AI Article Synopsis
- * Researchers propose a second visual landmark called the transverse turbinate line (TTL), which provides a 2-millimeter zone of confidence for accurately positioning the MSNO alongside the existing maxillary line.
- * Findings from dissecting 40 cadaveric sinuses show consistent results for the TTL, suggesting that using this additional landmark could improve surgical accuracy, reduce time in training, and decrease long-term surgery complications.
Article Abstract
Objectives: Approximating the maxillary sinus natural ostium's (MSNO) natural position during anterograde surgery is challenging, as only a single visual "landmark," the maxillary line, is routinely offered to guide the identification of the MSNO in three-dimensional space. Despite almost 40 years of endoscopic sinus surgery (ESS) experience in North America, maxillary recirculation and discontinuity between the natural and surgical ostia are commonly encountered during revision ESS. Consequently, we feel an additional visual landmark would assist in localizing the MSNO with or without image guidance. In this study, we aim to provide a second reliable landmark in the sinonasal cavity.
Methods: We present a cadaveric anatomical landmark series that provides a second visual landmark for the MSNO, which we have labeled the transverse turbinate line (TTL): a 2-millimeter zone of confidence for the craniocaudal positioning of the MSNO that can be combined with the anteroposterior (AP) landmark of the maxillary line.
Results: In our study, 40 cadaveric sinuses were dissected, and the TTL was found to correspond consistently with the zone between the superior and inferior aspects of the MSNO.
Conclusion: We anticipate that this second relational landmark may decrease the time required for anterograde access to the MSNO in trainees, increase the accuracy of identification, and translate to lower long-term recirculation and maxillary surgery failure rates.
Level Of Evidence: NA Laryngoscope, 133:3285-3291, 2023.
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| http://dx.doi.org/10.1002/lary.30678 | DOI Listing |
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