Evaluation of Maxillary Sinus and Nasolacrimal Canal Relationship via Paranasal Sinus Tomography Imaging

Year 2019, Volume: 2 Issue: 3, 71 - 74, 07.12.2019

Servet Akyüz , Fatma Nur Yıldırım , Can Zafer Karaman , Hatice Sema Başak

Abstract

Objective: Transnasal endoscopic surgical treatments of the maxillary sinus (MS) and nasolacrimal canal (NLC) pathologies are very common. A detailed understanding of the anatomy of this region preoperatively affects the chances of surgical success. Advances in paranasal sinus computed tomography (PNSCT) have yielded a better understanding of the surgical anatomy.

Material and Methods: The anatomical relationships between the medial and anterior walls of MS and NLC involving 81 patients (41 males and 41 females) were analyzed by means of PNSCT sections. The anatomical relationship of NLC with the MS anterior wall was evaluated and classified into unified and separate types. The separate-type NLC was further classified as protruding or nonprotruding according to the localization of the medial wall of the MS. In addition, the vertical height of the lower meatus and long and short diameters of the NLC were measured.

Results: The unified type was detected in 54 (32.9%) patients out of the total MSs of 164 patients. The distance between the anterior walls of the MS and NLC was 3.50 mm in females and 3.95 mm in males; this did not significantly differ between the genders. Further, 26 MSs were of the protruding type. The vertical height of the lower meatus was 10.75 mm in females and 12.15 mm in males. The long diameter of the NLC was 6.30 mm in women and 6.80 mm in men. The short diameter of the NLC was 4.85 mm in women and 5.00 mm in men.

Conclusion: The relationship between the NLC and MS shows anatomical variations. Understanding these variations before surgery can increase the success rate of endoscopic surgical procedures directed toward the medial wall of MSs.

Keywords

Maxillary sinus , medial maxillectomy , nasolacrimal canal

References

• Wang X, Chen X, Zheng M, Liu C, Wang C, Zhang L. The relationships between the nasolacrimal duct and the anterior wall of the maxillary sinus. Laryngoscope 2019; 129: 1030-4.
• Park D Y, Choo O, Hong S, Kim H. Infratemporal fossa cellulitis caused by a remnant iatrogenic foreign body after a bimaxillary operation. J Craniofac Surg 2015; 26: 196-7.
• Moriyama M, Kodama S, Hirano T, Suzuki M. Endoscopic-modified medial maxillectomy and its limitation for a solitary fibrous tumor of the lacrimal sac and nasolacrimal duct. Auris Nasus Larynx 2017; 44: 370-4.
• Küçük B, Yorulmaz İ. Nazal ve Paranazal Tümörlerin Medial Maksillektomi ile Rezeksiyonunda Nazolakrimal Sistemin Korunması. K.B.B. ve Baş Boyun Cerrahisi Derg 2000; 8: 28-32.
• Sieskiewicz A, Buczko K, Janica J, Lukasiewicz A, Lebkowska U, Piszczatowski B, et al. Minimally invasive medial maxillectomy and the position of nasolacrimal duct: the CT study. Eur Arch Otorhinolaryngol 2017; 274: 1515-9.
• Navarro Pde L, Machado AJ Jr, Crespo AN. Assessment of the lacrimal recess of the maxillary sinus on computed tomography scans. Eur J Radiol 2013; 82: 802- 5.
• Meyers A, Hawes MJ. Nasolacrimal obstruction after inferior meatus nasal antrostomy. Arch Otolaryngol Head Neck Surg 1991; 117: 208-11.
• Ghosh A, Pal S, Srıvastava A, Saha S. Modification of endoscopic medial maxillectomy: a novel approach for inverted papilloma of the maxillary sinus. J Laryngol Otol 2015; 129: 159-63
• Simmen D, Veerasigamani N, Briner H, Jones N, Schuknecht B. Anterior maxillary wall and lacrimal duct relationship - CT analysis for prelacrimal access to the maxillary sinus. Rhinology 2017; 55: 170-4.
• Groell R, Schaffler G, Uggowitzer M, Szolar DH, Muellner K. CT-anatomy of the nasolacrimal sac and duct. Surg Radiol Anat 1997; 19: 189-91.
• Ramey NA, Hoang JK, Richard MJ. Multidetector CT of nasolacrimal canal morphology: normal variation by age, gender, and race. Ophthal Plast Reconstr Surg 2013; 29: 475-80.
• Ela AS, Cigdem KE, Karagoz Y, Yigit O, Longur ES. Morphometric measurements of bony nasolacrimal canal in children. J Craniofac Surg 2018; 29: 282-7.