No abstract available.
Ethmoid Sinus*

Sinochoanal polyp is an inflammatory polyp that originates in the paranasal sinus, passes through a sinus ostium, and extends into the choana. While antrochoanal polyp is the most common type of sinochoanal polyp, sphenochoanal polyp is rare and ethmochoanal polyp is extremely more rare to find. To minimize postsurgical recurrence, it is essential to completely remove the polyp together with the base of its origin. We have recently experienced and successfully managed three cases of ethmochoanal polyp by endoscopic sinus surgery. It was difficult to histologically differentiate ethmochoanal polyp from sinonasal polyps associated with chronic rhinosinusitis. For this reason, ethmochoanal polyp should be suspected and completely removed together with the base of its origin when a large polyp originates from the ethmoid sinus and extends into the choana. Now we report three cases of ethmochoanal polyp with a brief review of the related literatures.
Ethmoid Sinus* ; Polyps* ; Recurrence

Osteoma is a tumor of mature bone showing slow growth of well-differentiated bone. It occasionally produces symptoms of space occupying lesion and symptoms of ethmoid osteoma occur earlier than that of osteoma of the frontal sinus. Osteoma of orbital area is uncommon and it may produce ophthalmologic symptoms and cosmetic problems. Treatment remains controversial: open procedures are typically being used, however, small sized ethmoid osteoma are removed by intranasal procedure. Recently, the authors have experienced a case of giant ethmoid osteoma with orbital extension, which was removed with intranasal endoscopic and external ethmoidectomy approach. Hence, we report this case with a review of literature.
Ethmoid Sinus ; Frontal Sinus ; Methods ; Orbit* ; Osteoma*

PURPOSE: As the use of computed tomographic scanning spread, the diagnosis of blow-out fractures of the medial orbital wall increased. Conventionally, the surgery of blow-out fractures in medial orbital wall was performed by various approaches with external incision or endoscopic approach. Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of the fracture site, blind dissection of the orbital wall, and difficulty in insertion of implant. In order to overcome these shortcomings, we explored the use of endoscopic transnasal approach together with subciliary approach. METHODS: The entrapped periorbital tissues in the ethmoid sinus were completely reduced endoscopically, and the bone defect of medial orbital wall was reconstructed with Medpor(R) insertion via subciliary approach. This technique was applied to 13 patients who had medial orbital wall fracture. RESULTS: The patients were followed-up for 3 to 24 months with an average of 9 months. The postoperative courses were satisfactory in all cases. CONCLUSION: The conjunction of endoscopic transnasal and subciliary approach technique seems to produce good results in medial orbital wall fracture.
Diagnosis ; Ethmoid Sinus ; Humans ; Orbit* ; Orbital Fractures

A large osteoma arising from the ethmoid sinus produced exophthalmos and diplopia. The troublesome symptoms disappeared after surgical removal of the lesion. The osteoma was an ivory type.
Diplopia ; Ethmoid Sinus ; Exophthalmos ; Orbit* ; Osteoma*

OBJECTIVE: We often observe the variation of Crista galli (CG) which lies in the midline above the cribriform plate on computed tomography (CT) scans. We investigated the variations in CG and the factors which affect its pneumatization. MATERIALS AND METHODS: We analyzed the CT images of 818 chronic rhinosinusitis patients between July 2003 and July 2011. We investigated height, position relative to the cribriform plate, degree of pneumatization, and cell origin for the pneumatization in CG. We analyzed the relationship between several factors (age, sex, and position of CG) and pneumatization of CG. RESULTS: The average height of CG was 17.98 mm. In 13.9% of subjects, the base of CG did not extend below the level of the cribriform plate. In 84.2%, CG extended less than 50% of its height below the cribriform plate. In 1.8%, CG extended more than 50% of its height below the cribriform plate. Pneumatization of CG was found in 12.2%. Except one, every pneumatization was connected with the frontal sinus. The rate of pneumatization was significantly different depending on age. CONCLUSION: Our study demonstrated that CG showed various morphology and pneumatizaiton. The pneumatization of CG was mainly originated from frontal sinus and related to aging.
Aging ; Ethmoid Bone ; Frontal Sinus ; Humans

