Abstract
Background:- Endoscopic sinus surgery , nowadays is going to replace the ordinary surgery
Despite many landmarks were recognized and used in these surgeries, still there are major
intraorbital complications. The aim of this work:- Was to study the anatomical variations in the
maxillary ostium ,uncinate process of ethmoid bone and nasal fontanelle , to determine the following
distances :From the anterior nasal spine to uncinate process ,anterior and posterior margins of nasal
fontanelle and maxillary ostium . From the posterior margin of nasal fontanelle to sphenopalatine
foramen .To study the relationship between: The upper margin of nasal fontanelle with orbital floor
and the most posterior margin of medial wall of maxillary sinus with optic foramen . Materials and
methods:- This study was carried out on 70 sides of dried skulls and 30 sides of cadaveric heath. In
each half, the middle meatuses were examined for variations in the maxillary ostium , uncinate
process and nasal fontanelle . Also the above distances were measured .The dried skulls were
sectioned in midorbital plane to study the relation between maxillary sinus walls and orbit. Results:
In 86.7% of soft specimens,the maxillary ostium was located in the ethmoidal infundibulum ,and
1 hidden by uncinate process, while in 13.3% of soft specimens was located in posterior fontanelle
behind the uncinate process. The maxillary ostium was rounded in shape 93.3 % of soft specimens
and oval in 6.7% of soft specimens .The anteroposterior diameter of maxillary sinus ostium was
3.5+ 1.5mm. The number of maxillary ostium was single in 73.3 % of soft specimens and accessory
ostium in the anterior fontanelle in 26.7%. The uncinate process was classified into 5 types
according to articulation of its posteroinferior end with the surrounding bones :In type I, the
posteroinferior end of uncinate process articulated with the inferior concha in 42.9% of soft
specimens .In type II, this end was five in 18.6%. In type III, this end was free and pneumatized in
17.1%. In type IV, this end articulated with the inferior concha and bulla ethmoidal in 14.3%. In
type V, this end articulated with the bulks ethmoidal in 7.1% .The nasal fontanelle had different
shapes .In type I ,the anterior nasal fontanelle was oval in shape ,while the posterior nasal
fontanelle was triangular in shape in 42.9%. In type II, the nasal fontanelle was U-shaped in 18.6%.
-In types III ,IV ,V , the nasal fontanelle was oval in shape in 38.5% . The following distances from
anterior nasal spine were measured : The distance between the anterior nasal spine and
posteroinferior end of uncinate process ,anterior edge of nasal fontanelle ,anterior edge of maxillary |
