The middle turbinate as an anatomical landmark for a safe maxillary antrostomy during endoscopic sinus surgery: A computed tomography study

The purpose of this study is to characterize the anatomical relationship of the middle turbinate to the lamina papyracea and nasolacrimal duct and to understand if the middle turbinate can be used to landmark a safe maxillary antrostomy. Axial and coronal paranasal computed tomography scans of 109 patients were analyzed. Using the Picture Archiving and Communication Software measurement tool on coronal view, distances were measured. In 99% of CT scans, a maxillary antrostomy could be created safely at a minimum of 16.4 mm posterior to the anterior border of middle turbinate without injury to the nasolacrimal duct. In 98.5% of CT scans, a maxillary antrostomy could be safely initiated at the inferior border of middle turbinate, without injury to the orbit. The middle turbinate may be used as an effective adjunctive anatomical landmark when creating a maxillary antrostomy.