Supraorbital Ethmoid Air Cell - Its Role in Sinonasal Pathologies

The supraorbital ethmoid air cell (SOEC) is an anatomical variation of the ethmoid air cell system that pneumatizes the orbital plate of the frontal bone. It affects the frontal recess configuration by opening posterior and lateral to the frontal sinus ostium. This cross-sectional observational study includes 100 patients with Supra orbital ethmoid air cells including various pathologies. We picked up the first 100 patients who had SOEC in all the CT PNS done for various sinonasal pathologies. The incidence of the cell was about 43%. The most common type was the cell extending up to the medial wall of the orbit which was noted in 37% of the cases. Cribriform plate was low-lying in patients with SOEC and the most common type was Keros 3 in about 49% of the study group. 83 patients had anterior ethmoid artery (AEA) lying away from the skull base hanging freely in the mesentery. The most common pathologies observed in patients with supraorbital ethmoid cells were chronic rhinosinusitis followed by mucoceles. The recurrence rate of sinusitis is high in patients with SOEC. The recurrences were mostly because of mistaking the SOEC to be frontal sinus or incomplete removal of partition between them. study stresses the importance of SOEC and its orientation preoperatively to avoid complications during and after the surgery. Detailed preoperative evaluation with the CT helps the surgeon to identify the cells, their extent and associated anatomical variations thereby preventing damage to AEA, cribriform plate and lateral lamella and can get good results.