Cysts ; Endoscopy ; Ethmoid Sinus ; surgery ; Humans ; Orbit

Sinus osteoma is a common nasal and sinus disease, while the clinical cases of osteoma with a diameter greater than 30 millimeter are rarely seen. This paper reports a case of a 39-years-old male patient discovered with one-year long swelling pain in the right eye. The patients' right eye was mildly prominent and he suffered from hypopsia and diplopia. After CT scanned, he have ethmoid osteoma been discovered, besides, the right media rectus compression and orbital apex compression and consequent pathologically were diagnosed. The solid tumor ranged widely from the anterior skull base to the superior and interior orbital walls,and thus deprived the patient's complete surgical resection. As an attempt to prevent complications, most parts of the tumors were sur gically removed.
Adult ; Ethmoid Sinus ; Humans ; Male ; Osteoma

PURPOSE: To evaluate the anatomical relation between anterior ethmoidal sinus and the lacrimal sac fossa, and thus help prevent complications during dacryocystorhinostomy. MATERIALS AND METHODS: Fifty three people without previous history of trauma, surgery, or paranasal sinus disease were randomly selected, and the 106 lacrimal sac fossas of these subjects were evaluated by high resolution CT. A series of three 2-mm thick axial sections at least 2 mm from the inferior orbital wall were obtained. The bony landmarks of the lacrimal sac fossa were established and the location of the most anterior ethmoid sinus was classified as one of three types. In type 1, no sinuses were anterior to the posterior lacrimal crest. while in type 2, sinuses extended anterior to this crest but remained behind the suture at the anterior edge of the lacrimal bone. In type 3, sinuses extended into the frontal process of the maxilla, anterior to the lacrimal bone suture. In addition, the category of both orbits of the same patient was compared. RESULTS: Among the 106 orbits examined, only seven (6.6%) were classified as type 1, with no ethmoid air cells positioned under the lacrimal sac fossa. Seventy six (71.7%) qualified as type 2, while the remaining 23 (21.7%) were type 3, demonstrating anterior ethmoid air cells within the nasal process of the maxilla. The position of the air cells was symmetric in 41 of the 53 subjects (77.4%) and asymmetric in 12 (22.6%). CONCLUSION: In cases involving surgery of the lacrimal sac fossa, such as dacryocystorhinostomy, a knowledge of the consistent anatomic relationship between the anterior ethmoidal sinus and the lacrimal sac fossa is invaluable.
Dacryocystorhinostomy ; Ethmoid Sinus ; Humans ; Maxilla ; Orbit ; Paranasal Sinus Diseases ; Sutures

PURPOSE: To evaluate the anatomical relation between anterior ethmoidal sinus and the lacrimal sac fossa, and thus help prevent complications during dacryocystorhinostomy. MATERIALS AND METHODS: Fifty three people without previous history of trauma, surgery, or paranasal sinus disease were randomly selected, and the 106 lacrimal sac fossas of these subjects were evaluated by high resolution CT. A series of three 2-mm thick axial sections at least 2 mm from the inferior orbital wall were obtained. The bony landmarks of the lacrimal sac fossa were established and the location of the most anterior ethmoid sinus was classified as one of three types. In type 1, no sinuses were anterior to the posterior lacrimal crest. while in type 2, sinuses extended anterior to this crest but remained behind the suture at the anterior edge of the lacrimal bone. In type 3, sinuses extended into the frontal process of the maxilla, anterior to the lacrimal bone suture. In addition, the category of both orbits of the same patient was compared. RESULTS: Among the 106 orbits examined, only seven (6.6%) were classified as type 1, with no ethmoid air cells positioned under the lacrimal sac fossa. Seventy six (71.7%) qualified as type 2, while the remaining 23 (21.7%) were type 3, demonstrating anterior ethmoid air cells within the nasal process of the maxilla. The position of the air cells was symmetric in 41 of the 53 subjects (77.4%) and asymmetric in 12 (22.6%). CONCLUSION: In cases involving surgery of the lacrimal sac fossa, such as dacryocystorhinostomy, a knowledge of the consistent anatomic relationship between the anterior ethmoidal sinus and the lacrimal sac fossa is invaluable.
Dacryocystorhinostomy ; Ethmoid Sinus ; Humans ; Maxilla ; Orbit ; Paranasal Sinus Diseases ; Sutures