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Bone density measurements of the paranasal sinuses on plastinated whole‐organ sections: Anatomic data to prevent complications in endoscopic sinus surgery
Author(s) -
Sprinzl Georg Mathias,
Menzler Andreas,
Eckel Hans Edmund,
Sittel Christian,
Koebke Juergen,
Thumfart Walter Franz
Publication year - 1999
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-199903000-00011
Subject(s) - paranasal sinuses , sinus (botany) , frontal sinus , cadaver , anatomy , coronal plane , medicine , bone density , sagittal plane , maxillary sinus , surgery , pathology , osteoporosis , biology , botany , genus
Objective/Hypothesis : Although anatomic data regarding the gross anatomy of the paranasal sinuses are available, severe complications of endonasal sinus surgery (ESS) are frequently reported. To understand and to avoid these complications, density of bony walls of the paranasal sinuses were studied in this report. Special attention was given to the analysis of the bone density in regions where minor and major complications occur in ESS. Methods : Thirty cadaver heads were embedded in epoxy resin. The plastic blocks were sectioned with a diamond‐coated wire saw into 1.0‐mm thick, parallel slices in axial, coronal, and sagittal planes for 10 specimens each. The slices were x‐rayed and scanned with a computerized image analyzing system. For each specimen the bone density in 12 regions of interest was measured. Results : Besides the macroscopic examination of the plastinated specimens, a bone density analysis based on x‐ray films is presented. Lowest bone density was found at the lateral wall of the sphenoid sinus (3.31 ± 0.99 mm aluminum [Al]); highest density was measured at the roof of the sphenoid sinus (12.91 ± 1.75 mm Al). Overall bone density in female specimens was 0.41 mm Al (mean) lower than in male specimens. Conclusions : This study is the first to use plastinated whole‐organ serial sections and bone density images for the analysis of potential complications in ESS. The illustration of regions with minor and major bone density of the paranasal sinuses and the ethmoid floor as presented in this study may help the novice sinus surgeon to minimize the risks of ESS and to avoid severe complications.