Three-dimensional structure of the basal lamella of the middle turbinate

• Published in: Scientific reports Vol. 11; no. 1; p. 17960
• Main Authors: Eördögh, Márton, Baksa, Gábor, Grimm, András, Bárány, László, Petneházy, Örs, Reisch, Robert, Schroeder, Henry W. S., Briner, Hans Rudolf, Hosemann, Werner
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09.09.2021; Nature Publishing Group; Nature Portfolio
• Subjects: 631/1647/245/2221; 692/698; Bone; Cadavers; Classification; Humanities and Social Sciences; Morphology; multidisciplinary; Nose; Phenotypes; Science; Science (multidisciplinary); Skull; Triple Bottom Line
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-021-97331-2

The middle turbinate’s basal lamella (3BL) is a variable landmark which needs to be understood in endoscopic transnasal skull base surgery. It comprises an anterior frontal and a posterior horizontal part and appears in its simplest depiction to be “L”-shaped, when viewed laterally. In this study we analyzed its 3D morphology and variations focusing on a precise and systematic description of the anatomy. CBCTs of 25 adults, 19 cadavers and 6 skulls (total: 100 sides) were investigated with the 3DSlicer software, creating 3D models of the 3BL. We introduced a novel geometrical classification of the 3BL’s shape, based on segments. We analyzed their parameters and relationship to neighboring structures. When viewed laterally, there was no consistent “L”-shaped appearance of the 3BL, as it is frequently quoted. A classification of 9 segment types was used to describe the 3BL. The 3BLs had in average of 2.95 ± 0.70 segments (median: 3), the most frequent was the horizontal plate (23.05% of all segments), next a concave/convex plate (22.71%), then a sigma plate (22.37%). Further types were rare. We identified a horizontal plate in 68% of all lateral views whilst 32% of the 3BLs were vertical. A sigma–concave/convex–horizontal trisegmental 3BL was the most common phenotype (27%). Globally, the sigma–concave/convex pattern was present in 42%. The 3BL adhered the ethmoidal bulla in 87%. The segmenting method is eligible to describe the 3BL’s sophisticated morphology.