해부학적 차이에 따른 전누골와 접근법의 신경학적 이환율 발생 가능성에 대한 연구
A Study on the Possibility of Neurological Morbidity of Prelacrimal Recess Approach Depending on Anatomical Differences
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Background and Objectives The maxillary sinus disease is mainly treated through themiddle meatal antrostomy, but there is a disadvantage in that it does not approach the lesionsof the anterior wall of the maxillary sinus. On the other hand, the prelacrimal recess approach(PLA) can be used to access the lesions of the anterior wall of the maxillary sinus. However,complications after PLA may include nasal bleeding, infection, epiphora, and neurologicalsymptoms. We investigated the possibility of neurological morbidity (anterior superior alveo-lar nerve injury) after PLA by imaging. Subjects and Method A total of 253 people were studied by using 506 samples of paranasalsinus CT. According to the Simmen and Arosio methods, the study groups were classified intothe following categories: PLA type I (<3 mm), type II (3-7 mm), and type III (>7 mm), inter-nal angle of pyriform notch (IAPN), type A (below 45°), type B (from 45° to 60°), and type C(60° excessive). Results Of the PLA types, the IAPN value was the largest in the type III and smallest in thetype I, and there were significant differences among the three groups ( p<0.001). Conclusion CT Evaluation prior to PLA would help physicians to predict the likelihood ofneurological morbidity such as maxillary sensory abnormalities.
Abstract
Background and Objectives The maxillary sinus disease is mainly treated through themiddle meatal antrostomy, but there is a disadvantage in that it does not approach the lesionsof the anterior wall of the maxillary sinus. On the other hand, the prelacrimal recess approach(PLA) can be used to access the lesions of the anterior wall of the maxillary sinus. However,complications after PLA may include nasal bleeding, infection, epiphora, and neurologicalsymptoms. We investigated the possibility of neurological morbidity (anterior superior alveo-lar nerve injury) after PLA by imaging. Subjects and Method A total of 253 people were studied by using 506 samples of paranasalsinus CT. According to the Simmen and Arosio methods, the study groups were classified intothe following categories: PLA type I (<3 mm), type II (3-7 mm), and type III (>7 mm), inter-nal angle of pyriform notch (IAPN), type A (below 45°), type B (from 45° to 60°), and type C(60° excessive). Results Of the PLA types, the IAPN value was the largest in the type III and smallest in thetype I, and there were significant differences among the three groups ( p<0.001). Conclusion CT Evaluation prior to PLA would help physicians to predict the likelihood ofneurological morbidity such as maxillary sensory abnormalities.
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