Yağmur Ali Rıza, Çıvgın Esra, Özcan Kürşat Murat, Yurtsever Kum Nurcan, Karakuş Mehmet Fatih, Dere Hacı Hüseyin
Department of Otorhinolaryngology, Head and Neck Surgery, Ankara Lokman Hekim University, Ankara, Turkey.
Department of Radiology, Ankara City Hospital, Ankara, Turkey.
Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3146-3151. doi: 10.1007/s12070-023-03931-x. Epub 2023 Jun 14.
The aim of the study was to investigate the relations between anatomical structures that are susceptible to inadvertent injuries during the surgery using preoperative computed tomography (CT) scans. 153 CT scans were reviewed and the distance from the lamina papyracea (LP) to the midline and the distance of the anterior ethmoidal artery (AEA) to the skull base were measured bilaterally. Also, the depth of olfactory fossa was measured and categorized using the Keros classification. The measurements were analyzed to determine whether LP-to-midline distance was correlated with the distance between the AEA and the skull base and Keros classification. Additionally, correlation of Keros classification with the distance from the AEA to the skull base was investigated. In a total of 306 measurements, 26 (%8.49) were classified as Keros type I, 200 (65.35%) as Keros type II and 80 (25.14%) as Keros type III. Statistically, LP-to-midline distances on the right and left sides were significantly associated with the distance from the AEA to the skull base on the same side (R:p < 0.001, L:p = 0.01) and the Keros classification on the same side (R:p < 0.001, L:p = 0.004). Also, a significant association was found between the Keros classification and the distance from the AEA to the skull base (R:p < 0.001, L:p = 0.02). The locations of anatomical structures are defined in relation to each other during the development of maxillofacial bones. CT scans should be examined and anatomical structures and relations among them reviewed very carefully before ESS. Otherwise, some accidental injuries may arise during the surgery while trying to avoid complications.
The online version contains supplementary material available at 10.1007/s12070-023-03931-x.
本研究的目的是利用术前计算机断层扫描（CT）来调查手术过程中易受意外伤害的解剖结构之间的关系。回顾了153例CT扫描图像，双侧测量了筛骨纸板（LP）到中线的距离以及筛前动脉（AEA）到颅底的距离。此外，使用凯罗斯分类法测量并分类了嗅窝的深度。对这些测量值进行分析，以确定LP到中线的距离是否与AEA和颅底之间的距离以及凯罗斯分类相关。此外，还研究了凯罗斯分类与AEA到颅底距离的相关性。在总共306次测量中，26次（8.49%）被分类为凯罗斯I型，200次（65.35%）为凯罗斯II型，80次（25.14%）为凯罗斯III型。从统计学上看，左右两侧LP到中线的距离与同侧AEA到颅底的距离（右侧：p < 0.001，左侧：p = 0.01）以及同侧的凯罗斯分类（右侧：p < 0.001，左侧：p = 0.004）显著相关。此外，还发现凯罗斯分类与AEA到颅底的距离之间存在显著关联（右侧：p < 0.001，左侧：p = 0.02）。在颌面骨发育过程中，解剖结构的位置是相互关联定义的。在进行内窥镜鼻窦手术（ESS）之前，应仔细检查CT扫描图像，并复查解剖结构及其相互关系。否则，在试图避免并发症的手术过程中可能会出现一些意外伤害。
在线版本包含可在10.1007/s12070-023-03931-x获取的补充材料。
