Academic literature on the topic 'Ethmoidal cells'

Objective: The aim of this study is to investigate the anatomy of the posterior and middle ethmoidal arteries from the viewpoint of an endoscopic sinus surgeon. Methods: Based on 100 computed tomography images, the anatomical position of the posterior ethmoidal artery in relation to the posterior ethmoid cells was classified into five types. The presence of the posterior and middle ethmoidal arteries, their distance from the skull base, and their length exposed in the ethmoid cells were measured. The association of patients’ age and sex, presence of the middle ethmoidal artery, and anatomical type of the posterior ethmoidal artery with the posterior ethmoidal artery distance from the ethmoid roof was analyzed. Results: The posterior ethmoidal artery’s position, relative to the ethmoid cell walls, was most often near the first wall, anterior to the optic canal (92.5%). The posterior ethmoidal artery’s distance from the skull base ranged from 0 to 6.4 mm (mean: 1.2 mm). Older age, longer length of the posterior ethmoidal artery exposed in the ethmoid cells, and absence of the middle ethmoidal artery were positively associated with a longer posterior ethmoidal artery distance from the skull base. Conclusion: Attention should be paid to the posterior and middle ethmoidal arteries.

AbstractObjectives:This study aimed to radiologically evaluate the influence of inflammatory changes in frontal recess cells on frontal sinusitis.Methods:A total of 93 patients (186 sides) who underwent primary sinonasal surgery at Hyogo College of Medicine were enrolled in 2015 and 2016. Opacification of agger nasi, fronto-ethmoidal, ethmoid bulla, suprabullar and frontal bulla cells was determined by pre-operative computed tomography and its influence on frontal sinusitis was investigated.Results:In all, 42 per cent of 186 sides were affected by frontal sinusitis. Agger nasi, ethmoid bulla, fronto-ethmoidal, suprabullar and frontal bulla cells were identified in 99 per cent, 100 per cent, 38 per cent, 69 per cent, and 16 per cent of sides, respectively. The presence of frontal recess cells and frontal ostium size did not significantly influence frontal sinusitis development. However, opacification of agger nasi, type 1 fronto-ethmoidal and suprabullar cells significantly influenced frontal sinusitis development.Conclusion:Frontal sinusitis is caused by inflammatory changes in frontal recess cells.

Abstract OBJECTIVE: Vascular lesions of the anterior cranial fossa can receive significant blood supply from the anterior ethmoidal artery. Embolization of this blood supply exposes the parent vessel, the ophthalmic artery, to possible embolic complications, which can lead to loss of vision. A study of the microsurgical anatomy can help delineate the course of the anterior ethmoidal artery and find the best points for proximal control of the blood supply to these lesions. Clinical cases are presented to illustrate how lesions with prominent anterior ethmoidal artery feeders are best approached through fronto-orbital single-flap craniotomies. METHODS: Eight cadaveric dissections to demonstrate the microsurgical anatomy of the anterior ethmoidal artery were performed to study the relevant anatomy. Two clinical cases are presented that demonstrate clinical application of this anatomy through fronto-orbital single-flap craniotomies. RESULTS: Eight arteries were studied in four cadaveric heads. The dissections show the course of the anterior ethmoidal artery from the ophthalmic artery in the orbit, through the anterior ethmoidal foramen into the ethmoid air cells, to the cribriform plate, where it turns superiorly to become the anterior falx artery. The first surgical case is of a giant tuberculum sellae meningioma that was resected with coagulation and division of the anterior ethmoidal arteries at the anterior ethmoidal foramina at the laminae papyraceae of both medial orbital walls. The second surgical case is of a large deep right frontal arteriovenous malformation that was resected with coagulation and division of the anterior ethmoidal artery at the anterior ethmoidal foramen of the lamina papyracea of the right medial orbital wall. CONCLUSION: The cadaveric dissections and our surgical experience show that the anterior ethmoidal artery has three important sites for surgical access: 1) the anterior ethmoidal foramen at the lamina papyracea of the medial orbital wall; 2) the anterior ethmoid canal at the lateral ethmoid wall; and 3) extradurally, at the cribriform plate. These three sites are best accessed through a fronto-orbital single-flap craniotomy, which can be unilateral or bilateral, depending on the pathological findings. The described orbital-cranial approach in this article is not being advocated to replace the standard pterional and frontal approaches; rather, we suggest it as an option in these complex cases that require early proximal control of the anterior ethmoidal artery feeders.

