Anat Cell Biol.  2023 Jun;56(2):179-184. 10.5115/acb.22.230.

Study of frontal and ethmoid sinus of sinonasal complex along with olfactory fossa: anatomical considerations for endoscopic sinus surgery

• Gandhi KR
• Patil ST
• Kumar B
• Patel M
• Chaware P

• KMID: 2544078
• DOI: http://doi.org/10.5115/acb.22.230

Abstract

The Functional endoscopic sinus surgery through transnasal approach is a common modality of treatment for disorders of the nasal cavity, paranasal air sinuses as well as cranial cavity. The olfactory fossa (OF) is located along the superior aspect of cribriform plate which varies in shape and depth. This variable measurement of the depth of OF is mostly responsible for greater risk of intracranial infiltration during endoscopic procedures in and around the nasal cavity. The morphology of frontal and ethmoid sinus (ES) vary from simple to complex. This cadaveric study is planned to improve the ability of the otolaryngologist, radiologist to understand the possible morphological variations and plan steps of less invasive “precision surgery” to have a safe and complication free procedures. A total of 37 human head regions were included in the study. For classification of OF, Modified Kero’s classification was used. The size, shape and cells of frontal and ES were noted. We found, type II (60.8%) OF was more common followed by type I (29.7%) than type III (9.5%). The shape of frontal sinus was comma shaped (55.4%) followed by oval (18.9%) than irregular (16.2%). Most common two cells type of ES was seen in 50.0% of both anterior and posterior ES. Out of 74 ES, 8.1% of Onodi cells and 14.9% of agger nasi cells were seen.

Keyword

Cribriform plate; Frontal sinus; Ethmoid sinus; Paranasal sinuses; Nasal cavity; Ethmoid bone

Figure

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  Fig. 1 Showing different shapes of the frontal sinus. (A) Irregular. (B) Comma shaped. (C) Oval. (D) Hypoplasia of frontal sinus. Horizontal arrows are directed towards the anterior aspect and upward arrows indicate a superior aspect of a specimen.

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  Fig. 2 Showing frontal sinus (A) Eccentric septa inside the frontal sinus. (B) Aplasia of frontal sinus on right side marked by 2. (C) Irregular frontal sins with lateral expansion in roof of orbit marked by a star. Arrow in the figure is directed to indicate anterior aspect of the specimen.

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  Fig. 3 Sagittal section of head for paranasal sinus. AN, agger nasi cell; FS, frontal sinus; OC, onodi cell; SS, sphenoid sinus; Ant., anterior; Sup., superior. Aspect of specimen are indicated by red arrows.

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