Ethmoidal Width as a Predictor of the Size and Surgical Freedom of the Transcribriform Corridor

The trans-cribriform corridor is an extended endoscopic endonasal approach to treat pathologies of the anterior skull base (ASB). We present a predictive model that uses the ethmoidal width to predict the size of and the surgical freedom of this corridor. A 103 computed tomography scans of the head were selected. Exclusion criteria included patients <18 years of age, radiographic evidence of trauma, neoplasm, infection, or previous surgery. The images were analyzed using OsiriX MD (Bernex, Switzerland). We recorded the ASB length, surface area, freedom of movement (FOM) in sagittal and coronal planes, and ethmoidal width. We used univariate linear regression to create a prediction model, and cross folding to test the validity of the model. We included 103 patients with an average age of 44.9 years and 47% males. The mean ASB length, surface area, sagittal FOM, coronal FOM were 48.7 mm (SD ± 3.8), 11.5 cm² (SD ± 1.5), 34.3 degrees (SD ± 2.9), and 27.2 degrees (SD ± 3.1), respectively. The ethmoidal width was 23.9 mm (SD ± 2.9; [Fig. 1]). Our model uses a single input variable (ethmoidal width) to predict the size and freedom of movement of the trans-cribriform corridor. The model also showed good fitness and validity. Clinically, it can be used to help neurosurgeons to estimate and determine the optimal surgical corridor using patients' anatomy.

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Artikel online veröffentlicht:
12. Februar 2021