Skip to main content
Erschienen in: Surgical and Radiologic Anatomy 9/2013

01.11.2013 | Anatomic Variations

Asymmetry of lateral lamella of the cribriform plate: a software-based analysis of coronal computed tomography and its clinical relevance in endoscopic sinus surgery

verfasst von: Mohammad Adeel, Mubasher Ikram, Mohammad Shaheryar Ahmed Rajput, Asif Arain, Yasir Jamil Khattak

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 9/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

Endoscopic sinus surgery is a known approach for sinonasal pathologies. Due to close proximity of sinuses to orbits and brain, surgeon should be aware of sinonasal anatomy and associated variations. The roof of ethmoid (fovea ethmoidalis) separates the ethmoidal cells from the anterior cranial fossa. Medially the fovea attaches to the lateral lamella of the cribriform plate, which is the thinnest bone of the skull base. Hence, it is at a high risk of getting damaged during surgery.

Objective

To ascertain the quantitative analysis of height of lateral lamella according to Keros classification in the computed tomographic (CT) images of patients presenting to our clinic.

Methods

It was retrospective review of 77 CT scans using computerized software known as picture archiving and communication system. The height of lateral lamella was examined for both sides and then classified according to Keros classification. Asymmetry between two sides was also reported.

Results

Keros type I was seen in 46 sides (29.8 %), type II in 75 sides (48.7 %) and type III was seen in 33 (21.4 %) sides. Keros type I was seen in 38 sides in males and 8 sides in females. Type II was seen in 46 and 29 sides in males and females, respectively. Type III was seen in 18 sides in males and in 15 sides in females.