AbstractBackground. Functional endoscopic sinus surgery may be indicated when certain anatomic variations impede the normal drainage of the paranasal sinuses through the ostiomeatal complex. We aimed at studying the drainage system of the maxillary sinus which consists of the maxillary infundibulum, the main ostium of the maxillary sinus, the ethmoidal infundibulum and the hiatus semilunaris inferior.Material and methods. The study was performed retrospectively on cone beam computed tomography (CBCT) scans of 60 subjects (N=120 maxillary sinuses). The anatomical pattern of the maxillary sinus drainage was studied on coronal scans.Results. As related to different morphological possibilities in the supero-lateral limit of the maxillary sinus drainage system, five different patterns were defined: in type I (55%) there was no pneumatization in that situs, in type II (18%) there was an infraorbital recess of the maxillary sinus placed above the sinus ostium, in type III (14%) an ethmoidal recess of the maxillary sinus was expanded within the ethmoid bone, above the ethmoidal infundibulum, in type IV (3%) there were Haller cells above the sinus ostium, while in type V (10%) there were non-infraorbital ethmoid air cells above and draining into the ethmoidal infundibulum.Conclusion. It appears that CBCT is a reliable tool to make an anatomical distinction of the variable pattern of pneumatization impeding a normal drainage of the maxillary sinus, between maxillary sinus- and ethmoid-derived air-filled spaces.

Abstract Sinoliths are calculi found particularly in paranasal sinuses, the rarest location being the ethmoid air cells. There were previously reported only 4 cases of unilateral large ethmoidal sinoliths (ES), this one being the fifth report. We report here the incidental bilateral evidence in a 34-year-old female patient evaluated in Cone Beam Computed Tomography (CBCT) of minor ES. The left ES, of 1.6 mm2 sagittal size, occupied the suprabullar cell, in front of the ground lamella and behind the anterior ethmoidal canal. The right ES, of 7.6 mm2, was located behind the ground lamella. The radiodensity of each ES was about 1000 HU, their bone quality being thus assessed. This is the first evidence of bilateral and clinically silent ethmoidal sinoliths. Being small-sized and incidentally found, it seems reasonable to consider that ethmoidal sinoliths could have a higher incidence but they are overlooked due to the lack of clinical manifestations.

AbstractObjective:We describe a previously unreported case of ethmoid silent sinus syndrome.Method:Case report and review of the world literature regarding silent sinus syndrome.Results:A 33-year-old woman developed medial displacement of the left orbital contents in the absence of trauma, surgery or other significant pathology. Imaging showed opacification of the left ethmoid sinus and implosion of the medial orbital wall. Previously reported cases of silent sinus syndrome have all involved the maxillary sinus, with subsequent implosion of the orbital floor. Computed tomography scans of our patient showed wide, flat ethmoidal bulla and surrounding cells, with few horizontal bony septae reinforcing the area of collapse.Conclusion:This case represents the first report of ethmoid silent sinus syndrome. We argue that, in anatomically susceptible individuals, the silent sinus syndrome can present due to chronic ethmoidal sinusitis.

