Haerian Hoda, Ghaffari Roshanak, Azari Shabnam
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Islamic Azad University, Isfahan (Khorasgan) Branch, Isfahan, Iran.
Dent Res J (Isfahan). 2024 Nov 26;21:64. doi: 10.4103/drj.drj_50_23. eCollection 2024.
The ethmoid roof separates the ethmoid cells from the anterior cranial fossa. From the medial side, the roof of the ethmoid is connected to the lateral lamella of the ethmoid plate, which is the thinnest bone at the base of the skull and is most vulnerable to damage during endoscopic surgeries. The purpose of this study is to investigate the height of the lateral lamella in patients with hypoplasia/aplasia of the paranasal sinuses and deviation of the nasal septum using reconstructed multiplanar images by cone-beam computed tomography (CBCT).
In this descriptive-analytical (cross-sectional) study, 192 CBCT images (89 males and 103 females) with an age range of 18 years and older were examined. These 192 participants included 58 cases of frontal sinus (FS) hypoplasia/aplasia, 42 cases of maxillary sinus (MS) hypoplasia/aplasia, 12 cases of sphenoid sinus (SS) hypoplasia/aplasia, 40 cases of nasal septum deviation, and 40 cases as a control group. As Keros classification indicates, the depth of the olfactory fossa was estimated in three categories: type 1 (1-3 mm), type 2 (4-7 mm), and type 3 (8-16 mm). The height of the lateral lamella was measured in the coronal section in all images. The septum deviation angle was also measured in the coronal section. For statistical analysis, Shapiro-Wilk, independent , nonparametric Mann-Whitney, Pearson correlation, and Kruskal-Wallis tests were done using the SPSS 22 software.
The most common type of olfactory fossa in all disorders and the control group was type II of the Keros classification. The highest average lateral lamella height was in the SS hypoplasia group (6.226 mm) and the lowest in the FS aplasia group (4.411 mm). The lateral lamella height in FS aplasia/hypoplasia groups was significantly lower than the control group ( = 0.002 and = 0.044). The average deviation angle of the nasal septum was 19.73° ±5.35° and no significant relationship was found between this angle and the height of lateral lamella ( = 0.938). The height of the lateral lamella in the FS hypoplasia group was significantly higher in men than in women ( = 0.019), but in other groups, there was no relationship between lateral lamella height and gender. Seventy-five percent of the participants of the nasal septum deviation group were type II of Keros classification and the remaining 25% were type I.
The lateral lamella height in hypoplastic/aplastic FSs is lower than normal, and this information is useful in preventing complications during endoscopic sinus surgery.
筛窦顶将筛窦气房与前颅窝分隔开。从内侧看，筛窦顶与筛板外侧板相连，筛板外侧板是颅底最薄的骨头，在内镜手术中最易受损。本研究的目的是使用锥形束计算机断层扫描（CBCT）重建的多平面图像，研究鼻窦发育不全/发育不良和鼻中隔偏曲患者的筛板外侧板高度。
在这项描述性分析（横断面）研究中，检查了192张年龄在18岁及以上的CBCT图像（89名男性和103名女性）。这192名参与者包括58例额窦（FS）发育不全/发育不良、42例上颌窦（MS）发育不全/发育不良、12例蝶窦（SS）发育不全/发育不良、40例鼻中隔偏曲以及40例作为对照组。根据凯罗斯分类法，嗅窝深度分为三类进行估计：1型（1 - 3毫米）、2型（4 - 7毫米）和3型（8 - 16毫米）。在所有图像的冠状面测量筛板外侧板的高度。在冠状面也测量鼻中隔偏曲角度。进行统计分析时，使用SPSS 22软件进行了夏皮罗 - 威尔克检验、独立样本检验、非参数曼 - 惠特尼检验、皮尔逊相关性检验和克鲁斯卡尔 - 沃利斯检验。
在所有疾病组和对照组中，最常见的嗅窝类型是凯罗斯分类法中的II型。筛板外侧板平均高度最高的是SS发育不全组（6.226毫米），最低的是FS发育不良组（4.411毫米）。FS发育不良/发育不全组的筛板外侧板高度显著低于对照组（分别为 = 0.002和 = 0.044）。鼻中隔平均偏曲角度为19.73°±5.35°，该角度与筛板外侧板高度之间未发现显著关系（ = 0.938）。FS发育不良组中男性的筛板外侧板高度显著高于女性（ = 0.019），但在其他组中，筛板外侧板高度与性别无关。鼻中隔偏曲组75%的参与者为凯罗斯分类法中的II型，其余25%为I型。
发育不全/发育不良的FS的筛板外侧板高度低于正常，该信息有助于预防鼻内镜鼻窦手术中的并发症。
