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The bulla ethmoidalis: lamella or a true cell?
1Department of Otolaryngology, The University of Western Ontario, London.
The Journal of Otolaryngology
|January 5, 2002
Summary
The ethmoidal bulla, crucial in endoscopic sinus surgery, is re-evaluated. This study reveals it
Area of Science:
- Anatomy
- Otolaryngology
- Surgical Anatomy
Background:
- The anterior ethmoidal region, particularly the ethmoidal bulla, is frequently targeted in functional endoscopic sinus surgery (FESS).
- Accurate anatomical understanding of the ethmoidal bulla is paramount for surgical safety and efficacy.
Purpose of the Study:
- To investigate the anatomical characteristics and true nature of the ethmoidal bulla.
- To challenge the conventional classification of the ethmoidal bulla as a distinct ethmoid cell.
Main Methods:
- Performed detailed gross anatomical sagittal dissections on 14 human sinonasal complexes.
- Focused analysis on the ethmoidal bulla, adjacent structures, and associated pneumatization pathways.
Main Results:
- The ethmoidal bulla consistently presented as a bony lamella, not a discrete cell, lacking a complete posterior wall.
- Pneumatization within this lamella, originating from the retrobullar recess, created the characteristic 'bulla' appearance.
- The posterior boundary of the bulla-like space was formed by the basal lamella.
Conclusions:
- The ethmoidal bulla is anatomically a bony lamella with a posterior air space, not an independent ethmoid cell.
- The term 'bulla' may be imprecise for this anatomical structure, suggesting a need for revised terminology.
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