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THE LATERAL NASAL WALL IN FILIPINOS: A STUDY BASED ON<br />
FIFTY CONSECUTIVE CADAVER DISSECTIONS"<br />
AUTHORS<br />
CHARLOI-fEM. CHIONG,M.D.*<br />
ARMANDOM.CHIONG,JR.M.D.*<br />
CESARANTHONYP.YABUT,M.D.*<br />
EDITHC.YAP,M.D.*<br />
ARMANO0T,CHIONG,M.D.'*<br />
JACOBS. MATUSIS,M.D.***<br />
ABSTRACT within the major sinuses. Obstruction in this area<br />
either due to osteomeatal inflammaztion or anatomic<br />
This study investigated anatomical variations and variation can perpetuate sinus infection. Functional<br />
actual measurements of anatomic structures in the lateral endoscopic sinus surgery emphasizes endoscopic idennasal<br />
wait in fifty consecutive Filipino cadavers tification and operation of the diseased ethmoidal<br />
dissected. Such measurements were compared with infundibulum with the aim of reestablishing drainage<br />
values published in anatomy textbooks. This study and ventilation of the dependent large sinuses via their<br />
proves that Caucasian-based figures need not reflect physiological ostia. Van Alyea and Myerson, with<br />
thOSe in Filipinos. Anatomic variations were noted the knowledge of this important physiologic concept,<br />
and their clinical significance discussed. This study gave impetus to cannulation of the ostium maxillare<br />
gives baseline values in Filipinos and is of potential to treat seemingly "irreversible" sinus pathology.<br />
use for the clinician in practice as well as for instru- Zuckekandl recognized the importance of anatomic<br />
ment design for specific use in nasal surgery on Filipino variations in the middle meatal area responsible for<br />
patients, pathogenesis of sinus disease. The basic knowledge<br />
of the anatomy, of this critical importance. In this<br />
respect, the rhinologist who wants to cannulate the<br />
INTRODUCTION maxillary ostium or the sinonasal endoscopist must be<br />
familiar with the dimensions and spatial orientation<br />
The specialty of Otorhinolaryngology-Head and of the important structures in this area. In our setting,<br />
Neck Surgery has recently gained major advances in these advances are now being introduced. However,<br />
the area of rhinology and sinus surgery. There has basic anatomy textbooks deal mainly with measurebeen<br />
increased discussion regarding the advantages of ments and anatomic observations made on Caucasians.<br />
newer surgical techniques like functional endoscopic Considering that Filipinos are generally anthorpomsurgery<br />
over conventional sinus surgery and vice-versa, etrically smaller, idiosyncrasies and variable dimen-<br />
The area of osteomeatal complex, while poorly visu- sions of the structures are expected. Consequently,<br />
alized on anterior rhinoscopy or plain radiographs is these values may dictate the use of indigenous spemost<br />
important in the pathogenesis of secondary disease cialized instruments designed for Filipinos as well as<br />
guide the surgeons _in performing simple surgical<br />
•intervention or during endoscopy of the sinonasal areas.<br />
Clinical correlation with certain unique rhinopathol-<br />
+ First prize, <strong>PSO</strong>-HN$ 8th Annual Residez_ts" Research Contest held ogic conditions and surgical intervention deserve special<br />
on October 26, 19t_$, Manila Midtown Hotel<br />
consideration. To investigate the hypothesis that foreign<br />
* Residents,, Department of OtollLryngology, UP-PGH Medical Center published data on the anatomy of lhe lateral nasalwall<br />
need not reflect those of the Filipinos, actual meas-<br />
** Chairman, Department of Otolaryngology, UP-PGH Medical Center<br />
uremcnts and description of the anatomy of the lateral<br />
*** Consultant, Department ofOtola_yngology, UP-PGHMedic_I nasal wall was based on fifty consecutive cadaver<br />
Center dissections of Filipino adult skulls. Particular attem<br />
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