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EVALUATION OF CRIBRIFORM PLATE DEPTH AND ASYMMETRY OF THE POPULATION IN THE LAKES DISTRICT TOGETHER WITH COMPUTED TOMOGRAPHY AND KEROS CLASSIFICATION

Year 2021, Volume: 28 Issue: 4, 641 - 647, 30.12.2021
https://doi.org/10.17343/sdutfd.980181

Abstract

Objective
With the developing medical technology, functional
endoscopic sinus surgery (FESS) is applied
quite frequently in paranasal sinus surgeries in
otolaryngology practice. However, due to the nasal
cavity structure, variations and neighborhoods,
it is the body cavity that should be considered.
Preoperative paranasal sinus computed tomography
(CT) evaluation of the nasal cavity is mandatory. In
our study, we especially aimed to reveal olfactory
fossa variations with paranasal CT. With this article,
we aimed to define the pre-FESC variations of the
people in the Lakes District and to increase the
awareness of surgeons against complications in the
preoperative period.
Material and Methods
The images of the patients who applied to our hospital
for sinusitis and underwent paranasal sinus CT
between 01.01.2019 and 15.03.2019 were analyzed
retrospectively by two radiologists. 112 men and 88
women; A total of 200 patients aged 18-69 years were
included. The measurements of the lateral laminae in
the right and left nasal cavity for each patient and
the depths of the olfactory fossa were classified
according to Keros types. The lateral lamina height
was determined and the patients were classified into
3 groups. Depths of 1-3 mm for keros type 1, 4-7 mm
for keros type 2 and 8-16 mm for keros type 3 were
taken. The obtained data were then compared with
similar data in the literature.
Results
Lateral lamina lengths for right side; 144 (72%)
individuals in the keros type 1 group and 56 (28%)
individuals in the keros type 2 group were classified,
and 142 (71%) individuals in the keros type 1 group
and 58 (29%) individuals in the keros type 2 group
were classified for the left side. In the keros type
1 variation on the right, 76 individuals were male
and 68 individuals were female. In the keros type
2 variation on the right, 36 individuals were male
and 20 individuals were female. In the keros type 1
variation on the left, 74 individuals were male and 68
individuals were female. In the keros type 2 variation
on the left, 38 individuals were male and 20 individuals
were female. No individuals were classified for right
and left in the keros type 3 group. Right; The mean
lamina lateralis length was calculated as 2,49±0,76
in the keros type 1 variation, and 4,21±0,54 in the
keros type 2 variation. On the left; The mean length
of the lamina lateralis in the keros type 1 variation
was calculated as 2,33±0,79, while the mean length
in the keros type 2 variation was calculated as
4,2±0,54. The number of individuals with different
keros types in the right and left measurements and
keros asymmetry was observed as 52 (26%) out of
200 individuals.
Conclusion
While keros type 1 was observed most frequently in
our study with a rate of 71.5%, Keros Type 3 was
never encountered, and we found keros asymmetry
as 26% in our study. In our study, type 1 variant was
observed at a high rate for both genders, but it did
not create a statistically significant difference. In a
similar study conducted in the literature, significant
differences were observed in the percentages, and we
interpreted this difference as the variation belonging
to the people of the Lakes District. In particular, nasal
cavity variations show various variations in different
regions. The absence of type 3 variation in the Lakes
District is an advantage for this region. Although
the type 1 variation with the smallest depth of the
olfactory fossa does not make a statistically significant
difference, the highest number of observations is also
an advantage for the people of the Lakes District, as
it carries less risk of complications.

References

  • 1. McMains KC. Safety in endoscopic sinus surgery. Current opinion in otolaryngology & head and neck surgery. 2008;16(3):247-51.
  • 2. Souza SA, Souza MMAd, Idagawa M, Wolosker ÂMB, Ajzen SA. Computed tomography assessment of the ethmoid roof: a relevant region at risk in endoscopic sinus surgery. Radiologia Brasileira. 2008;41:143-7.
  • 3. Keros P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Zeitschrift fur Laryngologie, Rhinologie, Otologie und ihre Grenzgebiete. 1962;41:809-13.
  • 4. Kaplanoglu H, Kaplanoglu V, Dilli A, Toprak U, Hekimoğlu B. An analysis of the anatomic variations of the paranasal sinuses and ethmoid roof using computed tomography. The Eurasian journal of medicine. 2013;45(2):115.
  • 5. Luong A, Marple BF. Sinus surgery. Clinical Reviews in Allergy & Immunology. 2006;30(3):217-22.
  • 6. Ooi E. ENDOSCOPIC SINUS SURGERY: ANATOMY, THREE-DIMENSIONAL RECONSTRUCTION, AND SURGICAL TECHNIQUE, 3rd edn. PJ Wormald. Thieme, 2012. ISBN 978 1 60406 687 6 pp 304 Price£ 127.99. The Journal of Laryngology & Otology. 2014;128(S1):S59-S.
  • 7. Chang CC, Incaudo GA, Gershwin ME. Diseases of the sinuses: a comprehensive textbook of diagnosis and treatment: Springer; 2014.
  • 8. Stammberger H. Special endoscopic anatomy of the lateral nasal wall and ethmoidal sinuses. Functional Endoscopic Sinus Surgery Philadelphia: BC Dekker. 1991:49-65.
  • 9. Gauba V, Saleh G, Dua G, Agarwal S, Ell S, Vize C. Radiological classification of anterior skull base anatomy prior to performing medial orbital wall decompression. Orbit. 2006;25(2):93-6.
  • 10. Başak S, Akdilli A, Karaman CZ, Kunt T. Assessment of some important anatomical variations and dangerous areas of the paranasal sinuses by computed tomography in children. International journal of pediatric otorhinolaryngology. 2000;55(2):81-9.
  • 11. Jang Y, Park H, Kim H. The radiographic incidence of bony defects in the lateral lamella of the cribriform plate. Clinical Otolaryngology & Allied Sciences. 1999;24(5):440-2.
  • 12. Wormald P-J. Surgery of the frontal recess and frontal sinus. Rhinology. 2005;43(2):82-5.
  • 13. Elwany S, Medanni A, Eid M, Aly A, El-Daly A, Ammar S. Radiological observations on the olfactory fossa and ethmoid roof. The Journal of Laryngology & Otology. 2010;124(12):1251-6.

