Endoscopic anatomy of tristar of grooves / 解放军医学杂志

ABSTRACT

Objective To explore the features of ostiomeatal complex under endoscopic observation,so as to provide reliable landmarks for a safe and perfect endoscopic sinus surgery.Methods Twelve heads from adult cadavers(8 males and 4 females) were split axially on midline with the nasal septum removed,and nasal endoscopic operation was performed for the observation of tristar of groove with professional surgical instruments on anterior ethmoid,frontal sinus and maxillory sinus.Results The tristar of groove was consisted of beak of the ethmoidal bulla and its prolonging process,apex of the uncinate process and anterior peak of the middle turbinate,at the region of frontal recess.The structures called meatal groove,uncinate groove and bullar groove were observed around the ethmoidal bulla and the tristar of groove located at their origination.Under endoscopic view these structures looked like a triangular clefts,so it was named.The cells of the meatal groove located anteromedially to the tristar,the cells of the uncinate groove were anterolateral and just inferoposterior to the meatal groove,those of the bullar groove superoposteriorly located to the cells of the uncinate groove.The ostia of these cells were constant and did not connect each other,their locations at the tristar of grooves were fixed relatively.Conclusion Tristar of grooves is a key area for endoscopic frontal sinusotomy.Due to the great structural variations,the constant landmarks,which can be seen under sinus endoscope,and the regular pattern of the nasal sinuses distribution are important and can guide the endoscopic sinus surgery.