Evaluation of the Bone Resistance of the Sphenoid and Ethmoid Sinuses

Abstract

Functional endoscopic sinus surgery can be associated with iatrogenic complications. Some anatomical structures have been identified this clinically as specific danger sites. The aim of this study was to confirm and to compare these clinical data with measurements of the bone resistance of the sphenoid and ethmoid walls and to point out regions that have increased bony fragility. Critical dynamometric evaluation of the resistance to breakage of these bony structures was made on 21 anatomic specimens. This study allowed the authors to localization of surgical complications, to demonstrate that other regions renowned for their fragility can be relatively robust, and to point out that robust sites can be dangerously fragile as a result of individual morphological variations. Results from this study provide a supplement to the guidelines for novice surgeons to use in identifying dangerous areas.

A Systematic Review of Outcomes after Dacryocystorhinostomy in Adults

“…Wagner et al 8 bilaterally measured five formalin-fixed heads, using a torque sensor mounted on an endoscope to perform osteotomies. Waridel et al 9 published results on 21 sectioned specimens preserved in 40% ethanol. A dynamometer was used to measure breaking force perpendicular to the osteotomy site.…”

“…Two previous studies 8,9 have shown forces ranging between 2 and 12 N are needed to breach ethmoid bone but neither of these studies were performed using surgical instruments. The aim of the current study is to investigate the magnitude of the axial forces exerted when punch osteotomies are performed within the paranasal sinuses and surrounding structures during ESS.…”

Measurement of Osteotomy Force during Endoscopic Sinus Surgery

“…As robotic technology matures, the automation of endoscopic sinus procedures 1,7 and other otorhinolaryngological surgical procedures 8 can already be envisioned. To design a control system for a robotic application to undertake sinus surgery, our knowledge of the anatomy and material properties of the paranasal sinus system has to be formalized.…”

“…This has led to attempts to objectively quantify the forces required to fracture paranasal sinus lamella. 1–3 …”

Bone density measurements of the paranasal sinuses on plastinated whole‐organ sections: Anatomic data to prevent complications in endoscopic sinus surgery

“…Although extensive descriptive anatomic data regarding the surgical anatomy of the paranasal sinuses are available today, 13,14 only limited information on the bony walls of the paranasal sinuses (e.g., bone density or bone resistance, for understanding complications related to ESS) can be found in the literature 15,16 . Up to the present, there have been no reports on the application of bone density measurements on plastinated specimens in the field of rhinology.…”