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Posterior Ethmoid Surgical Procedures

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Most of the surgery for functional endoscopic

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sinus surgery is directed towards the anterior sinonasal

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cavity, that being the maxillary sinus, the

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anterior ethmoid air cells, and the frontal sinuses.

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However, occasionally you will have a patient whose

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inflammatory disease is concentrated in the posterior

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portion of the sinonasal cavity, those being the

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posterior ethmoid air cells and the sphenoid sinus.

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As I mentioned, the drainage for the

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posterior ethmoid air cells, which you see

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here, and the sphenoid sinus goes through a

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channel known as the sphenoethmoidal recess.

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You might see SER on the request slip, and that is a

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narrow channel, which again, can be obstructed with

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secretions and can lead to backup into the posterior

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ethmoid air cells and the sphenoid sinus, leading to

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sinusitis. For surgery on this condition,

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once again, usually they're doing a sinusotomy,

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an opening to that, widening of that opening rather

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than removing all the septations of the posterior

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ethmoid air cells and the sphenoid sinus.

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So they're basically trying to widen the opening,

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so that way normal mucociliary clearance

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in the sphenoid sinus and the posterior

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ethmoid sinus will drain that downward,

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and then posteriorly into the back of the

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middle meatus, and from there, back to your

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pharynx, where we all do *sniff* and swallow it down.

Report

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Mahla Radmard, MD

Postdoctoral Research Fellow

Johns Hopkins University School of Medicine

Tags

Sinus

Sinonasal Cavity

Oncologic Imaging

Neuroradiology

CT

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