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Development of the paranasal sinuses in children
J Medina1, H Hernandez, L W Tom
1Department of Otolaryngology, Children's Hospital of Philadelphia, Pennsylvania 19104, USA.
Insights
Understanding pediatric paranasal sinus anatomy is crucial for safe endoscopic sinus surgery. This study details sinus development in children, providing essential anatomical data for surgeons.
Area of Science:
- Otolaryngology
- Pediatric Anatomy
- Medical Imaging
Background:
- Computed tomography (CT) and functional endoscopic sinus surgery (FESS) have advanced sinusitis care.
- Pediatric sinus anatomy differs significantly from adult anatomy, necessitating specialized knowledge for FESS in children.
Purpose of the Study:
- To define the developmental anatomy of pediatric paranasal sinuses.
- To provide anatomical guidance for performing FESS in pediatric patients.
Main Methods:
- Analysis of 145 computed tomograms from patients under 18 years of age.
- Emphasis on landmarks at the maxillary sinus ostium.
- Measurement of distances and angles from the nasal spine to sinus points.
- Digitization and calculation of means and standard deviations by age.
Main Results:
- Detailed developmental data of paranasal sinus anatomy in children.
- Identification of age-related anatomical variations.
- Quantification of key anatomical landmarks relevant to FESS.
Conclusions:
- Enhanced understanding of pediatric sinus development.
- Provides crucial anatomical references for safe and effective pediatric FESS.
- Aids surgeons in navigating pediatric sinus anatomy during endoscopic procedures.
Abstract:
The development of computed tomography and functional endoscopic sinus surgery has improved diagnosis and management of sinusitis. It has also renewed interest in the developmental anatomy of the paranasal sinuses. There are significant differences between adult and pediatric sinus anatomy, and to safely perform functional endoscopic sinus surgery in children, the surgeon must be aware of these differences. To define the developmental anatomy of the paranasal sinuses, we analyzed 145 computed tomograms from patients under 18 years of age. The study emphasized landmarks at the level of the maxillary sinus ostium. In addition, distances and angles from the nasal spine to various points in the sinuses were determined. The structures were identified and traced on a digitizing tablet. Means and standard deviations were calculated for each measure as a function of age. This study can aid a better understanding of sinus development in children and provide guidance to the endoscopic sinus surgeon.