Objective:To investigate the CT image characteristics of anterior ethmoidal artery（AEA） through CT scan and its significance in nasal endoscopic surgery. Methods:A retrospective study of 82 patients（164 sides） with chronic sinusitis was conducted. All patients underwent CT scan and the images were reconstructed. The AEA classification was used and calculate the rate of AEA suspension. The AEA was classified, and the suspension rate of the AEA was calculated. The height of the lateral lamella of the cribriform plate （LLCP） was measured, and Keros classification was performed. The relationship between Keros classification and AEA suspension was analyzed. The supraorbital ethmoidal cell （SOEC） was identified, and its relationship with AEA suspension was analyzed. Results:Type Ⅰ AEA accounted for 42.07%（69/164）. Type Ⅱ AEA accounted for 22.56%（37/164）. Type Ⅲ AEA accounted for 35.37%（58/164）. The suspension rate was 35.37%. The average height of the LLCP was （3.7±1.8） mm. In the Keros classification, type Ⅰaccounted for 53.05%（87/164）, Type Ⅱaccounted for 37.80%（62/164）. Type Ⅲ accounted for 9.15%（15/164）. The results of the Spearman analysis showed that there was a moderate positive correlation between the Keros classification and the suspension of the AEA（r=0.526, P<0.01）. Among 164 sides, SOEC was present in 15 sides. The suspension rate of AEA in the group with SOEC was significantly higher than that in the group without SOEC（P<0.01）. Conclusion:Sinus CT and multiplanar reconstruction can clarify the image characteristics of AEA and its relationship with surrounding structures. When the level of Keros classification is higher or SOEC is present, the suspension rate of AEA increases significantly. It is of great significance to clarify the characteristics of AEA before surgery in order to avoid injury during surgery.
Humans ; Retrospective Studies ; Endoscopy ; Ethmoid Sinus/diagnostic imaging* ; Tomography, X-Ray Computed ; Arteries/diagnostic imaging* ; Sinusitis/diagnostic imaging* ; Male ; Female ; Middle Aged ; Adult ; Aged

To investigate the morphologic characteristics of the retromaxillary posterior ethmoid.A total of 103 outpatients encountered in our hospital during March 2012 and December 2012,who completed paranasal sinus CT examination,were included in this study.Patients had no sinus trauma,surgery or tumor history.Their paranasal sinus CT scans were analyzed from scheduled axial and coronal plane.The incidence and imaging features of the retromaxillary posterior ethmoid were observed.The retromaxillary posterior ethmoid(RMPE)was the posterior ethmoid cell that expanded along the lamina papyracea toward the infraorbital region.RMPE was located behind the posterior wall of the maxillary sinus and under the orbital floor.The occurrence rate of the RMPE was 74.3%.The ethmomaxillary septum is the bony septum the between the maxillary sinus and posterior ethmoid.Anatomical confirmation of RMPE is based mainly on the presence of the ethmomaxillary septum.RMPE is located at the back of ethmomaxillary septum.The sagittal angulation of the ethmomaxillary septum ranged from 22 to 87 degrees,with an average of(50.34±12.10)degrees.The ethmomaxillary septum is important for anatomic recognition of the RMPE.Accurate identification of the RMPE before ESS can help improve the removal of the posterior ethmoid sinus.
Ethmoid Bone ; Ethmoid Sinus ; diagnostic imaging ; Humans ; Maxillary Sinus ; Paranasal Sinus Diseases ; diagnostic imaging ; Tomography, X-Ray Computed

