Microsurgical anatomy of the olfactory filaments in the nasal mucosa

Author:

Ilgaz Hasan Barış12,Urgun Kamran1,Yener Ulaş1,Mut Melike1,Liu James K.345,Yağmurlu Kaan6

Affiliation:

1. Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia;

2. Department of Anatomy, Hacettepe Medical School, Ankara, Turkey;

3. Department of Neurosurgery, Cooperman Barnabas Medical Center, RWJ Barnabas Health, Livingston, New Jersey;

4. Skull Base Institute of New Jersey, Neurosurgeons of New Jersey, NYU Langone Neurosurgery Network, Livingston, New Jersey;

5. Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey; and

6. Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee

Abstract

OBJECTIVE The aim of this study was to examine the distribution of olfactory filaments (OFs) in the nasal mucosa to facilitate preservation of olfactory function in endonasal approaches and preparation of a nasoseptal flap. METHODS One formalin-fixed and 9 fresh cadaveric silicone-injected specimens with 20 total sides were studied to measure the distance of the OFs to the anatomical landmarks and compare the OF presence in the nasal septum mucosa (NSM) and ethmoidal mucosa (EM). RESULTS The mean distance from the first to the last OF was 19.37 ± 2.16 mm in the NSM and 23.44 ± 5.42 mm in the EM. The NSM had a mean of 7.55 ± 1.31 OFs and the EM had 14.3 ± 1.78. Average OF lengths were measured at 6.44 ± 1.48 (range 3.75–12.40) mm in the NSM and 8.05 ± 1.76 (range 4.14–13.20) mm in the EM. The mean values of the EM measurements were compared with those of the NSM; the number of OFs, the distance between the first and last OF, the average OF length, and the number of OFs between anterior and posterior ethmoidal arteries in the NSM were significantly less (p < 0.05) than those in the EM. The distance between the first OF to the nasal bone on the NSM was greater than on the EM. CONCLUSIONS Compared with the EM, the OFs are significantly fewer in number and smaller in size in the NSM. The uppermost edge of the nasoseptal flap incision in the NSM might be safer to start below 12 mm from the cribriform plate for OF protection.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Reference52 articles.

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2. Anatomy of the olfactory nerve: a comprehensive review with cadaveric dissection;López-Elizalde R,2018

3. The Human Central Nervous System: A Synopsis and Atlas;Nieuwenhuys R,2007

4. A Textbook of Neuroanatomy;Patestas MA,2016

5. Endonasal anatomy of the olfactory neural network: surgical implications;Gomez Galarce M,2018

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