Facial sinus endoscopic evaluation, radiologic assessment, and classification.

Alicandri-Ciufelli, Matteo; Fermi, Matteo; Bonali, Marco; Presutti, Livio; Marchioni, Daniele; Todeschini, Alessandra; Anschütz, Lukas (2018). Facial sinus endoscopic evaluation, radiologic assessment, and classification. The Laryngoscope, 128(10), pp. 2397-2402. Wiley 10.1002/lary.27135

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OBJECTIVES To describe facial sinus anatomy from an endoscopic perspective and present a radiologic classification. METHODS Facial sinus was studied by endoscopy and high-resolution computed tomography (HRCT) scan in 39 temporal bones that underwent exclusive transcanal endoscopic approach. A radiomorphologic classification based on the relationship between the facial sinus and the mastoid portion of the facial nerve is created as follows. In type A facial sinus, the pneumatization of the facial sinus did not extend medially or posteriorly to the mastoid portion of the facial nerve. In type B facial sinus, the pneumatization extended posteriorly to the mastoid portion of the facial nerve. In type C facial sinus, the pneumatization extended posteriorly and medially to the mastoid portion of the facial nerve. RESULTS In all the specimens that underwent HRCT (n = 31), facial sinus could be identified, and its depth classified, in relation to the facial nerve. In this group, 58% type A, 29% type B, and 13% type C facial sinuses were identified. In all the specimens (n = 39), the facial sinus could be assessed by means of an exclusive endoscopic transcanal approach, and anatomical variants of the chordiculus, previously known as chordal ridge, could be described: ridge (39%), bridge (18%), incomplete (15%), and absent (28%). CONCLUSION Endoscopic exploration of the retrotympanum guarantees a very good exposure of the facial sinus, allowing detailed anatomic descriptions of its conformation and relationships with other structures. Improvement in our knowledge of its anatomy might decrease the possibility of residual disease during cholesteatoma surgery. Angled endoscopes (e.g. 45 °, 70 °) can guarantee a better view of the facial sinus. LEVEL OF EVIDENCE NA. Laryngoscope, 128:2397-2402, 2018.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)

UniBE Contributor:

Anschütz, Lukas Peter

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1531-4995

Publisher:

Wiley

Language:

English

Submitter:

Stefan Weder

Date Deposited:

23 Jan 2019 15:36

Last Modified:

15 Oct 2019 14:35

Publisher DOI:

10.1002/lary.27135

PubMed ID:

29513386

Uncontrolled Keywords:

Facial sinus chordiculus lateral tympanic sinus middle ear radiologic classification retrotympanum transcanal endoscopic approach

BORIS DOI:

10.7892/boris.123713

URI:

https://boris.unibe.ch/id/eprint/123713

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