GÖLLER YÖRESİNDEKİ POPÜLASYONUN KRİBRİFORM PLATE DERİNLİĞİ VE ASİMETRİSİNİN BİLGİSAYARLI TOMOGRAFİ VE KEROS SINIFLAMASI İLE BİRLİKTE DEĞERLENDİRİLMESİ

Year 2021, Volume: 28 Issue: 4, 641 - 647, 30.12.2021
https://doi.org/10.17343/sdutfd.980181

Abstract

Amaç
Gelişen tıp teknolojisi ile kulak burun boğaz pratiğinde
paranazal sinüs ameliyatlarında oldukça sık fonksiyonel
endoskopik sinüs cerrahisi(FESC) uygulanmaktadır.
Ancak nazal kavite; yapısı, varyasyonları ve
komşulukları nedeniyle dikkat edilmesi gereken vücut
boşluğudur. Nazal kavitenin preoperatif paranazal sinüs
bilgisayarlı tomografi (BT) ile değerlendirilmesi
zorunludur. Çalışmamızda özellikle olfaktör fossa varyasyonlarını
paranazal BT ile ortaya koymayı amaçladık.
Bu yazımızla birlikte Göller yöresindeki insanların
FESC öncesi varyasyonlarını tanımlamayı ve komplikasyonlara
karşı preoperatif dönemde cerrahların
farkındalığını arttırmayı amaçladık.
Gereç ve Yöntem
01.01.2019 ile 15.03.2019 tarihleri arasında hastanemize
sinüzit nedeniyle başvuran ve paranazal sinüs
BT çekilen hastaların görüntüleri iki radyoloji uzmanı
tarafından retrospektif olarak incelendi. Çalışmaya
112’si erkek, 88'i kadın; 18-69 yaş aralığında toplam
200 hasta dahil edildi. Lateral laminaların her hasta
için sağ ve sol nazal kavitede ölçümleri ve olfaktör
fossa derinlikleri keros tiplerine göre klasifiye edildi.
Lateral lamina yüksekliği belirlenerek hastalar 3 gruba
ayrıldı. Keros tip 1 için derinlik 1-3 mm olanlar, keros
tip 2 için derinlik 4-7 mm ve keros tip 3 için derinlik
8-16 mm olacak şekilde kabul edildi. Daha sonra elde
edilen veriler literatürde benzer verilerle karşılaştırıldı.
Bulgular
Lateral lamina uzunlukları sağ taraf için; keros tip 1
grubunda 144 (%72), keros tip 2 grubunda 56 (%28)
birey sınıflandı ve sol taraf için keros tip 1 grubunda
142 (%71), keros tip 2 grubunda 58 (%29) birey sınıflandı.
Sağda keros tip 1 varyasyonunda 76 birey
erkek 68 birey kadındı. Sağda keros tip 2 sınıflandırmasında
36 birey erkek, 20 birey kadındı. Solda keros
tip 1 varyasyonunda 74 birey erkek 68 birey kadındı.
Solda keros tip 2 varyasyonunda 38 birey erkek 20 birey
kadındı. Keros tip 3 grubunda sağ ve sol için hiçbir
birey sınıflandırılmadı. Sağda; keros tip 1 varyasyonunda
lamina lateralis uzunluk ortalaması 2,49±0,76
olarak hesaplanmıştır, keros tip 2 varyasyonunda ortalama
4,21±0,54 olarak hesaplanmıştır. Solda; keros
tip 1 varyasyonunda lamina lateralis uzunluk orta-
laması 2,33±0,79 olarak hesaplanmıştır, keros tip 2
varyasyonunda uzunluk ortalaması 4,2±0,54 olarak
hesaplanmıştır. Sağ ve sol ölçümlerinde keros tiplerinin
farklı olduğu keros asimetrisi gözlenen bireylerin
sayısı 200 kişiden 52 (%26) kişi olarak gözlenmiştir.
Sonuç
Çalışmamızda en sık yüzde %71,5 ile keros tip 1 izlenirken
Keros Tip 3 ile hiç karşılaşılmadı. Ayrıca çalışmamızda
keros asimetrisini %26 olarak saptadık.
Yaptığımız bu çalışmada tip 1 varyantı her iki cinsiyet
için yüksek oranda gözlendi, ancak istatistiksel anlamlı
fark izlenmedi. Literatürde yapılan benzer çalışmada
yüzdelerde belirgin farklılıklar gözlenmiş olup
biz bu farklılığı Göller yöresi insanlarına ait varyasyon
olarak yorumladık. Özelikle nazal kavite varyasyonları
farklı bölgelerde çeşitli varyasyonlar göstermektedir.
Göller yöresinde tip 3 varyasyon görülmemesi
bu bölge için bir avantajdır. Olfaktör fossa derinliği en
az olan tip 1 varyasyonunun da her ne kadar istatistiksel
anlamlı fark oluşturmasa da en yüksek sayıda
gözlenmesi de daha az komplikasyon riskini taşıması
bakımından Göller yöresi insanları için bir avantajdır.

