Anatomycal features of the ethmoidal labyrinth and nasal cavity structures in childhood

Abstract

The morphotopometric variability of the ethmoidal labyrinth and the parameters of the nasal cavity for 87 children’s cranium (1–21 years) has been determined. The growth of the ethmoidal labyrinth and the nasal cavity occurs undulating and unevenly. The increase of the height of the ethmoidal labyrinth begins earlier than its width and length from 2–3 years to 13–16 years old. Growth periods the height of ethmoidal labyrinth occur for 2–3 years, 8–12 and 13–16 years; widths – 4–7, 8–12 and 17–21 years; length – 4–7, 8–12 and 13–16 years. At the ethmoidotomy in the infant and early childhood, the smallest size of the ethmoidal labyrinth should be taken into account: width – 7–8 mm, height – 14–16 mm, length – 27–29 mm, so in these age periods there is a high risk of damage of the cribriform and orbital plates ethmoid bone with the development of iatrogenic complications. The nasal cavity штchildren expands posteriorly as well as in adults. In the infancy, the width of the nasal cavity at the back corresponds to the width in the front section, from 2 years prevails than in front and by adolescence becomes larger for 3–3,5 mm. Knowing these age–related features of the structure of the children’s nasal cavity, during surgery the rhinosurgeon when shifting the middle nasal shells medially or laterally should ensure to maintain the physiological model of the nasal cavity. In infancy, the width of the ethmoidal labyrinth is larger than the width of the nasal cavity by 38,5%, and by adolescence this ratio increases to 76,8%. The length of the nasal cavity increases from 4–7 years to adolescence, the length of the ethmoidal labyrinth grows parallel to the maximum length of the nasal cavity and it is less for more than a half in all children’s age groups: in the infancy by 74%, in adolescence – by 85.1%. The height of the nasal cavity is twice the height of the labyrinth in any childhood age, the distance from the bottom of the nasal cavity to the lower edge of the middle nasal shell must be correlated with the distance above the level of the average nasal shell during intranasal surgeries and do not exceed it for the introduction of tools.

Keywords

ethmoidal labyrinth / children / craniometry / nose anatomy / age–related variability / endoscopic rhinosurgery / ostiomeatal complex / ethmoidotomy / sinusitis

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RIGHTS & PERMISSIONS

Markeeva M.V., Aleshkina O.Y., Tarasova N.V., Gaivoronsky I.V.