Age-Related Variability of the Width of the Nasal Meatuses According to Data of the Craniometry

Abstract

The use of video-endoscopic equipment in pediatric rhino-surgery necessitates a thorough study of the structure of the nasal cavity structures at different age periods. The aim of the study was to study the width of the nasal meatuses in childhood based on craniometrics data. Craniometry of 65 children's skulls was performed, divided into six groups (infancy, early childhood, first and second childhood, adolescence and youth). It was found that the width of the nasal meatuses increases unevenly with the age of the child; periods of the permanency are replaced by periods of growth. The maximum values of the width of the lower and middle nasal meatuses of the skull reach in adolescence, and the general meatuses - in adolescence. Also, an increase in the width of the middle and common nasal meatuses was revealed along their length from the anterior to posterior edges of the nasal conches by an average of 30%, while the width of the lower nasal meatuses remains constant. The ratios of the width of the lower and middle nasal meatuses to the width of the common nasal passages were determined depending on age. The width of the inferior nasal meatus to the width of the common nasal meatus at 1-1.5 years is 1: 2 at the level of the anterior end of the inferior nasal conchae and 1: 3 at the level of its posterior end, in other age groups it is 1: 1.5 and 1: 2 respectively. The width of the middle nasal meatus to the width of the common nasal meatus at the level of both ends of the middle meatus in each age group is 1: 1. The obtained data are of clinical importance for the choice of trans-nasal surgical access, for the choice of the size of endoscopic instruments, the diameter and angle of view of endoscopes, the preservation of age-related physiological relationships of the structures of the nasal cavity, and the reduction of the risk of intraoperative complications. Up to 4 years old, it is recommended to use endoscopes and endoscopic instruments of the smallest diameter; over 4 years old, the size of the nasal passages makes it possible to increase the diameter of the endoscopic set to improve access.