Alhumaid Humaid, Alsowinea Abdulrahman, Alamer Ali
Department of Otolaryngology Head and Neck Surgery, College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia.
College of Medicine, Qassim University, Buraydah 52571, Saudi Arabia.
Life (Basel). 2025 Mar 13;15(3):453. doi: 10.3390/life15030453.
Functional endoscopic sinus Surgery (FESS) is a form of safe and effective management for chronic rhinosinusitis. Nevertheless, although FESS is minimally invasive, it poses a risk of rare orbital complications. This study aims to investigate the variations in the medial maxillary wall relative to the medial orbital wall, as depicted on computed tomography (CT) scans. We retrospectively included CT scans of the sinuses between November 2022 and April 2023. To maintain consistency, we used the coronal image that delineated the anterior ethmoidal foramen. The attachment site of the inferior turbinate to the medial maxillary wall was categorized into three classes according to its position relative to the inferomedial orbital strut. Class I indicates that the site of attachment is located within 2 mm, either medially or laterally. Class II indicates that it has been medially displaced by more than 2 mm, whereas Class III indicates that it has been laterally displaced by more than 2 mm. We enrolled 183 patients, yielding a total of 363 sides. Classes I, II, and III account for 55.4%, 41.3%, and 3.3% of the cases, respectively. A significant correlation exists between the classification and the dimensions and volume of the maxillary sinus ( < 0.001). The logistic regression model indicates a significant negative correlation between the width of the maxillary sinus and risk classification ( < 0.001), implying a protective effect with increasing width. Knowledge of the variations in the medial wall of the maxillary sinus relative to the medial orbital wall is essential for guidance toward the optimal endoscopic approach, and it demonstrates relevance to risk stratification.
功能性鼻内镜鼻窦手术（FESS）是慢性鼻窦炎一种安全有效的治疗方式。然而，尽管FESS是微创手术，但仍存在罕见眼眶并发症的风险。本研究旨在调查计算机断层扫描（CT）图像上显示的上颌骨内侧壁相对于眶内侧壁的变异情况。我们回顾性纳入了2022年11月至2023年4月间的鼻窦CT扫描图像。为保持一致性，我们使用了描绘筛前孔的冠状位图像。根据下鼻甲附着于上颌骨内侧壁的位置相对于眶内下支柱的位置，将其分为三类。I类表示附着部位位于内侧或外侧2mm范围内。II类表示其向内移位超过2mm，而III类表示其向外移位超过2mm。我们纳入了183例患者，共363侧。I类、II类和III类分别占病例的55.4%、41.3%和3.3%。分类与上颌窦的尺寸和容积之间存在显著相关性（<0.001）。逻辑回归模型表明上颌窦宽度与风险分类之间存在显著负相关（<0.001），这意味着随着宽度增加有保护作用。了解上颌窦内侧壁相对于眶内侧壁的变异情况对于指导最佳内镜手术入路至关重要，并且显示出与风险分层相关。
