Evaluation of anatomic variations of lateral nasal wall in functional endoscopic sinus surgery

ABSTRACT

Sinus endoscopic surgery requires sufficient anatomical knowledge of the area. The objective of this study was to determine the variations of anatomic landmarks in patients undergoing functional endoscopic sinus surgery. This retrospective study was based on reviewing the recorded video tapes obtained during operation of 100 patients with chronic sinusitis or other sinonasal diseases who underwent endoscopic sinus surgery. At the beginning of each operation, both nasal cavities were reviewed by 0 and 30 degrees, 4 millimeter telescope. Anatomic structures of the lateral nasal wall was viewed and findings were recorded on VHS videotapes. These videotapes were re-evaluated later. The following data were obtained by reviewing these anatomic variations in 170 nasal cavities in 100 patients Middle turbinate typical [70%], concha bullosa [10%], sagittal cleft [4.5%], lateral displacement [5%], lateral bending [4.5%], medial bending [3%], medial displacement [3%] and transverse cleft [0%]. Uncinate process typical [82%] and medially rotated [18%]. Bulla ethmoidalis balloon shaped [typical] [60%], sausage shape [22%] and flat [18%]. Accessory ostium round [67%] and oval [33%]. Sphenoid sinus ostium oval [50%], slit [35%] and round [15%]. This study attempted to determine the anatomic variations of the lateral nasal wall. Knowledge of these variations is important for differentiating pathologic conditions from normal anatomic variations and offers a safer and more effective endoscopic sinus surgery with less complications