Evaluating the safety of frontal sinus trephination

The Laryngoscope
Annie S LeeGrant S Gillman

Abstract

The depth of the frontal sinus was measured using axial computed tomography (CT) images to examine the safety of frontal sinus trephination at selected distances from the midline. Review of 200 sinus CT scans. Two hundred sinus CT scans (400 frontal sinuses) were reviewed to measure the frontal sinus depth at 5 mm, 10 mm, and 15 mm from midline. Males had a significantly deeper frontal sinus than females at all measurements points (P < .001). The measurements revealed a considerable number of small but nonhypoplastic frontal sinuses, which were shallower than the length of standard frontal trephine instruments (7 mm) and would risk penetration of the posterior table of the sinus. Of all frontal sinuses studied, 9.54% were <7 mm deep at 5 mm from the midline, 10.12% at 10 mm, and 8.96% at 15 mm from the midline. Overall, 15.3% of all frontal sinuses studied had at least one point where the measured depth was <7 mm. Although the majority of patients have frontal sinuses deep enough to accommodate standard trephine instruments, surgeons should recognize that up to 15% of nonhypoplastic frontal sinuses may not be sufficiently deep at a given point to allow safe trephination without risking unintentional transgression of the posteri...Continue Reading

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Citations

Dec 25, 2012·Current Opinion in Otolaryngology & Head and Neck Surgery·John S SchneiderJames A Duncavage
Jul 6, 2015·Otolaryngologic Clinics of North America·John S SchneiderJames Duncavage
Jun 23, 2016·Otolaryngologic Clinics of North America·Jean Anderson EloyMichael Setzen
Jun 23, 2016·Otolaryngologic Clinics of North America·Adam J FolbeJean Anderson Eloy

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