By Werner Hosemann, J Fanghänel
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Extra info for A Dissection Course On Endoscopic Endonasal Sinus Surgery
The vertical lamella of the middle turbinate can now be resected. Identify the cribriform plate and the lateral wall of the olfactory fossa, which is usually thin. Explore the site where the anterior ethmoidal artery enters the olfactory fossa (frequent dehiscences, see above). " Then cover the perforation with a small flap of autologous mucosa. • Now incise the periorbita: first incise the periorbita from posterior to anterior, making several passes with the knife (Fig. 41). The posterior-to-anterior cut is advantageous in vivo for keeping fat from herniating into the visual field.
In 32% of cases the ethmoid bone covers half of the AP dimension of the lacrimal fossa [Whitnall 1932). Fig. 37 Relationship of the posterior extension of the middle turbinate to the sphenopalatine foramen. The ethmoid crest is interrupted by the sphenopalatine foramen (from Wareing and Padgham 1998). A Dissection Course On Endoscopic Endonasal Sinus Surgery 33 sphenopalatine artery close to the sphenopalatine ostium (Fig. 38). 5-2 mm in diameter; usually this occurs in front of the ostium and less commonly past it.
31 • The usual result is a conspicuous neo-ostium through which the posterior wall of the frontal sinus can be seen (also the roof of the frontal sinus in favorable cases). 9 Demonstrating the Olfactory Fibers The olfactory fibers course in the upper part of the bony vertical lamella of the middle turbinate. In 10% of cases they also course in the mucosa lateral to the bony lamella. It is common to find grooves in the lamella for the olfactory nerves, and they can provide useful landmarks (Kennedy 1992, Kim et al.
A Dissection Course On Endoscopic Endonasal Sinus Surgery by Werner Hosemann, J Fanghänel