3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway

Objective: The objective of this presentation is to display a series of new anatomical concepts and terms regarding the frontal sinus, its drainage pathway and cells vs. spaces of the anterior ethmoid, based on Three-Dimensional Computer X-ray Tomography Stereoscopic Imaging (3DCTSI) and contrast th...

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Main Authors: S.J. Zinreich, F.A. Kuhn, N.R. London Jr., D. Kennedy, M. Solaiyappan, W. Hosemann
Format: Article
Language:English
Published: Stichting NASE 2020-11-01
Series:Rhinology Online
Subjects:
Online Access:https://www.rhinologyonline.org/Rhinology_online_issues/manuscript_99.pdf
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author S.J. Zinreich
F.A. Kuhn
N.R. London Jr.
D. Kennedy
M. Solaiyappan
W. Hosemann
author_facet S.J. Zinreich
F.A. Kuhn
N.R. London Jr.
D. Kennedy
M. Solaiyappan
W. Hosemann
author_sort S.J. Zinreich
collection DOAJ
description Objective: The objective of this presentation is to display a series of new anatomical concepts and terms regarding the frontal sinus, its drainage pathway and cells vs. spaces of the anterior ethmoid, based on Three-Dimensional Computer X-ray Tomography Stereoscopic Imaging (3DCTSI) and contrast these concepts to those reported in the current literature. Methods: Given the new anatomic observations provided by 3DCTSI, and the widespread anatomic variations a small sample was initially selected to describe our observations. Six exemplary cases according to the “Classification of Fronto-Ethmoidal cells” by Kuhn, Bent et al., Lee et al., expanded by Wormald et al., and adopted by Ramakrishnan et al., Huang et al., and Void et al. (1-7) were chosen to illustrate our detailed anatomic observations. Additional observations and data of prevalence identified in a larger series will follow. Results and Conclusion: Conceptually, the anterior ethmoid “cells” are in essence “spaces” with openings that communicate with the middle meatus and/or the ethmoidal infundibulum. The frontal sinus and frontal recess are a united and continuous three-dimensional, irregularly shaped space, the Frontal Sinus/Recess Space (FSRS). The uncinate process has two segments: the Ethmoidal Uncinate Process (EUP), which encompasses the Infundibular Space of the EUP (IS-EUP), currently known as the Agger Nasi cell; and the Turbinal Uncinate Process (TUP), which borders the Turbinal Infundibulum (TI) medially. The superior attachment of the EUP will be detailed in each of the six cases (Table 2). The middle meatus and infundibular passages are the drainage pathways from the frontal sinus and maxillary sinus to the nasal cavity.
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spelling doaj.art-59d94f39ac46421f827f2eb6afca56922022-12-21T23:14:51ZengStichting NASERhinology Online2589-56132020-11-01320222010.4193/RHINOL/20.0613D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathwayS.J. Zinreich0F.A. Kuhn1 N.R. London Jr.2D. Kennedy3M. Solaiyappan4W. Hosemann5The Russel H. Morgan Departments of Radiology, The Johns Hopkins Medical Institutions, Baltimore, MD, USAThe Georgia Nasal and Sinus Institute Savannah, GA, USAThe Department of Otorhinolaryngology Head and Neck Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD, USAThe Department of Otorhinolaryngology Head and Neck Surgery, the Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USAThe Russel H. Morgan Departments of Radiology, The Johns Hopkins Medical Institutions, Baltimore, MD, USADepartment of General Otorhinolaryngology-Head and Neck Surgery, University of Greifswald, GermanyObjective: The objective of this presentation is to display a series of new anatomical concepts and terms regarding the frontal sinus, its drainage pathway and cells vs. spaces of the anterior ethmoid, based on Three-Dimensional Computer X-ray Tomography Stereoscopic Imaging (3DCTSI) and contrast these concepts to those reported in the current literature. Methods: Given the new anatomic observations provided by 3DCTSI, and the widespread anatomic variations a small sample was initially selected to describe our observations. Six exemplary cases according to the “Classification of Fronto-Ethmoidal cells” by Kuhn, Bent et al., Lee et al., expanded by Wormald et al., and adopted by Ramakrishnan et al., Huang et al., and Void et al. (1-7) were chosen to illustrate our detailed anatomic observations. Additional observations and data of prevalence identified in a larger series will follow. Results and Conclusion: Conceptually, the anterior ethmoid “cells” are in essence “spaces” with openings that communicate with the middle meatus and/or the ethmoidal infundibulum. The frontal sinus and frontal recess are a united and continuous three-dimensional, irregularly shaped space, the Frontal Sinus/Recess Space (FSRS). The uncinate process has two segments: the Ethmoidal Uncinate Process (EUP), which encompasses the Infundibular Space of the EUP (IS-EUP), currently known as the Agger Nasi cell; and the Turbinal Uncinate Process (TUP), which borders the Turbinal Infundibulum (TI) medially. The superior attachment of the EUP will be detailed in each of the six cases (Table 2). The middle meatus and infundibular passages are the drainage pathways from the frontal sinus and maxillary sinus to the nasal cavity.https://www.rhinologyonline.org/Rhinology_online_issues/manuscript_99.pdffrontal sinusfrontal recessfrontal sinus drainage pathwayuncinate processinfundibulumethmoid3d ct stereoscopic imaging
spellingShingle S.J. Zinreich
F.A. Kuhn
N.R. London Jr.
D. Kennedy
M. Solaiyappan
W. Hosemann
3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway
Rhinology Online
frontal sinus
frontal recess
frontal sinus drainage pathway
uncinate process
infundibulum
ethmoid
3d ct stereoscopic imaging
title 3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway
title_full 3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway
title_fullStr 3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway
title_full_unstemmed 3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway
title_short 3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway
title_sort 3d ct stereoscopic imaging an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway
topic frontal sinus
frontal recess
frontal sinus drainage pathway
uncinate process
infundibulum
ethmoid
3d ct stereoscopic imaging
url https://www.rhinologyonline.org/Rhinology_online_issues/manuscript_99.pdf
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