The importance of investigation of anatomic variations in the ethmoid cells by computerized tomography in the planning of endoscopic nasal surgery

The ethmoidal cells comprise many cavities that show many anatomical variations. Some of these variations deserve special attention when associated with sinusitis and the need of surgery. Computed tomography, considered a gold standard on the pathological investigation of the nasal cavity and the anatomic description of paranasal sinus, offers information about these cells, essential to minimize the surgical risks. The authors present a bibliographic revision of the importance of computed tomography on the investigation of anatomic variations of ethmoid cells. Not recurrent cells in all individuals, like Haller's cells, Onodi's cells and pneumatization of agger nasi, will do the endoscopic approach with precaution. The ethmoidal roof evaluation will result in more safety on the upper limits of the nasal cavity. The size and pneumatization level of ethmoidal bulla, ethmoidal crest, and middle nasal concha are important on the evaluation of the endoscopic accesses and the gravity of the stroked pathology and even diagnose your origin. (author)