Korean J Otorhinolaryngol-Head Neck Surg.  2024 Jan;67(1):16-21. 10.3342/kjorl-hns.2023.00199.

A Study on the Possibility of Neurological Morbidity of Prelacrimal Recess Approach Depending on Anatomical Differences

• Koo HB
• Son SJ
• Lee JH

• KMID: 2551078
• DOI: http://doi.org/10.3342/kjorl-hns.2023.00199

Abstract

Background and Objectives
The maxillary sinus disease is mainly treated through the middle meatal antrostomy, but there is a disadvantage in that it does not approach the lesions of the anterior wall of the maxillary sinus. On the other hand, the prelacrimal recess approach (PLA) can be used to access the lesions of the anterior wall of the maxillary sinus. However, complications after PLA may include nasal bleeding, infection, epiphora, and neurological symptoms. We investigated the possibility of neurological morbidity (anterior superior alveolar nerve injury) after PLA by imaging.
Subjects and Method
A total of 253 people were studied by using 506 samples of paranasal sinus CT. According to the Simmen and Arosio methods, the study groups were classified into the following categories: PLA type I (<3 mm), type II (3-7 mm), and type III (>7 mm), internal angle of pyriform notch (IAPN), type A (below 45°), type B (from 45° to 60°), and type C (60° excessive).
Results
Of the PLA types, the IAPN value was the largest in the type III and smallest in the type I, and there were significant differences among the three groups (p<0.001).
Conclusion
CT Evaluation prior to PLA would help physicians to predict the likelihood of neurological morbidity such as maxillary sensory abnormalities.

Keyword

Anterior superior alveolar nerve; Computed tomography; Neurological morbidity; Prelacrimal recess approach; Pyriform notch