Comparative Analysis on Anatomical Measurements of Paranasal Sinuses Using Nasal Endoscope and CT / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: It is rare to find any studies reporting on the practical measurements of landmarks in the paranasal sinuses that are done intraoperatively as well as comparative analysis on the anatomical and radiological measurements of the paranasal sinuses. The aim of this study was to analyze the anatomical measurements of the paranasal sinuses using nasal endoscope and CT scout films to determine the statistical significance. MATERIALS AND METHODS: In 130 patients the authors used bayonet forceps and seekers to measure the distances from the anterior nares to some of the intranasal structures, such as the uncinate process, bulla ethmoidalis, basal lamella, maxillary ostium, posterior wall of ethmoid sinus, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus. Then, using the CT scout films, we measured the distances between the anterior nasal spine and the basal lamella (B.L.), the anterior wall of sphenoid sinus (A.W.S.), and the posterior wall of sphenoid sinus (P.W.S.). We analyzed the mean values of the basal lamella, the anterior and posterior wall of sphenoid sinus from all the available data in order to compare the endoscopic and radiologic measurements, and carried out a paired t-test. RESULTS: There was a statistically significant discrepancy in the comparative analysis of the CT scout film and the endoscopic measurements of the basal lamella, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus, althought there were no significant discrepancy for basal lamella in female patients (p>0.05). CONCLUSION: The differnces between the CT and operative measurements observed in this study were due to differnt measuring points, differences in the measuring angles, and inaccurate locations of the landmarks on the CT scout films owing to their small sizes. These findings indicate that a more accurate method need to be introduced in using the CT films to measure the anatomical landmarks in the paranasl sinuses.

Anatomical Measurements of the Nose and Paranasal Sinuses Using Nasal Endoscope / 대한이비인후과학회지

Endoscopic sinus surgery as a surgical technique for chronic sinusitis has become very popular. So, surgeons should be familiar with the structures and variation of the paranasal sinus to avoid the risks of endoscopic sinus surgery. Many investigations were performed to measure the sinus structure with CT and cadaver dissection. But, there were not to be performed precise measurements in paranasal sinus during operation. The authors measured the distance between anterior nares to intranasal structures such as uncinate process, bulla ethmoidalis, basal lamella, maxillary ostium, posterior wall of ethmoid sinus, anterior wall of sphenoid sinus and posterior wall of sphenoid sinus in 86 patients during endoscopic sinus surgery which were performed by one surgeon. The authors analyzed between measured distance in paranasal sinus and circumference and anteroposterior diameter of head using t-test. The results were as followed. 1) The distance from anterior nares to uncinate process was 45.3+/-2.8mm, to basal lamella 57.9+/-4.6mm, to maxillary ostium 48.3+/-4.7mm, to anterior wall of sphenoid sinus 69.9+/-3.6mm, and to posterior wall of sphenoid sinus 83.7+/-4.3mm. 2) There were no significant difference between sex, circumference and anteroposterior diameter of head.