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Published on: July 5, 2011
Evaluating the safety of frontal sinus trephination
Annie S Lee1, Barry M Schaitkin, Grant S Gillman
1Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
The Laryngoscope
|February 5, 2010
Summary
Frontal sinus depth varies, with up to 15% of nonhypoplastic sinuses being too shallow for safe trephination. Surgeons must evaluate CT scans to avoid injuring the posterior table during frontal sinus procedures.
Area of Science:
- Neurosurgery
- Otolaryngology
- Radiology
Background:
- Frontal sinus trephination is a surgical procedure.
- Assessing anatomical safety is crucial for preventing complications.
Purpose of the Study:
- To measure frontal sinus depth at various distances from the midline using computed tomography (CT) scans.
- To evaluate the safety of standard frontal sinus trephination distances.
Main Methods:
- Retrospective review of 200 sinus CT scans (400 frontal sinuses).
- Measurement of frontal sinus depth at 5 mm, 10 mm, and 15 mm from the midline.
- Comparison of sinus depth between males and females.
Main Results:
- Males exhibited significantly deeper frontal sinuses than females (P < .001).
- A notable percentage of nonhypoplastic frontal sinuses were shallower than 7 mm (standard trephine instrument length).
- 15.3% of all frontal sinuses had at least one point <7 mm deep, posing a risk of posterior table penetration.
Conclusions:
- Up to 15% of nonhypoplastic frontal sinuses may not be deep enough for safe trephination at standard distances.
- Routine trephination at predetermined distances from the midline may be unsafe.
- Individualized CT scan evaluation is essential to determine the safest trephination site and avoid inadvertent injury.