open access

Vol 79, No 3 (2020)
CASE REPORTS
Published online: 2019-10-09
Submitted: 2019-08-20
Accepted: 2019-09-13
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Three-dimensional anatomy of the transantral intraseptal infraorbital canal with the use of cone-beam computed tomography

L. Cârstocea, M. C. Rusu, C. Pascale, M. Săndulescu
DOI: 10.5603/FM.a2019.0109
·
Pubmed: 31617577
·
Folia Morphol 2020;79(3):649-653.

open access

Vol 79, No 3 (2020)
CASE REPORTS
Published online: 2019-10-09
Submitted: 2019-08-20
Accepted: 2019-09-13

Abstract

The transantral or ectopic infraorbital canal (IOC) courses diagonally through the maxillary sinus (MS), thereby being exposed to risk during a number of surgical procedures. A few prior reports have presented evidence of a septa-embedded IOC, albeit only on single-plane slices. We identified this extremely rare variation of the IOC during a retrospective study of the cone-beam computed tomography files of 2 patients. In the first case, which involved a 34-year-old female patient, the canals and septa within the MS were bilaterally asymmetrical. On the right side, the sinus roof was attached to a short transverse septum that was traversed by the IOC, while the left sinus featured an oblique large septum that divided it into antero-superior and posterior chambers. The left IOC was embedded within the septum rather than within the orbital floor above the septum. In the second case, which concerned a 36-year-old male patient, the left MS featured an almost completely oblique/vertical septum that divided it into anterior and posterior chambers and also embedded the respective IOC, which was thus absent from the orbital floor. In both cases, infraorbital recesses in the anterior chambers of the MS were found that, if not documented on three-dimensional (3D) renderisations, could have been misidentified as infraorbital (Haller) cells. To the best of our knowledge, this is the first report to document the 3D anatomy of an extremely rare variant, namely a septum-embedded transantral IOC. Such a variant, if not adequately documented preoperatively, could divert the transmaxillary corridors down false paths or else expose the IOC to damage during surgical procedures involving access to tumours.

Abstract

The transantral or ectopic infraorbital canal (IOC) courses diagonally through the maxillary sinus (MS), thereby being exposed to risk during a number of surgical procedures. A few prior reports have presented evidence of a septa-embedded IOC, albeit only on single-plane slices. We identified this extremely rare variation of the IOC during a retrospective study of the cone-beam computed tomography files of 2 patients. In the first case, which involved a 34-year-old female patient, the canals and septa within the MS were bilaterally asymmetrical. On the right side, the sinus roof was attached to a short transverse septum that was traversed by the IOC, while the left sinus featured an oblique large septum that divided it into antero-superior and posterior chambers. The left IOC was embedded within the septum rather than within the orbital floor above the septum. In the second case, which concerned a 36-year-old male patient, the left MS featured an almost completely oblique/vertical septum that divided it into anterior and posterior chambers and also embedded the respective IOC, which was thus absent from the orbital floor. In both cases, infraorbital recesses in the anterior chambers of the MS were found that, if not documented on three-dimensional (3D) renderisations, could have been misidentified as infraorbital (Haller) cells. To the best of our knowledge, this is the first report to document the 3D anatomy of an extremely rare variant, namely a septum-embedded transantral IOC. Such a variant, if not adequately documented preoperatively, could divert the transmaxillary corridors down false paths or else expose the IOC to damage during surgical procedures involving access to tumours.

Get Citation

Keywords

maxillary nerve; infraorbital nerve; antrum of Highmore; canalis sinuosus; cone-beam computed tomography

About this article
Title

Three-dimensional anatomy of the transantral intraseptal infraorbital canal with the use of cone-beam computed tomography

Journal

Folia Morphologica

Issue

Vol 79, No 3 (2020)

Pages

649-653

Published online

2019-10-09

DOI

10.5603/FM.a2019.0109

Pubmed

31617577

Bibliographic record

Folia Morphol 2020;79(3):649-653.

Keywords

maxillary nerve
infraorbital nerve
antrum of Highmore
canalis sinuosus
cone-beam computed tomography

Authors

L. Cârstocea
M. C. Rusu
C. Pascale
M. Săndulescu

References (10)
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  9. Rusu MC, Sava CJ, Ilie AC, et al. Agger Nasi Cells Versus Lacrimal Cells and Uncinate Bullae in Cone-Beam Computed Tomography. Ear Nose Throat J. 2019; 98(6): 334–339.
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