2017 Sec 1 Green Book

Sagi

et

al.

/ International

Journal

of Pediatric Otorhinolaryngology 79

(2015)

690–693

L.

The study population consisted of children who underwent ESS for drainage of an SPOA between the years 1995 and 2006. Children with significant congenital syndromes such as Down’s syndrome and cystic fibrosis [13] , a history of significant maxillofacial trauma, nasal fractures, or previous nasoseptal surgery were excluded. All children underwent a CT scan demonstrating sinusitis and an SPOA. All ESS procedures for drainage of the abscess were performed by the same surgeon, using the same approach and technique.

Surgical

procedure

2.1.

0 8

30 8

performed

using

4-mm

and

telescopes

under

ESS was

lamina papyracea was completely exposed

general anesthesia. The

removed

after

removal

of

the

uncinate

process,

bulla small

and

and

anterior

and

posterior

ethmoid

cells.

A

ethmoidalis

left

in

the middle meatus

until

the

following morning

pack was

[14] .

Patient

evaluation

2.2.

contacted

for

initial

assessment by phone

for

All patients were

epidemiologic

data, head

including

queries

regarding

any ESS

collecting imaging procedure. The appropriate) next

modality

of

the

region

performed

since

the

step was

to

invite

the

child

(and

his

parents when

for

medical

history,

including

nasal

history,

face

and

additional

surgery

in

the

sinuses

and

nose

along

the

trauma

the outpatient

years, and a complete head and neck examination at

An

informed

consent was

provided

by

the

patient

(or

his

clinic.

appropriate).

parents when

Fig.

1.

Illustration

of

the

five

transverse

linear measurements.

Cephalometric

radiography

and measurement

2.3.

cephalometric

radiograph

for evaluation

All patients had an AP

any

asymmetry

between

the

two

sides

of

the

face.

of

cephalometric

images

are

the

2D

interpretation

of

3D

The

2. LO

–

latero-orbitale

–

the

intersection

of

the

lateral

orbital

In

cephalometry,

the

X-ray

source

was

fixed

at

a

structures.

the

innominate

line

(left

and

right);

contour with

cm

from of 15

the mid

sagittal plane, and

the film was

distance of 152.4

3. LPA

–

lateral

piriform

aperture

–

the most

lateral

aspect

of

the

at

a distance

cm

from

the mid

sagittal plane.

The

ear the

placed

aperture

(left

and

right);

piriform

were

inserted

into

the

external

auditory

canals,

while

rods

4. ZFMA

–

zygomatico-frontal

medial

suture

point

–

point

at

plane was

parallel

to

the

floor.

The

central

X-ray

beam

Frankfort penetrated trans-meatal

of

the

zygomatico-frontal

suture

(left

and

the medial margin

the

patient’s

skull

in

an AP

direction

and

bisected

the

right).

axis

perpendicularly.

In

lateral

and

frontal

cephalo-

plane

(the

5th

plane),

from

which

all

other

The midsagittal

many

structures

overlap

as

complex

3D

structures

are

grams,

calculated was

drawn

through:

planes were

inherent

projected on a 2D plane. The magnification and distortion

conventional

radiography make

it

difficult

to

accurately

assess

in

Top: OM – orbital midpoint –

the projection on

the

line LO–LO of

patient’s

anatomy

[15] .

The

properly

adjusted

cephalostat

the

top

of

the

nasal

septum

at

the

base

of

the

crista

galli;

the

prevent

a

slight

translation

or

rotation

of

the mid-sagittal

cannot plane.

–

top

nasal

septum

–

the

highest

point

on

the

superior

TNS

These

variations

in

skull

position may

lead

to

variations

in

of

the

nasal

septum;

aspect

cephalometric measurements. One investigator (blinded to

Bottom: ANS—anterior

nasal

spine.

the

side

of

operation)

evaluated

7 reference points on

the cephalometric

radiograph and compared

two sides of

the

face. Cephalograms were

traced and measured

the

Statistical

evaluation

2.4.

hand,

and

all measurements made

by

one

investigator.

Five

by

variables

were

reported

as

frequency

and

Categorical

linear measurements

were measured

on

each

radio-

transverse

and

continuous

variables

as

medians

and

inter-

percentages,

These

are

shown

in

Fig.

1

(see

legend

for

definitions

of

graph.

ranges

(IQR). We

used

the Wilcoxon

test

to

study

the

quartile

abbreviations). The linear

between

the

two

sides

of

the

face,

using

the

four

difference

transverse measurements used in

the

study were

as

Spearman Correlation Coefficient was used

variables measured.

follows: Our

assess

the

correlation

between

age

at

surgery,

age

at

to

4

anatomic

landmark

reference

points

used

for

the

time

of

follow

up

and

the

difference

between

the

evaluation,

( Fig.

1 ):

measurements

facial sided. A two-tailed p < 0.05were

measurements of the two

statistically

significant.

Analyses

were

performed

considered

1. MO

– medio-orbitale

–

the

point

on

the medial

orbital margin

SPSS

version

21.

with

is

closest

to

the median

lane

(left

and

right);

that

93