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Study of Length of Lateral Lamella of the Cribriform Plate

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Introduction: The roof of ethmoid (fovea ethmoidalis) separates the ethmoidal cells from the anterior cranial fossa. Medially the fovea attaches to the lateral lamella of the cribriform plate (LLCP), which is the thinnest bone of the skull base. Hence, it is at a high risk of getting damaged during endoscopic sinus surgery. Objective: To evaluate the height of lateral lamella of cribriform plate using the computed tomographic (CT) images of patients. Materials and Methods: Coronal views of 80 computed tomography films of paranasal sinus region were studied. Coronal sections at the level of centre of infra-orbital foramina were taken as the reference slide. The height of the lateral lamella of the cribriform plate was measured and then classified according to Keros classification. Results: The CT scans from 80 patients were analyzed. The median height of the LLCP in 160 sides was 3.3 mm (SD+1.63). The LLCP height was 0 to 3.9 mm in 122 sides, 4.0 to 7.0 mm in 33 sides, and greater than 7.0m min 5 sides. The lateral lamella of the cribriform plate averaged 3.47 mm (SD +1.68) in height on the right side and 3.08 mm (SD+1.59) on the left. The LLCP height was greater on the right side in 55 patients, greater on the left side in 19 and equal on both sides in 6 patients. The difference between sides was 0 to 1.9 mm in 78 patients, 2.0 to 3.9 mm in 1 patient, and greater than 4.0 mm in 1 patient. Student t test was used to compare the mean height of LLCP on each side. t value = 1.519. The difference of the height was not significant when right and left sides were compared (p = 0.131). Conclusion: In our study, the median height of the LLCP was 3.3 mm. Mean height of the LLCP on right side (3.47) was more than mean height of the LLCP on left side (3.08). But the difference was not statistically significant. However, variations do exist between right and left sides. A surgeon must take proper caution while operating in the area of lateral lamella of cribriform plate to prevent unintentional skull base injury and cerebrospinal fluid leak. A proper pre-operative evaluation of computed tomography of para nasal sinuses is essential to avoid life threatening complications during endoscopic sinus surgery.

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Introduction: The roof of ethmoid (fovea ethmoidalis) separates the ethmoidal cells from the anterior cranial fossa. Medially the fovea attaches to the lateral lamella of the cribriform plate (LLCP), which is the thinnest bone of the skull base. Hence, it is at a high risk of getting damaged during endoscopic sinus surgery. Objective: To evaluate the height of lateral lamella of cribriform plate using the computed tomographic (CT) images of patients. Materials and Methods: Coronal views of 80 computed tomography films of paranasal sinus region were studied. Coronal sections at the level of centre of infra-orbital foramina were taken as the reference slide. The height of the lateral lamella of the cribriform plate was measured and then classified according to Keros classification. Results: The CT scans from 80 patients were analyzed. The median height of the LLCP in 160 sides was 3.3 mm (SD+1.63). The LLCP height was 0 to 3.9 mm in 122 sides, 4.0 to 7.0 mm in 33 sides, and greater than 7.0m min 5 sides. The lateral lamella of the cribriform plate averaged 3.47 mm (SD +1.68) in height on the right side and 3.08 mm (SD+1.59) on the left. The LLCP height was greater on the right side in 55 patients, greater on the left side in 19 and equal on both sides in 6 patients. The difference between sides was 0 to 1.9 mm in 78 patients, 2.0 to 3.9 mm in 1 patient, and greater than 4.0 mm in 1 patient. Student t test was used to compare the mean height of LLCP on each side. t value = 1.519. The difference of the height was not significant when right and left sides were compared (p = 0.131). Conclusion: In our study, the median height of the LLCP was 3.3 mm. Mean height of the LLCP on right side (3.47) was more than mean height of the LLCP on left side (3.08). But the difference was not statistically significant. However, variations do exist between right and left sides. A surgeon must take proper caution while operating in the area of lateral lamella of cribriform plate to prevent unintentional skull base injury and cerebrospinal fluid leak. A proper pre-operative evaluation of computed tomography of para nasal sinuses is essential to avoid life threatening complications during endoscopic sinus surgery.

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This page is a summary of: Study of Length of Lateral Lamella of the Cribriform Plate, Indian Journal of Anatomy, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ija.2320.0022.8119.4.
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