[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.161.249.135. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Article
December 1990

Anterior Ethmoid Anatomy Facilitates Dacryocystorhinostomy

Author Affiliations

From the Department of Ophthalmology, West Virginia University School of Medicine, Morgantown. Dr Blaylock is now with the Department of Ophthalmology, Eastern Virginia Medical School, Norfolk. Dr Linberg is now with the Cleveland (Ohio) Clinic Foundation.

Arch Ophthalmol. 1990;108(12):1774-1777. doi:10.1001/archopht.1990.01070140128045
Abstract

• The ethmoid air cell labyrinth lies adjacent to the medial orbital wall, extending even beyond the sutures of the ethmoid bone. Its anatomic relationship to the lacrimal sac fossa is important in lacrimal surgery. We evaluated computed tomographic scans of 190 orbits with normal ethmoid anatomy to define the anatomic relationship of anterior ethmoid air cells to the lacrimal sac fossa. In 93% of the orbits, the cells extended anterior to the posterior lacrimal crest, with 40% entering the frontal process of the maxilla. This anatomic relationship may be used to facilitate the osteotomy during dacryocystorhinostomy. During a 10-year period (310 cases), one of us routinely entered the anterior ethmoid air cells to initiate the osteotomy during dacryocystorhinostomy. This technique has helped to avoid lacerations of the nasal mucosa.

References
1.
Mosher HP.  The surgical anatomy of the ethmoid labyrinth . Ann Otol Rhinol Laryngol . 1929;38:869-901.
2.
Ritter FN.  The middle turbinate and its relationship to the ethmoid labyrinth and the orbit . Laryngoscope . 1982;92:479-482.Article
3.
Bagatella F, Guirado CR.  The ethmoid labyrinth: an anatomical and radiological study . Acta Otolaryngol Suppl (Stockh) . 1983;403( (suppl) ):1-19.Article
4.
Terrier F, Weber W, Ruefennacht D, Porcellini B.  Anatomy of the ethmoid: CT, endoscopic and macroscopic . Am J Radiol . 1985;144:493-500.
5.
Mattox DE, Delaney RG.  Anatomy of the ethmoid sinus . Otolaryngol Clin North Am . 1985;18:3-42.
6.
Teatini G, Simonetti G, Salvolini U, et al.  Computed tomography of the ethmoid labyrinth and adjacent structures . Ann Otol Rhinol Laryngol . 1987;96:239-250.
7.
Masala W, Perugini S, Salvolini U, Teatini GP.  Multiplanar reconstructions in the study of ethmoid anatomy . Neuroradiology . 1989;31:151-155.Article
8.
Whitnall SE.  The relations of the lacrimal fossa to the ethmoid cells . Ophthalmic Rev . 1911;30:321-325.
9.
Toti A.  Nuovo metodo conservatore di cura radicale delle supporazioni cronicle del sacco lacrimale . Clin Mod Firenze . 1904;10:385-389.
10.
Ohm J.  Nerbesserungen an meinem Nystagmographen . Klin Monatsbl Augenheilkd . 1926;1:791-794.
11.
Dupuy-Dutemps L, Bourguet.  Procede plastique de dacryocystorhinostomie et ses resultats . Ann Ocul . 1921;158:241-261.
12.
Campbell CB, Flanagan JC, Schaefer AJ.  Acquired lacrimal disorders . In: Smith BC, ed. Ophthalmic Plastic and Reconstructive Surgery . St Louis, Mo: CV Mosby Co; 1987:955-967.
13.
Hughes WL, Guy LP, Bogart DW.  Dacryocystorhinostomy . Surg Gynecol Obstet . 1941;73:375-380.
14.
Romanes GJ.  Dacryocystorhinostomy: clinical report of fifty cases . Br J Ophthalmol . 1955;39:237-240.Article
15.
McPherson SD, Egleston D.  Dacryocystorhinostomy: a review of 106 operations . Am J Ophthalmol . 1959;47:328-331.
16.
Kasper KA.  Dacryocystorhinostomy . Surv Ophthalmol . 1961;6:95-107.
17.
Iliff CE.  A simplified dacryocystorhinostomy: 1954-1970 . Arch Ophthalmol . 1971;85:586-591.Article
18.
Pico G.  A modified technique of external dacryocystorhinostomy . Am J Ophthalmol . 1971;72:679-690.
19.
Cassady JR.  A simplified dacryocystorhinostomy technique . Ophthalmic Surg . 1980;11:319-322.
20.
Burns JA, Cahill KV.  Modified Kinosian dacryocystorhinostomy: a review of 122 cases . Ophthalmic Surg . 1985;16:710-716.
21.
McLachlan DL, Shannon GM, Flanagan JC.  Results of dacryocystorhinostomy: analysis of the reoperations . Ophthalmic Surg . 1980;11:427-430.
22.
Welham RAN, Wulc AE.  Management of unsuccessful lacrimal surgery . Br J Ophthalmol . 1987;71:152-157.Article
23.
Linberg JV, Anderson RL, Bumsted RM, Barreras R.  Study of intranasal ostium external dacryocystorhinostomy . Arch Ophthalmol . 1982;100:1758-1762.Article
×