2025, Number 1
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Acta de Otorrinolaringología CCC 2025; 53 (1)
Anatomical variables with potential risk profi le for papyrus lamina injury during nasal endoscopic surgery in computed tomography at the Hospital Militar Central
Díaz-Oliveros MA, González-Marín NR, Mora DC
Language: Spanish
References: 19
Page: 76-84
PDF size: 315.10 Kb.
ABSTRACT
Introduction: Accidental damage to the lamina papyracea during endoscopic en-
donasal surgery is a common complication. Determining its position relative to the
maxillary drainage ostium in preoperative tomographic analysis will allow us to
reduce the risk of injury.
Objective: This study aims to describe how these anato-
mical risk variables are distributed. This imaging assessment was performed using
computed tomography images of healthy patients over 18 years old who attended
the Central Military Hospital between June 2019 and April 2022. Study design: Descriptive
observational cross-sectional study.
Materials and methods: A sample size
calculation was performed where 410 computed tomography scans of healthy adult
patients’ paranasal sinuses were randomly selected. The position of the lamina pa-
pyracea on each side was categorized concerning the maxillary drainage ostium at
the level of the inferior turbinate insertion in the lateral nasal wall.
Results: A total of
410 tomographies were analyzed, revealing that the position of the lamina papyracea
in relation to the medial antrostomy line (MAL) was classifi ed as type I in 65.1%
to 69.8% of cases, type II in 28.8% to 22.4%, and type III in 6.1% to 7.8%. These
fi ndings were consistent with previous studies, where type I was the most common
position, followed by type II and, lastly, type III.
REFERENCES
Christmas DA, Mirante JP, Yanagisawa E. 25 years of poweredendoscopic maxillary antrostomy. Ear Nose Throat J. 2017Mar;96(3):94-98. doi: 10.1177/014556131709600304
Tajudeen BA, Kennedy DW. Thirty years of endoscopic sinussurgery: What have we learned? World J OtorhinolaryngolHead Neck Surg. 2017;3(2):115-121. doi: 10.1016/j.wjorl.2016.12.001
García-Garrigós E, Arenas-Jiménez JJ, Monjas-CánovasI, Abarca-Olivas J, Cortés-Vela JJ, De La Hoz-Rosa J, et al.Transsphenoidal Approach in Endoscopic Endonasal Surgeryfor Skull Base Lesions: What Radiologists and Surgeons Needto Know. Radiographics. 2015;35(4):1170-85. doi: 10.1148/rg.2015140105
Kennedy DW, Adappa ND. Endoscopic maxillary antrostomy:not just a simple procedure. Laryngoscope. 2011;121(10):2142-
doi: 10.1002/lary.221695. Flint PW, Francis HW, Haughey BH, Lesperance MM, LundVJ, Robbins KT, et al. Cummings Otolaryngology Head andNeck Surgery. 7.a edición. Philadelphia: Elsevier; 2021.
Seredyka-Burduk M, Burduk PK, Wierzchowska M, KaluznyB, Malukiewicz G. Ophthalmic complications of endoscopicsinus surgery. Braz J Otorhinolaryngol. 2017;83(3):318-323.doi: 10.1016/j.bjorl.2016.04.006
Bhatti MT. Neuro-ophthalmic complications of endoscopicsinus surgery. Curr Opin Ophthalmol. 2007;18(6):450-8. doi:10.1097/ICU.0b013e3282f0b47e
Humphreys IM, Hwang PH. Avoiding Complications inEndoscopic Sinus Surgery. Otolaryngol Clin North Am.2015;48(5):871-81. doi: 10.1016/j.otc.2015.05.013.
Dalziel K, Stein K, Round A, Garside R, Royle P. Endoscopicsinus surgery for the excision of nasal polyps: A systematicreview of safety and effectiveness. Am J Rhinol. 2006;20(5):506-19. doi: 10.2500/ajr.2006.20.2923
Bhatti MT, Schmalfuss IM, Mancuso AA. Orbitalcomplications of functional endoscopic sinus surgery: MR andCT findings. Clin Radiol. 2005;60(8):894-904. doi: 10.1016/j.crad.2005.03.005
Demirayak B, Altıntaş Ö, Ağır H, Alagöz Ş. Medial RectusMuscle Injuries after Functional Endoscopic Sinus Surgery.Turk J Ophthalmol. 2015;45(4):175-178. doi: 10.4274/tjo.01328
Herzallah IR, Marglani OA, Shaikh AM. Variations of laminapapyracea position from the endoscopic view: a retrospectivecomputed tomography analysis. Int Forum Allergy Rhinol.2015;5(3):263-70. doi: 10.1002/alr.21450
Meyers RM, Valvassori G. Interpretation of anatomicvariations of computed tomography scans of the sinuses: asurgeon’s perspective. Laryngoscope. 1998;108(3):422-5. doi:10.1097/00005537-199803000-00020
Hosemann W. Fehler und Gefahren: Eingriffe an denNasennebenhöhlen und der Frontobasis unter Berücksichtigungmediko-legaler Aspekte [Comprehensive review on dangerpoints, complications and medico-legal aspects in endoscopicsinus surgery]. Laryngorhinootologie. 2013;92 Suppl 1:S88-136. German. doi: 10.1055/s-0033-1337908
Nautiyal A, Narayanan A, Mitra D, Honnegowda TM,Sivakumar. Computed Tomographic Study of RemarkableAnatomic Variations in Paranasal Sinus Region and theirClinical Importance - A Retrospective Study. Ann MaxillofacSurg. 2020;10(2):422-428. doi: 10.4103/ams.ams_192_19
Mathew R, Omami G, Hand A, Fellows D, Lurie A. Cone beamCT analysis of Haller cells: prevalence and clinical significance.Dentomaxillofac Radiol. 2013;42(9):20130055. doi: 10.1259/dmfr.20130055
Aramani A, Karadi RN, Kumar S. A Study of AnatomicalVariations of Osteomeatal Complex in Chronic RhinosinusitisPatients-CT Findings. J Clin Diagn Res. 2014;8(10):KC01-4.doi: 10.7860/JCDR/2014/9323.4923
Souza DAS, Costa FWG, de Mendonça DS, Ribeiro EC, deBarros Silva PG, Neves FS. Computed tomography assessmentof maxillary sinus hypoplasia and associated anatomicalvariations: a systematic review and meta-analysis of globalevidence. Oral Radiol. 2024;40(2):124-137. doi: 10.1007/s11282-023-00726-2
Moulin G, Dessi P, Chagnaud C, Bartoli JM, Vignoli P, GaubertJY, et al. Dehiscence of the lamina papyracea of the ethmoidbone: CT findings. AJNR Am J Neuroradiol. 1994;15(1):151-3.