Background: The thinnest portion of the medial wall of the orbit is Lamina orbitalis ossis ethmoidalis which separates the ethmoidal sinuses from the orbit. Congenital bony malformation of orbit and anatomical variation of ethmoidal sinuses are important in terms of the risk of complication development during endoscopic sinus surgery and to understanding the pathophysiology and spread of sinus disease.Materials and Methods: Accordingly the present study was designed to fi nd out the congenital malformation of medial wall of the orbit in relation to lamina orbitalis ossis ethmoidalis. The study was carried out using 100 dried adult human skulls and twenty six human cadavers irrespective of sex were obtained from the Department of Anatomy - Mayo Institute of Medical Sciences-Barabanki, Department of Anatomy - Melaka Manipal Medical College - Manipal and Department of Anatomy - KMCT Medical College, Manassery - Calicut.Results: In three skulls (2.380%) we noted unilateral unusual hole at the junction of medial wall and roof of orbit with dimensions of 2.3 cm long and 1 cm height in two skulls and another unusual vertical hole at the anterior part of medial wall and roof of orbit with dimensions of 2 cm height and 1 cm width. We also noted few ethmoidal cells extended in to the orbital plate and fovea ethmoidalis of the frontal bone.Conclusion: Congenital defective formation of bony orbit and variable anatomy of paranasal sinuses noted in this study is may be due to the defective formation of Lamina orbitalis ossis ethmoidalis from the lateral part of the nasal capsule near the fronto ethmoidal suture such comprehensive knowledge is necessary to understand the various disorders of this region and to avoid complications during surgical procedures involving this area.DOI: http://dx.doi.org/10.3126/ajms.v6i2.10534Asian Journal of Medical Sciences Vol.6(2) 2015 91-94


 Objective : This study aims to determine the prevalence of supraorbital ethmoidal cells (SOEC) among Filipinos in a single tertiary government institution. 
 Methods:
 
 Study Design: Retrospective review of CT scan images
 Setting: Single Tertiary Institution
 Patients: 123 patients aged 13-years-old and above
 
 Results: A total of 474 CT scans (60 PNS and 414 Craniofacial) performed during the study period were considered, with 55 excluded for age < 13, and 296 excluded for craniofacial fractures. None had congenital craniofacial deformities. Eighty-five of 123 CT scans (69.11%) or 147 of 246 sides (59.76%) demonstrated supraorbital ethmoidal cells. There were 62 (72.94%) males and 23 (27.06%) females, ages ranging from 13 to 83 (mean age between male and female was 39.53 and 43.57). The scans showed 62 (50.41%) patients with bilateral and 23 (18.70%) with unilateral SOEC. Twenty-two (25.9%) patients were identified with chronic rhinosinusitis and two of whom were considered to have maxillary sinus mass. Two out of 5 patients with SOEC presented with aplastic/hypoplastic frontal sinus.
 Conclusion: Our study suggests that Filipinos may have a higher prevalence rate of SOEC than their Chinese, Japanese and Korean counterparts and bilateral SOEC are more predominant than unilateral SOEC.
 
 Keywords: supraorbital ethmoid cell, anterior ethmoid artery, paranasal CT scan, craniofacial CT scan, frontal sinus surgery

Juvenile variant ossifying fibroma of sinonasal region is an extremely rare benign fibro-osseous lesion which is locally aggressive. A 21-year-old male presented with significant proptosis of right eye with stony-hard lump in the middle upper aspect of the right orbit and base of the nose. CT scan of head revealed a non-enhancing expansile lesion in right ethmoidal cells consistent with chronic ethmoidal mucocele. However Magnetic Resonance Imaging of brain revealed enhancing lesion in right ethmoid and frontal sinus extending up to anterior cranial fossa. He underwent right frontal craniotomy with surgical excision of tumor wherein cystic brown tumor of frontal and ethmoidal sinus was found. The procedure was supplemented with endoscopic transnasal approach. Histopathology report suggested an ossifying fibroma. This case highlights the importance of clinical, imaging and histopathological features of ossifying fibroma occurring in the sinonasal tract for better diagnosis and treatment through a multidisciplinary approach.