Conclusion

Understanding of the anatomy of ethmoid roof with its possible variation is crucial to give the surgeon optimal information about the possible risk that one can face during the surgery. Hence dreadful complications can be avoided.
Literatur
3.
Zurück zum Zitat Arslan H, AydInlIoglu AI, Bozkurt M, Egeli E (1999) Anatomic variations of the paranasal sinuses: CT examination for endoscopic sinus surgery. Auris Nasus Larynx 26(1):39–48PubMedCrossRef Arslan H, AydInlIoglu AI, Bozkurt M, Egeli E (1999) Anatomic variations of the paranasal sinuses: CT examination for endoscopic sinus surgery. Auris Nasus Larynx 26(1):39–48PubMedCrossRef
4.
Zurück zum Zitat Başak S, Akdilli A, Karaman CZ, Kunt T (2000) Assessment of some important anatomical variations and dangerous areas of the paranasal sinuses by computed tomography in children. Int J Pediatr Otorhinolaryngol 55(2):81–89PubMedCrossRef Başak S, Akdilli A, Karaman CZ, Kunt T (2000) Assessment of some important anatomical variations and dangerous areas of the paranasal sinuses by computed tomography in children. Int J Pediatr Otorhinolaryngol 55(2):81–89PubMedCrossRef
5.
Zurück zum Zitat Dessi P, Castro F, Triglia J, Zanaret M, Cannoni M (1994) Major complications of sinus surgery: a review of 1192 procedures. J Laryngol Otol 108(03):212–215PubMed Dessi P, Castro F, Triglia J, Zanaret M, Cannoni M (1994) Major complications of sinus surgery: a review of 1192 procedures. J Laryngol Otol 108(03):212–215PubMed
6.
Zurück zum Zitat Jang YJ, Park HM, Kim HG (1999) The radiographic incidence of bony defects in the lateral lamella of the cribriform plate. Clin Otolaryngol Allied Sci 24(5):440–442PubMedCrossRef Jang YJ, Park HM, Kim HG (1999) The radiographic incidence of bony defects in the lateral lamella of the cribriform plate. Clin Otolaryngol Allied Sci 24(5):440–442PubMedCrossRef
7.
Zurück zum Zitat Kainz J, Stammberger H (1988) The roof of the anterior ethmoid: a locus minoris resistentiae in the skull base. Laryngol Rhinol Otol 67(4):142CrossRef Kainz J, Stammberger H (1988) The roof of the anterior ethmoid: a locus minoris resistentiae in the skull base. Laryngol Rhinol Otol 67(4):142CrossRef
9.
Zurück zum Zitat Keros P (1962) On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Z Laryngol Rhinol Otol 41:809PubMed Keros P (1962) On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Z Laryngol Rhinol Otol 41:809PubMed
12.
Zurück zum Zitat Nitinavakarn B, Thanaviratananich S, Sangsilp N (2005) Anatomical variations of the lateral nasal wall and paranasal sinuses: a CT study for endoscopic sinus surgery (ESS) in thai patients. J Med Assoc Thai 88(6):763–768PubMed Nitinavakarn B, Thanaviratananich S, Sangsilp N (2005) Anatomical variations of the lateral nasal wall and paranasal sinuses: a CT study for endoscopic sinus surgery (ESS) in thai patients. J Med Assoc Thai 88(6):763–768PubMed
14.
Zurück zum Zitat Solares CA, Lee WT, Batra PS, Citardi MJ (2008) Lateral lamella of the cribriform plate: software-enabled computed tomographic analysis and its clinical relevance in skull base surgery. Arch Otolaryngol Head Neck Surg 134(3):285–289. doi:10.1001/archotol.134.3.285 PubMedCrossRef Solares CA, Lee WT, Batra PS, Citardi MJ (2008) Lateral lamella of the cribriform plate: software-enabled computed tomographic analysis and its clinical relevance in skull base surgery. Arch Otolaryngol Head Neck Surg 134(3):285–289. doi:10.​1001/​archotol.​134.​3.​285 PubMedCrossRef
15.
Zurück zum Zitat Souza SA, Souza MMA, Idagawa M, Wolosker ÂMB, Ajzen SA (2008) Computed tomography assessment of the ethmoid roof: a relevant region at risk in endoscopic sinus surgery. Radiologia Brasileira 41(3):143–147CrossRef Souza SA, Souza MMA, Idagawa M, Wolosker ÂMB, Ajzen SA (2008) Computed tomography assessment of the ethmoid roof: a relevant region at risk in endoscopic sinus surgery. Radiologia Brasileira 41(3):143–147CrossRef
16.
Zurück zum Zitat Stammberger H, Kennedy DW, Bolger W (1995) Paranasal sinuses: anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol 17–21 Stammberger H, Kennedy DW, Bolger W (1995) Paranasal sinuses: anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol 17–21
17.
Zurück zum Zitat Stankiewicz JA (1987) Complications of endoscopic intranasal ethmoidectomy. Laryngoscope 97(11):1270–1273PubMedCrossRef Stankiewicz JA (1987) Complications of endoscopic intranasal ethmoidectomy. Laryngoscope 97(11):1270–1273PubMedCrossRef
18.
Zurück zum Zitat Terrier F, Weber W, Ruefenacht D, Porcellini B (1985) Anatomy of the ethmoid: CT, endoscopic and macroscopic. Am J Neuroradiol 6(1):77–84 Terrier F, Weber W, Ruefenacht D, Porcellini B (1985) Anatomy of the ethmoid: CT, endoscopic and macroscopic. Am J Neuroradiol 6(1):77–84
20.
Zurück zum Zitat Zacharek MA, Han JK, Allen R, Weissman JL, Hwang PH (2005) Sagittal and coronal dimensions of the ethmoid roof: a radioanatomic study. Am J Rhinol 19(4):348–352PubMed Zacharek MA, Han JK, Allen R, Weissman JL, Hwang PH (2005) Sagittal and coronal dimensions of the ethmoid roof: a radioanatomic study. Am J Rhinol 19(4):348–352PubMed
Metadaten
Titel
Asymmetry of lateral lamella of the cribriform plate: a software-based analysis of coronal computed tomography and its clinical relevance in endoscopic sinus surgery
verfasst von
Mohammad Adeel
Mubasher Ikram
Mohammad Shaheryar Ahmed Rajput
Asif Arain
Yasir Jamil Khattak
Publikationsdatum
01.11.2013
Verlag
Springer Paris
Erschienen in
Surgical and Radiologic Anatomy / Ausgabe 9/2013
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-013-1106-4

Weitere Artikel der Ausgabe 9/2013

Surgical and Radiologic Anatomy 9/2013 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.