Die Haller'sehen Zellen: Morphologische Evaluierung und klinisch-chirurgische Bedeutung*

Abstract

Ethmoidal cells that have developed into the floor of the orbit or into the roof of the maxillary sinus, respectively, are known as Haller's cells. 528 patients, in whom functional endoscopic sinus surgery was performed, were explored regarding the presence of Haller's cells. 43 patients presented with Haller's cells at least on one side (8.14%). CT scans of these patients were evaluated morphometrically measuring the dimensions of the Haller's cells as well as of the maxillary sinus. Further anatomical variations of the paranasal sinuses (concha bullosa, supraorbital cell, agger nasi cell) and the keros type of the ethmoid sinus roof were seen. A highly significant difference could be demonstrated between the incidence of Haller's cells in men (4.9%) and women (11.9%). For the first time it was possible to demonstrate a frequency distribution between Haller's cells deriving from the anterior ethmoidal cells (88%) and those originating from the posterior ethmoidal cells (12%). In 56% Haller's cells were opacified on CT-scan showing a mucosal swelling respectively a retention of secretion during endoscopic surgery.

Role of Sinonasal Anatomic Variations in the Development of Maxillary Sinusitis: A Cone Beam CT Analysis

“…In the study performed by Kennedy and Zinreich, Haller cells were considered as ethmoid cells located below the ethmoid bulla within the orbital floor and in the region of the opening of the maxillary sinus [ 21 ]. Furthermore, Kainz et al defined Haller cells as air cells within the orbital floor [ 10 ].…”

Frequency and volumetry of infraorbital ethmoid cells (Haller cells) on cone-beam computed tomograms (CBCT) of the mid-face

“…Haller cells were investigated in cadaver studies [1], or in CT [15], [16], [25], [27], [45], [46], OPG [37], [38], [39], or CBCT studies [32], [33], [34], [35]. In addition, technological progress means that radiological devices deliver much more detailed images today compared to publications performed earlier or with greater layer thickness of the respective X-ray technology [15].…”

“…Infraorbital ethmoid cells are frequently found and are commonly known as “Haller cells” [3]. These cells may be an incidental finding or cause different disorders [12], [13], [16], [17], [18], [19], [22], [45], [49]. They are of special interest before sinus surgery, as they can lead to serious complications [14], [15], [49].…”

“…Haller cells have often been investigated in CT studies [15], [16], [17], [25], [45], [46], but CBCT studies are rare, as this is a new technique in sinunasal imaging [35]. We carried out a CBCT study to determine its ability to detect and measure variations in the region of the ethmoid complex.…”

The Ethmomaxillary Sinus—A False Duplicate Maxillary Sinus

“…22 According to this definition, they could be anterior or posterior. 20,23 If Haller cells are regarded as originating exclusively from the anterior ethmoid, they differ from the ethmoid bulla and are located laterally to the EI, 11,24,25 the posterior Haller cells are nothing else but EMSs. In 528 cases, posterior Haller cells, thus EMSs, were found with a prevalence of 12%.…”