Author(s)
Andrew Thamboo, MD, MHSc
Evan Walgama, MD
Noel Ayoub, BS
Zara Patel, MD
Affiliation(s)
Department of Otolaryngology–Head and Neck Surgery, Stanford School of Medicine
Abstract:
"Introduction
Olfactory loss following sinonasal and skull base surgery is a known risk that is devastating to patients. The olfactory fila are vital structures at potential risk during a number of sinonasal procedures. A better anatomical understanding is required to minimize harm to patients.
Objective
The objective of this study is to assess the relationship between the first and last olfactory fila and other more visible and consistent endoscopic landmarks.
Methods
A cadaveric study was performed on 8 fresh heads (a total of 16 sides). The distance between the first olfactory fila to the middle turbinate skull base insertion at the axilla, the distance from the posterior table of the frontal sinus to the first olfactory fila, and the distance between the last olfactory fila and the leading edge of the planum sphenoidale were recorded.
Results
The distances from the first olfactory fila to the middle turbinate axilla and the posterior table of the frontal sinus were 11.88 ± 3.67mm and 1.31 ± 1.89mm, respectively. The distance between the last olfactory fila and planum sphenoidale was 4.43 ± 2.39mm.
Conclusions
Our study delineates the distances of the first and last olfactory fila from consistent landmarks within the sinonasal cavity. An appreciation of these distances, as well as an understanding that these fila are not the beginning of the olfactory system, but instead the end bundle of coalescing neurons spread out beyond the fila within the nasal mucosal lining, should help surgeons minimize the risk to olfaction when performing sinonasal procedures."