The Relationship of High Septal Deviation, the Depth of Olfactory Fossa, and Gera Angle: Is High Septal Deviation Associated With Any Anatomic Abnormalities in the Anterior Skull Base?

Altunay, Zeynep Onerci; Önerci, T. Metin

doi:10.1177/0145561320926406

Cited by 4 publications

(4 citation statements)

References 8 publications

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“…It is an anatomic variant that has not been well studied, potentially due to the paucity of associated skull base abnormalities. 4 However, its severity and particular position opposite to the middle turbinate axilla can substantially restrict intraoperative sinus access as well as the ease of postoperative debridement. Correction of HASD during ESS is not always done, and the indications for correction are not well understood.…”

Section: Introductionmentioning

confidence: 99%

“…The present study focuses on high anterior septal deviation (HASD). It is an anatomic variant that has not been well studied, potentially due to the paucity of associated skull base abnormalities 4 . However, its severity and particular position opposite to the middle turbinate axilla can substantially restrict intraoperative sinus access as well as the ease of postoperative debridement.…”

Section: Introductionmentioning

confidence: 99%

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Radiological Assessment of High Anterior Septal Deviation and Its Impact on Sinus Access

Lee

Özgen

et al. 2021

The Laryngoscope

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Objectives/Hypothesis: High anterior septal deviation (HASD) is an underreported anatomic variant that can affect the decision to perform septoplasty for access during sinus surgery and ease of postoperative debridement. This study aims to 1) describe an objective method of assessing HASD, and 2) explore its prevalence and implications for performing septoplasty.Study Design: Retrospective cross-sectional study.Methods: Computed tomography scans from 2014 to 2020 were retrospectively reviewed. Two independent observers measured the following with respect to midline: distance to septum (SDD), distance to lateral nasal wall (LNW), and septal deviation angle (SDA).Results: A total of 147 patients were included, with excellent interrater reliability across 99 patients (0.8-0.9). Mean measurements across all patients were SDD (2.77 mm AE 1.34), SDD/LNW (0.26 AE 0.12), and SDA (8.9 AE 4.0). Of 102 patients who underwent sinus surgery, 47 received septoplasty. Compared to the non-septoplasty cohort, the septoplasty cohort had a greater mean SDD (3.61 mm AE 1.48 vs. 2.27 mm AE 0.95; d = 1.10 [95% CI 0.67-1.51]), SDD/LNW (0.34 AE 0.13 vs. 0.21 AE 0.09; d = 1.18 [95% CI 0.76-1.60]), and SDA (11.1 AE 4.3 vs. 7.3 AE 3.4;). Receiver operating characteristic cutoffs were SDD ≥2.43 mm, SDD/LNW ≥0.25, and SDA ≥7.6 , corresponding to a 49%-58% prevalence of HASD.Conclusion: HASD is relatively common and the methods described herein can reliably assess its dimensions. Measurements of SDD, SDD/LNW, and SDA exceeding cutoffs determined by this study may represent clinically significant deflections prompting consideration of septoplasty. These methods may aid in preoperative planning.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radiological Assessment of High Anterior Septal Deviation and Its Impact on Sinus Access

Lee

Özgen

et al. 2021

The Laryngoscope

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“…High anterior septal deviation (HASD) is an anatomical variation that has not been well researched, possibly because there are few concomitant anomalies in the skull base [7]. Nevertheless, the severity of the condition and its specific location opposite to the middle turbinate axilla might significantly limit the ability to enter the sinuses during surgery and make postoperative cleaning more difficult.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and clinical implications of high anterior septal deviation on sinus access: a retrospective cross-sectional study

Raziq,

Hamed,

Abdelsamie

2024

Egypt J Otolaryngol

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Background High anterior septal deviation is an underreported anatomical variant that can influence the decision to conduct septoplasty throughout FESS and to facilitate after-surgery care. Objective To assess the prevalence and clinical implications of HASD on sinus access. Methods This retrospective, cross-sectional research was performed on patients with symptoms of DNS and CRS who were prepared for FESS. CT scan PNS coronal sections have been requested with three measurements: distance to the septum (SDD), distance to lateral nasal wall (LNW), and septal deviation angle (SDA). Results One-hundred fifty-seven patients were included; 73 of them received septoplasty. There is significant increase in SDD (mm), LNW (mm), SDD/LNW, and SDA (degree) in septoplasty group with significant AUC that predict the need of septoplasty. Characteristic cutoffs were SDD more than or equal 2.55 mm, SDD/LNW more than or equal 0.239, and SDA more than or equal 8.95°. There is significant decrease in polyps and edema in septoplasty group postoperatively compared to preoperative. Conclusion Septoplasty during FESS allows room for endoscopic instrumentation, provides adequate visualization of the surgical field and throughout postoperative care, and can reduce the possibility of failed FESS.

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“…Firstly, it is most susceptible to iatrogenic leakage of cerebrospinal fluid. 10 Secondly, the structure which can be injured is the anterior ethmoidal artery, and damage to it can cause uncontrollable bleeding into the orbit. While performing ESS, injury in the intracranial region is likely to occur where the position of the roof is comparatively low.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Olfactory Fossa Depth based on Keros Classification using Computerised tomography (Ct) in Age Groups of Both Genders

Lakhani

Raza²,

Khan³

et al. 2022

JRMC

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Objective: Keros classification based assessment of olfactory fossa depth in different age groups of both genders using computerized tomography (CT) Methodology: Cross sectional study done at Ziauddin university, Clifton, Karachi. Sample size was 270 adults including 160 males & 110 females. The assessment of depth of Olfactory fossa was carried out by measuring the height of lateral lamella of cribriform plate on CT images. Result: Olfactory fossa of 270 patients from both sides of both genders were classified according to Keros classification. We found Type II to be the most frequent on both sides in both genders. No significant difference in olfactory fossa depth was found when compared in different age groups. Conclusion: The present study shows that vast majority of the population comes under Keros type II & type III thus emphasizing the need of pre-operative radiological assessment. Association of right & left olfactory fossa depth in different age groups was found to be insignificant.

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The Relationship of High Septal Deviation, the Depth of Olfactory Fossa, and Gera Angle: Is High Septal Deviation Associated With Any Anatomic Abnormalities in the Anterior Skull Base?

Cited by 4 publications

References 8 publications

Radiological Assessment of High Anterior Septal Deviation and Its Impact on Sinus Access

Radiological Assessment of High Anterior Septal Deviation and Its Impact on Sinus Access

Prevalence and clinical implications of high anterior septal deviation on sinus access: a retrospective cross-sectional study

Assessment of Olfactory Fossa Depth based on Keros Classification using Computerised tomography (Ct) in Age Groups of Both Genders

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