Risk Factors for Anterior Skull Base Injury in Endoscopic Sinus Surgery
Objectives This retrospective study aimed to investigate the relationships between the Keros classification, the Gera classification, the vertical height of the posterior ethmoid roof (ER), and anterior ethmoidal artery (AEA) types in Japanese patients. Methods We investigated the computed tomograph...
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| Veröffentlicht in: | Curēus (Palo Alto, CA) CA), 2023-11, Vol.15 (11), p.e49273-e49273 |
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| creator | Makihara, Seiichiro Uraguchi, Kensuke Naito, Tomoyuki Shimizu, Aiko Murai, Aya Higaki, Takaya Noda, Yohei Kariya, Shin Okano, Mitsuhiro Ando, Mizuo |
| description | Objectives This retrospective study aimed to investigate the relationships between the Keros classification, the Gera classification, the vertical height of the posterior ethmoid roof (ER), and anterior ethmoidal artery (AEA) types in Japanese patients. Methods We investigated the computed tomography (CT) slices of paranasal sinuses (120 sides) of 60 patients; measured the cribriform plate (CP) depth, lateral lamella CP angle (LLCPA), and vertical height of the lateral ER from the hard palate (LERHP) at the coronal plane of the posterior ethmoidal artery (PEA); and reviewed the AEA types, whether floating or non-floating. Results CP depth was positively correlated with LLCPA (r=0.63; p |
| doi_str_mv | 10.7759/cureus.49273 |
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p<0.05). The height of the LERHP in females was significantly lower than that in males. With increased CP depth, floating AEAs became prevalent (p<0.001). Conclusion In females, low height of the posterior ethmoid sinus roof, where cerebrospinal fluid (CSF) leaks occurred while penetrating the basal lamella, often existed; the heights positively correlated with the Keros classification in Japanese patients. The Keros and Gera classifications, AEA type, and posterior ER height do not individually constitute a complete risk assessment but may correlate, preventing major complications, such as CSF leak and orbital hemorrhage.</description><identifier>ISSN: 2168-8184</identifier><identifier>EISSN: 2168-8184</identifier><identifier>DOI: 10.7759/cureus.49273</identifier><identifier>PMID: 38143696</identifier><language>eng</language><publisher>United States: Cureus Inc</publisher><subject>Classification ; Endoscopy ; Fractures ; Injuries ; Navigation systems ; Otolaryngology ; Patients ; Sinuses ; Surgery ; Surgical outcomes ; Veins & arteries</subject><ispartof>Curēus (Palo Alto, CA), 2023-11, Vol.15 (11), p.e49273-e49273</ispartof><rights>Copyright © 2023, Makihara et al.</rights><rights>Copyright © 2023, Makihara et al. This work is published under https://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c288t-e511157a910c82721ddfb033f297e293afbcd3d9af8b9170b9697b81feeedbb33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38143696$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Makihara, Seiichiro</creatorcontrib><creatorcontrib>Uraguchi, Kensuke</creatorcontrib><creatorcontrib>Naito, Tomoyuki</creatorcontrib><creatorcontrib>Shimizu, Aiko</creatorcontrib><creatorcontrib>Murai, Aya</creatorcontrib><creatorcontrib>Higaki, Takaya</creatorcontrib><creatorcontrib>Noda, Yohei</creatorcontrib><creatorcontrib>Kariya, Shin</creatorcontrib><creatorcontrib>Okano, Mitsuhiro</creatorcontrib><creatorcontrib>Ando, Mizuo</creatorcontrib><title>Risk Factors for Anterior Skull Base Injury in Endoscopic Sinus Surgery</title><title>Curēus (Palo Alto, CA)</title><addtitle>Cureus</addtitle><description>Objectives This retrospective study aimed to investigate the relationships between the Keros classification, the Gera classification, the vertical height of the posterior ethmoid roof (ER), and anterior ethmoidal artery (AEA) types in Japanese patients. Methods We investigated the computed tomography (CT) slices of paranasal sinuses (120 sides) of 60 patients; measured the cribriform plate (CP) depth, lateral lamella CP angle (LLCPA), and vertical height of the lateral ER from the hard palate (LERHP) at the coronal plane of the posterior ethmoidal artery (PEA); and reviewed the AEA types, whether floating or non-floating. Results CP depth was positively correlated with LLCPA (r=0.63; p<0.01) and the height of LERHP (r=0.19;