References

  • 1. McMains KC. Safety in endoscopic sinus surgery. Current opinion in otolaryngology & head and neck surgery. 2008;16(3):247-51.
  • 2. Souza SA, Souza MMAd, Idagawa M, Wolosker ÂMB, Ajzen SA. Computed tomography assessment of the ethmoid roof: a relevant region at risk in endoscopic sinus surgery. Radiologia Brasileira. 2008;41:143-7.
  • 3. Keros P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Zeitschrift fur Laryngologie, Rhinologie, Otologie und ihre Grenzgebiete. 1962;41:809-13.
  • 4. Kaplanoglu H, Kaplanoglu V, Dilli A, Toprak U, Hekimoğlu B. An analysis of the anatomic variations of the paranasal sinuses and ethmoid roof using computed tomography. The Eurasian journal of medicine. 2013;45(2):115.
  • 5. Luong A, Marple BF. Sinus surgery. Clinical Reviews in Allergy & Immunology. 2006;30(3):217-22.
  • 6. Ooi E. ENDOSCOPIC SINUS SURGERY: ANATOMY, THREE-DIMENSIONAL RECONSTRUCTION, AND SURGICAL TECHNIQUE, 3rd edn. PJ Wormald. Thieme, 2012. ISBN 978 1 60406 687 6 pp 304 Price£ 127.99. The Journal of Laryngology & Otology. 2014;128(S1):S59-S.
  • 7. Chang CC, Incaudo GA, Gershwin ME. Diseases of the sinuses: a comprehensive textbook of diagnosis and treatment: Springer; 2014.
  • 8. Stammberger H. Special endoscopic anatomy of the lateral nasal wall and ethmoidal sinuses. Functional Endoscopic Sinus Surgery Philadelphia: BC Dekker. 1991:49-65.
  • 9. Gauba V, Saleh G, Dua G, Agarwal S, Ell S, Vize C. Radiological classification of anterior skull base anatomy prior to performing medial orbital wall decompression. Orbit. 2006;25(2):93-6.
  • 10. Başak S, Akdilli A, Karaman CZ, Kunt T. Assessment of some important anatomical variations and dangerous areas of the paranasal sinuses by computed tomography in children. International journal of pediatric otorhinolaryngology. 2000;55(2):81-9.
  • 11. Jang Y, Park H, Kim H. The radiographic incidence of bony defects in the lateral lamella of the cribriform plate. Clinical Otolaryngology & Allied Sciences. 1999;24(5):440-2.
  • 12. Wormald P-J. Surgery of the frontal recess and frontal sinus. Rhinology. 2005;43(2):82-5.
  • 13. Elwany S, Medanni A, Eid M, Aly A, El-Daly A, Ammar S. Radiological observations on the olfactory fossa and ethmoid roof. The Journal of Laryngology & Otology. 2010;124(12):1251-6.
There are 13 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research Articles
Authors

Hüseyin Alper Kızıloğlu 0000-0002-6921-8716

Veysel Atilla Ayyıldız 0000-0003-0252-9023

Nazan Okur 0000-0002-3458-2737

Publication Date December 30, 2021
Submission Date August 8, 2021
Acceptance Date August 26, 2021
Published in Issue Year 2021 Volume: 28 Issue: 4

Cite

Vancouver Kızıloğlu HA, Ayyıldız VA, Okur N. GÖLLER YÖRESİNDEKİ POPÜLASYONUN KRİBRİFORM PLATE DERİNLİĞİ VE ASİMETRİSİNİN BİLGİSAYARLI TOMOGRAFİ VE KEROS SINIFLAMASI İLE BİRLİKTE DEĞERLENDİRİLMESİ. Med J SDU. 2021;28(4):641-7.

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