Looking for landmarks in medial orbital trauma surgery

Area of Science:

• Anatomy
• Surgical Anatomy
• Ophthalmology

Background:

• Accurate identification of anatomical landmarks like the anterior ethmoid canal (AEC) and posterior ethmoid canal (PEC) is crucial for safe medial orbital wall surgery.
• Protection of the orbital nerve relies heavily on precise knowledge of these ethmoid canal locations.

Purpose of the Study:

• To identify the anterior ethmoid canal (AEC) and posterior ethmoid canal (PEC) in CT scans.
• To measure distances between these canals and assess inter-side symmetry.
• To evaluate the reliability of AEC and PEC as surgical landmarks.

Main Methods:

• Analysis of 100 consecutive computed tomography (CT) scans.
• Identification and measurement of anterior (AEC) and posterior ethmoid canals (PEC).
• Statistical correlation analysis to assess left-right symmetry.

Main Results:

• The anterior ethmoid canal (AEC) was not identified in one patient.
• The posterior ethmoid canal (PEC) had identification issues in seven patients, with one bilateral absence.
• Anatomical variations, including additional PECs, were found in nearly 25% of patients.
• Strong bilateral correlation (r=0.798-0.903, p<0.001) was observed when structures were present bilaterally.

Conclusions:

• Significant anatomical variations in the anterior (AEC) and posterior ethmoid canals (PEC) were observed.
• The frequency of variations challenges the consistent reliability of AEC and PEC as surgical landmarks in medial orbital surgery.
• Further research may be needed to refine surgical navigation techniques for the medial orbit.