KHẢO SÁT ĐẶC ĐIỂM HÌNH ẢNH HỌC CỬA SỔ TRƯỚC ỐNG LỆ MŨI VÀ ỨNG DỤNG TRONG PHẪU THUẬT NỘI SOI XOANG HÀM

Abstract

Objective: To investigate the morphological characteristics of the prelacrimal window on paranasal sinus computed tomography (CT) scans and to evaluate the applicability of the PLRA in Vietnamese patients. Materials and Methods: A prospective, descriptive cross-sectional study was conducted on 102 patients (204 sides) who underwent paranasal sinus CT scans at the University Medical Center Ho Chi Minh City from December 2024 to June 2025. The following parameters were measured on the axial plane: the width of the prelacrimal window (AB), the distance from the anterior wall of the maxillary sinus to the posterior wall of the nasolacrimal duct (AC), and the width of the nasolacrimal duct (BC). The prelacrimal window width was classified into three types according to Simmen: Type I (<3 mm), Type II (3-7 mm), and Type III (>7 mm). Results: The mean age of the subjects was 47.0 ± 14.6 years, with a male-to-female ratio of 1:1.4. The mean width of the prelacrimal window (AB) was 4.5 ± 2.3 mm. The mean distance from the anterior maxillary wall to the posterior wall of the nasolacrimal duct (AC) was 13.9 ± 2.6 mm. The mean width of the nasolacrimal duct (BC) was 9.4 ± 1.9 mm. The distribution rates for Type I, II, and III were 29.4%, 55.4%, and 15.2%, respectively. The applicability rate for PLRA (Type II and III) was 70.6%. A statistically significant difference was found in the prelacrimal window width between males (5.2 ± 2.2 mm) and females (4.0 ± 2.0 mm) (p<0.05). Conclusion: The anatomical characteristics of the prelacrimal window in the study population are suitable for performing the prelacrimal recess approach in the majority of patients. Preoperative assessment of these parameters on CT scans is essential for selecting the appropriate surgical approach, and special caution is advised in female patients, who tend to have a narrower space.