OBJECTIVE: To observe the CT three-dimensional imaging features of the frontal recess region with advanced three-dimensional reconstruction, and develop the real image of the important anatomical structures around the region to conduct surgery. METHOD: Thirty patients were undergone spiral CT by 16 line high speed spiral CT, and multiplanar reconstruction images using standard three-dimensional reconstruction protocol on a computer workstation. The structure of the frontal recess, the agger nasi cell and adhere style of the uncinate process were observed. The parameter of the important anatomic structure of frontal recess was measured precisely. RESULT: After the reconstruction, we get the three-dimensional model very close to the true state of the nasal cavity-sinuses cell, in which parts of the frontal recess can clearly identify the agger nasi cell, frontal cell and other important structures. In these patients, the height, width and depth of the agger nasi and frontal sinus were (9.45 ± 3.60)mm, (8.08 ± 3.37)mm, (26.98 ± 6.82)mm and (26.86 ± 9.45)mm, respectively. CONCLUSION This study tried to develop the standardized techniques and measurements from three-dimensional reconstructed images of the frontal sinus and to ascertain the usefulness of the frontal sinus in identification of patients. The project results in better preoperative patient counselling and in predicting postoperative improvement in clinical status.
Ethmoid Sinus ; diagnostic imaging ; Frontal Sinus ; diagnostic imaging ; Humans ; Image Processing, Computer-Assisted ; methods ; Imaging, Three-Dimensional ; Nasal Cavity ; Paranasal Sinuses ; diagnostic imaging ; Tomography, Spiral Computed ; methods

OBJECTIVEThe purpose of this study was to determine the prevalence of frontoethmoidal cells in normal Chinese subjects.

METHODSTwo hundred and two Chinese subjects without symptoms of frontal sinus disease were undergone spiral computed tomography (CT). The multiplanar reconstruction images were evaluated using a standard triplanar reconstruction protocol on a computer workstation.

RESULTSThere were 121 males and 81 females. The mean age was (39.4 +/- 13.5) years. Of all the frontal cells identified in 159 sides (39.4%) of frontal recesses, the prevalence of type I, type II, type III and type cells were 24.3% (98 sides), 6.9% (28 sides), 8.2% (33 sides) and 0% (0 side) respectively. Suprabulbar cell, supraorbital ethmoid cells, and frontal bulbar cell were identified in 148 sides (36.6%) Jian-hu, 22 sides (5.4%), and 36 sides (8.9%) respectively. While the interfrontal septal cells was found in 25 patients (12.4%). The prevalence of agger nasi cell was 94. 1% (380 sides). Two hundred and forty-four uncinate processes (60.4%) had one superior attachment for each uncinate process; the other 160 uncinate processes (39.6%) had two superior attachments for each uncinate process. The single superior attachment of the uncinate process into the surrounding structures was identified to have the following distribution: 53.0% (n=214) to the lamina papyracea, 5.2% (n=21) to the middle turbinate, 2.2% (n=9) to the skull base. Most of the uncinate process' two superior attachments were either into the lamina papyracea and the skull base (27.5%, n=111) or into the lamina papyracea and the middle turbinate (8.7%, n=35). The other 14 uncinate processes (3.5%) superiorly attached to the skull base and the middle turbinate. The prevalence of recessus terminalis was 89.1% (n=360).

CONCLUSIONThe result demonstrated the normal frontal recess pneumatization patterns in normal Chinese.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ethmoid Sinus ; diagnostic imaging ; Female ; Humans ; Imaging, Three-Dimensional ; Male ; Middle Aged ; Reference Values ; Tomography, Spiral Computed ; Young Adult

OBJECTIVE: To study the anatomical character of the ethmoid sinus with spiral CT, and provide correlated data for diagnosis and surgery operation. METHOD: One hundred patients whose vertebra artery was injected with Angiografin underwent axial consecutive computed tomography and these data were studied with multiplanar reformation. RESULT: Based on the relation of posterior ethmoid sinus to sphenoid sinus, the posterior ethmoid sinus was divided into antero sphenoid types and super sphenoid types. According to the relation between the posterior ethmoid and the optic canal, the posterior ethmoid sinus was divided into antero canal, seminal abut types, canal abut types. According to the degree of the bulging of the optic canal, the posterior ethmoid sinus was divided into notch types, seminal cover types, canal cover types. Bulging of the optic canal formed on the lateral wall of the posterior ethmoid sinus was 40 sides (20%). CONCLUSION MPR in spiral CT is powerful tool for the anatomical study of the ethmoid sinus, it could provide accuracy evaluation and analyzation, these results are helpful in directing the diagnose and therapy.
Adult ; Aged ; Asian Continental Ancestry Group ; Ethmoid Sinus ; diagnostic imaging ; Female ; Humans ; Male ; Middle Aged ; Sphenoid Sinus ; diagnostic imaging ; Tomography, Spiral Computed