Vol.:(0123456789) 1 3
European Archives of Oto-Rhino-Laryngology
https://doi.org/10.1007/s00405-018-5038-9
RHINOLOGY
Computed tomography analysis of intranasal distance of frontal
and sphenoid sinus ostiums in children
Cigdem Kalaycik Ertugay
1
· Ela Araz Server
1,3
· Yesim Karagoz
2
· Ozgur Yigit
1
· Ahmet Volkan Sunter
1
·
Ahmet Gorkem Yasak
1
Received: 8 December 2017 / Accepted: 14 June 2018
© Springer-Verlag GmbH Germany, part of Springer Nature 2018
Abstract
Purpose Pediatric population may be more prone to complications in comparison to adults because of the variability of
developmental changes of paranasal sinuses and skull base. Knowledge of standard columellar distances regarding age in
addition to anatomical landmarks is an important guide during functional endoscopic sinus surgery. We aimed to identify
standard distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid sinus
ostiums and provide an objective reference graph in regard to age in children.
Methods Subjects who are older than 1 year and younger than 18 years who had undergone a head-and-neck, maxillofacial
or temporal bone region high resolution computed tomography scan during the last 3 years were obtained from radiological
database. The distances from columella and anterior nasal spine to the anterior and posterior border of frontal and sphenoid
sinus ostiums were measured and nasofrontal and nasosphenoid angles were calculated.
Results A total number of 119 children (73 boys, 46 girls) were reviewed. The average age was 7.7 ± 5.0 years. All sub-
jects had normal sinonasal anatomy. We found statistically signifcantly positive correlation between age and all distances
(p < 0.001). Although all measured distances of boys were greater than girls, this diference did not reach statistical signif-
cance. Additionally, nasosphenoidal angles were signifcantly obtuse in boys (p < 0.05).
Conclusions Our columellar distance graphic can provide further improvement of surgeon confdence while performing
endoscopic sinus surgery or skull base surgery.
Keywords Frontal sinus · Sphenoid sinus · Pediatric · Children · Computed tomography · Sinus ostium
Introduction
Endoscopic sinus surgery (ESS), since frst per formed in
Europe during 1970s, has become one of the most common
surgical procedures in otolaryngology practice [1]. Further-
more, application of endoscopic techniques has included
This manuscript was presented in 38. Congress Of Turkish
National Otorhinolaryngology Association, 26–30 October 2016,
in Antalya, Turkey.
* Ela Araz Server
serverela@hotmail.com
Cigdem Kalaycik Ertugay
ckalaycik@gmail.com
Yesim Karagoz
yesimkar@yahoo.com
Ozgur Yigit
yigitdr@yahoo.com
Ahmet Volkan Sunter
avsunter@gmail.com
Ahmet Gorkem Yasak
gorkemyasak@hotmail.com
1
Department of Otorhinolaryngology/Head and Neck
Surgery, Istanbul Training and Research Hospital, Istanbul,
Turkey
2
Department of Radiology, Istanbul Training and Research
Hospital, Istanbul, Turkey
3
İstanbul Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz
Kliniği, Kasap İlyas Mah., Org. Abdurrahman Nafz Gürman
Cad., Fatih, 34098 Istanbul, Turkey