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Computed tomography analysis of the anterior ethmoid genu of the frontal recess in non-diseased sinuses

Published online by Cambridge University Press:  20 December 2021

K Raman Open the ORCID record for K Raman [Opens in a new window] ,
R Govindaraju ,
K James ,
M Z Abu Bakar ,
N Patil  and
M N Shah
K Raman*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
R Govindaraju
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
K James
Affiliation:
Department of Radiology, Sligo University Hospital, Sligo, Ireland
M Z Abu Bakar
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
N Patil
Affiliation:
Department of Otorhinolaryngology, Sligo University Hospital, Sligo, Ireland
M N Shah
Affiliation:
Department of Biomedical Imaging, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
*
Author for correspondence: Dr K Raman, Department of Otorhinolaryngology, Faculty of Medicine, University Malaya, Kuala Lumpur 50603, Malaysia E-mail: kugenew22@gmail.com Fax: +603 7955 6963
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Abstract

Objective

Knowledge of anatomical variations of the frontal recess and frontal sinus and recognition of endoscopic landmarks are vital for safe and effective endoscopic sinus surgery. This study revisited an anatomical landmark in the frontal recess that could serve as a guide to the frontal sinus.

Method

Prevalence of the anterior ethmoid genu, its morphology and its relationship with the frontal sinus drainage pathway was assessed. Computed tomography scans with multiplanar reconstruction were used to study non-diseased sinonasal complexes.

Results

The anterior ethmoidal genu was present in all 102 anatomical sides studied, independent of age, gender and race. Its position was within the frontal sinus drainage pathway, and the drainage pathway was medial to it in 98 of 102 cases. The anterior ethmoidal genu sometimes extended laterally and formed a recess bounded by the lamina papyracea laterally, by the uncinate process anteriorly and by the bulla ethmoidalis posteriorly. Distance of the anterior ethmoidal genu to frontal ostia can be determined by the height of the posterior wall of the agger nasi cell rather than its volume or other dimensions.

Conclusion

This study confirmed that the anterior ethmoidal genu is a constant anatomical structure positioned within frontal sinus drainage pathway. The description of anterior ethmoidal genu found in this study explained the anatomical connection between the agger nasi cell, uncinate process and bulla ethmoidalis and its structural organisation.

Keywords

Frontal SinusFrontal RecessFrontal Sinus DrainageUncinate ProcessBulla EthmoidalisEndoscopic Sinus Surgery
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 137 , Issue 2 , February 2023 , pp. 169 - 173
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Dr K Raman takes responsibility for the integrity of the content of the paper

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