机构：[1]Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China临床科室耳鼻咽喉-头颈外科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[2]Department of Otolaryngology–Head and Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio[3]Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland[4]Department of Neurological Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio
Background Caudal pneumatization of the pterygoid process may impact endonasal exposure of the lateral recess of sphenoid sinus (LRSS). Objectives This study aims to explore the implications of a pneumatized pterygoid process for an endonasal transpterygoid approach to the LRSS and to define strategies regarding the preservation or sacrifice of the vidian nerve. Methods Dissection of the LRSS (11 sides) was performed on 6 cadaveric specimens, preselected for the radiographic presence of an LRSS. In addition, the dimensions of the LRSS were measured on the deidentified CT images of 120 patients (240 sides). The sphenoid sinus was subdivided into 3 categories: Type 1 (no identifiable LRSS), Type 2 (lateral pneumatization of the greater wing above the vidian canal), and Type 3 (pneumatization of both the greater wing and the pterygoid process). Results On the cadaveric specimens, a Type 2 pneumatization often allowed access to the LRSS above the level of the vidian canal; thus, sparing the vidian neurovascular bundle. In Type 3 pneumatization, a frontal corridor through the pterygoid base could be created to reach the LRSS with preservation of the vidian nerve. Extreme Type 3 pneumatization, however, required the transposition or sacrifice of the vidian nerve to facilitate a full direct access to the superolateral LRSS. Measurements on CT images revealed that the extent of caudal pneumatization of the pterygoid process had no statistically significant correlation with the superolateral extension of the lateral recess in patients with Type 3 LRSS (P > .05). Conclusion Pneumatization of the LRSS toward a caudal or superolateral direction may develop independent from each other. Caudal pneumatization of the pterygoid process seems to variably impact the endonasal exposure of the LRSS.
基金：
National Key R&D Program of China [2019YFC0119301]
第一作者机构：[1]Department of Otolaryngology–Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China[2]Department of Otolaryngology–Head and Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio
通讯作者：
通讯机构：[2]Department of Otolaryngology–Head and Neck Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio[4]Department of Neurological Surgery, The James Cancer Hospital at the Wexner Medical Center of The Ohio State University, Columbus, Ohio[*1]The Ohio State University College of Medicine, The James Cancer Center at The Ohio State University Wexner Medical Center, Starling Loving Hall – Room B221, 320 West 10th Avenue, Columbus, OH 43210, USA
推荐引用方式(GB/T 7714)：
Li Lifeng,London Nyall R.,Prevedello Daniel M.,et al.Endonasal Exposure of Lateral Recess of the Sphenoid Sinus: Significance of Pterygoid Process Pneumatization[J].AMERICAN JOURNAL OF RHINOLOGY & ALLERGY.2023,37(3):291-297.doi:10.1177/19458924221139019.
APA：
Li, Lifeng,London, Nyall R.,Prevedello, Daniel M.&Carrau, Ricardo L..(2023).Endonasal Exposure of Lateral Recess of the Sphenoid Sinus: Significance of Pterygoid Process Pneumatization.AMERICAN JOURNAL OF RHINOLOGY & ALLERGY,37,(3)
MLA：
Li, Lifeng,et al."Endonasal Exposure of Lateral Recess of the Sphenoid Sinus: Significance of Pterygoid Process Pneumatization".AMERICAN JOURNAL OF RHINOLOGY & ALLERGY 37..3(2023):291-297
