Department of Otorhinolaryngology, Medical University of Graz, Graz, Austria.
Institute of Mathematics and Scientific Computing, University of Graz, Graz, Austria.
Sci Rep. 2021 Apr 8;11(1):7791. doi: 10.1038/s41598-021-87447-w.
The feasibility and surgical effort of a pre-lacrimal window approach (PLWA) depends on the width of the bony window anterior to the nasolacrimal duct. This study aimed to investigate gender-specific differences in feasibility of PLWA. A consecutive series of paranasal computed tomography scans from 50 females (n = 100) and 50 males (n = 100) were retrospectively analyzed. The primary outcome measure was the antero-posterior length of the bony pre-lacrimal window (BPLWA). The secondary outcome measure was the distribution of Simmen's PLWA feasibility types (major, moderate and minor surgical effort). On average, males had a 1.5 mm (95% CI 0.8-2.2) significantly higher BPLW length in comparison to females [t(198) = 4.4, p < 0.0001]. The requirement of major surgical effort occurred 29% more frequently in females [χ(1) = 17.7, p < 0.0001], whereas the necessity of moderate surgical effort was 21% more prevalent in males [χ(1) = 8.8, p = 0.003]. The need of only minor surgical effort was twice as high in males compared to females [χ(1) = 3, p = 0.081]. Our data indicates that females require more significant surgical effort during a PLWA to gain access to the maxillary sinus. These results are highly informative as a high amount of bone removal and nasolacrimal duct dislocation are associated with a higher likelihood of complications.
经泪前窗入路（PLWA）的可行性和手术难度取决于鼻泪管前的骨窗宽度。本研究旨在探讨 PLWA 可行性的性别差异。回顾性分析了 50 名女性（n=100）和 50 名男性（n=100）的一系列副鼻窦计算机断层扫描。主要结局测量指标为骨前泪前窗（BPLWA）的前后长度。次要结局测量指标为 Simmen 的 PLWA 可行性类型（主要、中度和轻度手术难度）的分布。平均而言，男性的 BPLWA 长度比女性长 1.5 毫米（95%CI 0.8-2.2）[t(198)=4.4，p<0.0001]。女性需要主要手术难度的比例高 29%[χ(1)=17.7，p<0.0001]，而男性需要中度手术难度的比例高 21%[χ(1)=8.8，p=0.003]。男性只需轻度手术难度的比例比女性高 2 倍[χ(1)=3，p=0.081]。我们的数据表明，女性在进行 PLWA 时需要更大的手术难度才能进入上颌窦。这些结果具有高度的信息性，因为大量的骨切除和鼻泪管脱位与更高的并发症发生几率相关。
