Evaluation of the ethmoid skull-base height prior to endoscopic sinus surgery: a preoperative computed tomography evaluation technique

Int Forum Allergy Rhinol. 2012 Mar-Apr;2(2):151-4. doi: 10.1002/alr.21006. Epub 2012 Jan 17.

Abstract

Introduction: Iatrogenic ethmoid skull base (ESB) injury during endoscopic sinus surgery (ESS) is a potentially devastating complication. The height of the ESB can vary substantially and should be assessed during preoperative evaluation of the sinus computed tomography (CT) scan.

Methods: The objective of this study is to describe an objective preoperative CT evaluation technique to assist the surgeon in defining the height of the ESB prior to performing ESS.

Results: We propose a technique which measures the height of the ESB from a single horizontal mid-orbital line located on a standardized coronal sinus CT image at the level of the anterior ethmoid artery canal.

Conclusions: Utilization of an objective preoperative CT measurement technique may quantify identification of a low ESB and optimize surgical awareness of this potentially dangerous anatomic skull base variation.

MeSH terms

  • Endoscopy
  • Ethmoid Bone / anatomy & histology
  • Ethmoid Bone / diagnostic imaging*
  • Humans
  • Orbit / anatomy & histology
  • Orbit / diagnostic imaging
  • Paranasal Sinuses / surgery
  • Preoperative Period
  • Skull Base / anatomy & histology
  • Skull Base / diagnostic imaging*
  • Tomography, X-Ray Computed / methods*