El-Anwar Mohammad Waheed, Alawady Mohamed Kamel, Alshawadfy Mohamed, Rabea Mohamed Mohamed, Elsayed Atef Hussein
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
Department of Otorhinolaryngology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
Arch Craniofac Surg. 2025 Aug;26(4):141-146. doi: 10.7181/acfs.2025.0023. Epub 2025 Aug 20.
The pre-lacrimal window (PLW) approach is a promising technique for accessing otherwise inaccessible maxillary sinus lesions. The objective of this study was to determine the computed tomography (CT) dimensions, measurements, and grading of the PLW.
One hundred paranasal CT scans were included in the study. For all subjects, axial images were obtained, and multiplanar reformats were used to obtain detailed views in the coronal and sagittal planes. The width of the PLW, the width of the nasolacrimal duct (NLD), and the angle between the axis of the NLD and the hard palate were measured and graded.
In 100 CT scans (200 sides), the mean PLW width was 5.6± 2.4 mm (range, 0-11.15 mm), the mean NLD width was 6.38± 1.84 mm (range, 1-11 mm), and the mean angle between the axis of the NLD and the hard palate was 68.6°± 6.77° (range, 54°-83°). There were no significant differences between sides or genders for any of the measurements.
The CT dimensions of the PLW should be carefully evaluated when considering different endoscopic approaches to, or through, the anterior aspect of the maxillary sinus. The current study enhances surgeon and radiologist awareness of PLW measurements and their variations, ultimately improving the application of the PLW approach.
泪前窗（PLW）入路是一种有前景的技术，可用于处理难以通过其他方式到达的上颌窦病变。本研究的目的是确定泪前窗的计算机断层扫描（CT）尺寸、测量值及分级。
本研究纳入了100例鼻旁窦CT扫描。对所有受试者均获取了轴位图像，并使用多平面重组技术在冠状面和矢状面获得详细图像。测量并分级泪前窗的宽度、鼻泪管（NLD）的宽度以及鼻泪管轴线与硬腭之间的角度。
在100例CT扫描（200侧）中，泪前窗平均宽度为5.6±2.4mm（范围为0 - 11.15mm），鼻泪管平均宽度为6.38±1.84mm（范围为1 - 11mm），鼻泪管轴线与硬腭之间的平均角度为68.6°±6.77°（范围为54° - 83°）。任何一项测量在两侧或性别之间均无显著差异。
在考虑对上颌窦前部采用不同的内镜入路或通过该区域时，应仔细评估泪前窗的CT尺寸。本研究提高了外科医生和放射科医生对泪前窗测量及其变异的认识，最终改善了泪前窗入路技术的应用。
