上测量为内侧眦点距离（MCPD）。在所有扫描图像上测量最大前后（AP）距离。
男性的平均MCPD为13.0毫米（8.7 - 20.4毫米），女性为12.0毫米（6.8 - 22.8毫米）。男性的平均AP距离为12.0毫米（4.5 - 20.2毫米），女性为10.4毫米（3.8 - 15.9毫米）。所有100例患者的平均距离为12.6毫米（范围7.5 - 22.8毫米）。在所有病例中，MCP均位于颅窝前方。混合效应模型分析显示MCPD与AP距离之间存在显著相关性（ = 0.006）。
MCP是一个一致的解剖标志，可作为安全进入额窦的辅助标志，与第一嗅神经纤维和CT导航系统一起使用。然而，患者选择仍然非常重要，较大且气化良好的额窦对于外科医生职业生涯早期处理最为理想。
无。