p<0.05). The height of the LERHP in females was significantly lower than that in males. With increased CP depth, floating AEAs became prevalent (p<0.001). Conclusion In females, low height of the posterior ethmoid sinus roof, where cerebrospinal fluid (CSF) leaks occurred while penetrating the basal lamella, often existed; the heights positively correlated with the Keros classification in Japanese patients. The Keros and Gera classifications, AEA type, and posterior ER height do not individually constitute a complete risk assessment but may correlate, preventing major complications, such as CSF leak and orbital hemorrhage.</description><subject>Classification</subject><subject>Endoscopy</subject><subject>Fractures</subject><subject>Injuries</subject><subject>Navigation systems</subject><subject>Otolaryngology</subject><subject>Patients</subject><subject>Sinuses</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Veins & arteries</subject><issn>2168-8184</issn><issn>2168-8184</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNpd0M1PwjAYBvDGaIQgN8-miRcPDvuxre0RCSAJiYnoeWm71gzGiu164L9nCBrj6X0Ovzx58wBwi9GIsUw86ehNDKNUEEYvQJ_gnCcc8_TyT-6BYQhrhBBGjCCGrkGPcpzSXOR9MH-rwgbOpG6dD9A6D8dNa3zVhdUm1jV8lsHARbOOfg-rBk6b0gXtdpWGq6qJAa6i_zR-fwOurKyDGZ7vAHzMpu-Tl2T5Ol9MxstEE87bxGQY44xJgZHmhBFcllYhSi0RzBBBpVW6pKWQliuBGVIiF0xxbI0xpVKUDsDDqXfn3Vc0oS22VdCmrmVjXAwFEShjnKRZ1tH7f3Ttom-6746KI4YZ4Z16PCntXQje2GLnq630-wKj4rhxcdq4-N6443fn0qi2pvzFP4vSA5Yud3M</recordid><startdate>20231123</startdate><enddate>20231123</enddate><creator>Makihara, Seiichiro</creator><creator>Uraguchi, Kensuke</creator><creator>Naito, Tomoyuki</creator><creator>Shimizu, Aiko</creator><creator>Murai, Aya</creator><creator>Higaki, Takaya</creator><creator>Noda, Yohei</creator><creator>Kariya, Shin</creator><creator>Okano, Mitsuhiro</creator><creator>Ando, Mizuo</creator><general>Cureus Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20231123</creationdate><title>Risk Factors for Anterior Skull Base Injury in Endoscopic Sinus Surgery</title><author>Makihara, Seiichiro ; Uraguchi, Kensuke ; Naito, Tomoyuki ; Shimizu, Aiko ; Murai, Aya ; Higaki, Takaya ; Noda, Yohei ; Kariya, Shin ; Okano, Mitsuhiro ; Ando, Mizuo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c288t-e511157a910c82721ddfb033f297e293afbcd3d9af8b9170b9697b81feeedbb33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Classification</topic><topic>Endoscopy</topic><topic>Fractures</topic><topic>Injuries</topic><topic>Navigation systems</topic><topic>Otolaryngology</topic><topic>Patients</topic><topic>Sinuses</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Makihara, Seiichiro</creatorcontrib><creatorcontrib>Uraguchi, Kensuke</creatorcontrib><creatorcontrib>Naito, Tomoyuki</creatorcontrib><creatorcontrib>Shimizu, Aiko</creatorcontrib><creatorcontrib>Murai, Aya</creatorcontrib><creatorcontrib>Higaki, Takaya</creatorcontrib><creatorcontrib>Noda, Yohei</creatorcontrib><creatorcontrib>Kariya, Shin</creatorcontrib><creatorcontrib>Okano, Mitsuhiro</creatorcontrib><creatorcontrib>Ando, Mizuo</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Curēus (Palo Alto, CA)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Makihara, Seiichiro</au><au>Uraguchi, Kensuke</au><au>Naito, Tomoyuki</au><au>Shimizu, Aiko</au><au>Murai, Aya</au><au>Higaki, Takaya</au><au>Noda, Yohei</au><au>Kariya, Shin</au><au>Okano, Mitsuhiro</au><au>Ando, Mizuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Anterior Skull Base Injury in Endoscopic Sinus Surgery</atitle><jtitle>Curēus (Palo Alto, CA)</jtitle><addtitle>Cureus</addtitle><date>2023-11-23</date><risdate>2023</risdate><volume>15</volume><issue>11</issue><spage>e49273</spage><epage>e49273</epage><pages>e49273-e49273</pages><issn>2168-8184</issn><eissn>2168-8184</eissn><abstract>Objectives This retrospective study aimed to investigate the relationships between the Keros classification, the Gera classification, the vertical height of the posterior ethmoid roof (ER), and anterior ethmoidal artery (AEA) types in Japanese patients. Methods We investigated the computed tomography (CT) slices of paranasal sinuses (120 sides) of 60 patients; measured the cribriform plate (CP) depth, lateral lamella CP angle (LLCPA), and vertical height of the lateral ER from the hard palate (LERHP) at the coronal plane of the posterior ethmoidal artery (PEA); and reviewed the AEA types, whether floating or non-floating. Results CP depth was positively correlated with LLCPA (r=0.63; p<0.01) and the height of LERHP (r=0.19;
p<0.05). The height of the LERHP in females was significantly lower than that in males. With increased CP depth, floating AEAs became prevalent (p<0.001). Conclusion In females, low height of the posterior ethmoid sinus roof, where cerebrospinal fluid (CSF) leaks occurred while penetrating the basal lamella, often existed; the heights positively correlated with the Keros classification in Japanese patients. The Keros and Gera classifications, AEA type, and posterior ER height do not individually constitute a complete risk assessment but may correlate, preventing major complications, such as CSF leak and orbital hemorrhage.</abstract><cop>United States</cop><pub>Cureus Inc</pub><pmid>38143696</pmid><doi>10.7759/cureus.49273</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Classification Endoscopy Fractures Injuries Navigation systems Otolaryngology Patients Sinuses Surgery Surgical outcomes Veins & arteries |
| title | Risk Factors for Anterior Skull Base Injury in Endoscopic Sinus Surgery |
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