Open AccessAnterior maxillary wall and lacrimal duct relationship - CT analysis for prelacrimal access to the maxillary sinus
Author(s) -
Daniel Simmen,
N. Veerasigamani,
Hans Rudolf Briner,
N. Jones,
B. Schuknecht
Publication year - 2017
Publication title -
rhinology (amsterdam. online)/rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.275
H-Index - 57
eISSN - 1996-8604
pISSN - 0300-0729
DOI - 10.4193/rhino16.318
Subject(s) - medicine , maxillary sinus , nasolacrimal duct , lacrimal sac , anterior wall , lacrimal duct , paranasal sinuses , anatomy , radiology , surgery
Background: The distance between the anterior wall of the maxillary sinus and the nasolacrimal duct shows a large individual variation. Methodology: To evaluate the feasibility of accessing the maxillary sinus through a prelacrimal window access (PLWA), a series of 100 paranasal CT scans from adult patients was analysed retrospectively. The distance between the anterior maxillary wall and the anterior border of the lacrimal duct (= prelacrimal window) were measured in 200 sides. Results: A distance of more the 7 mm was found in 12.5% maxillary sinuses and would enable straight forward PLWA. A distance between smaller than 7mm and larger than 3mm was present in 56.5% of sinuses, and would make surgical access more demanding. In 31.5% of maxillary sinuses the distance was smaller than or equal to 3mm and in these patients this approach would be difficult without transecting the nasolacrimal duct. Conclusion: Only in 12.5% of sinuses a prelacrimal endoscopic access is readily feasible, while in 56.5% temporary tear sac dislocation is required and in 31.5% lacrimal sac dislocation is always needed along with a significant amount of bone removal to enable PLWA.