{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:37:22Z","timestamp":1790293042083,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,2,21]],"date-time":"2019-02-21T00:00:00Z","timestamp":1550707200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Anatomy"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:p>Human sinonasal anatomy varies widely between patients, challenging surgeons operating in the sinuses. Ethmoid sinus anatomy is so variable it has been referred to as a labyrinth. Accordingly, reliable, consistent anatomic landmarks aid surgeons operating in this region. The goal of this investigation was to explore our observations and hypothesis that the ethmoidal bulla and the uncinate process are not entirely separate structures but rather attach, and the attachment could potentially provide a landmark for surgeons performing ethmoid and frontal recess surgery. Ethmoid sinus anatomy was studied in 57 sinonasal complexes through a variety of methods including gross anatomic dissection, endoscopic dissection and 3D CT stereoscopic imaging. The uncinate process and ethmoidal bulla were noted to fuse at the superior aspect of the hiatus semilunaris in 57\/57 cases, forming a genu\u2010like feature in the anterior ethmoid. This consistent anatomic feature related closely to the frontal sinus drainage pathway, which drained medial to it in 44\/57 (77%) cases. The anterior ethmoidal \u201cgenu\u201d appears to be an excellent anatomic feature that surgeons can use during ethmoid and frontal recess surgery. High resolution 3D stereoscopic CT scan is capable of demonstrating sinonasal anatomy in a detailed fashion previously only achieved by cadaveric dissection. This technology can potentially allow for a virtual dissection of a patient's anatomy prior to surgery and could improve minimally invasive procedures and reduce complications. Clin. Anat. 32:534\u2013540, 2019. \u00a9 2019 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ca.23347","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T11:56:04Z","timestamp":1549367764000},"page":"534-540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Anterior Ethmoidal \u201cGenu\u201d: A Newly Appreciated Anatomic Landmark for Endoscopic Sinus Surgery"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5919-1006","authenticated-orcid":false,"given":"William E.","family":"Bolger","sequence":"first","affiliation":[{"name":"North Florida Sinus Center  Jacksonville Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinz","family":"Stammberger","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaru","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery Johns Hopkins Medical Institute  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Ponikau","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Jacobs School of Medicine &amp; Biomedical Sciences University at Buffalo  Buffalo New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meiyappan","family":"Solaiyappan","sequence":"additional","affiliation":[{"name":"Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins School of Medicine  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simion James","family":"Zinreich","sequence":"additional","affiliation":[{"name":"Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins School of Medicine  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,21]]},"reference":[{"issue":"186","key":"e_1_2_8_2_1","first-page":"1","article-title":"Analysis of the sinus lateralis for endoscopic sinus surgery","volume":"110","author":"Bolger WE","year":"2001","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1936.00640040330006"},{"key":"e_1_2_8_4_1","first-page":"281","volume-title":"Diseases of the Sinuses: Diagnosis and Management","author":"Kuhn FA","year":"2001"},{"key":"e_1_2_8_5_1","first-page":"14","volume-title":"Endoscopy of the Nose","author":"Messerklinger W","year":"1978"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348942903800401"},{"key":"e_1_2_8_7_1","first-page":"376","article-title":"Symposium on the ethmoid: The surgical anatomy of the ethmoidal labyrinth","volume":"31","author":"Mosher HP","year":"1929","journal-title":"Trans Am Acad Ophthalmol Otolaryngol"},{"key":"e_1_2_8_8_1","volume-title":"The Accessory Sinuses of the Nose in Children: 102 Specimens Reproduced in Natural Size from Photographs","author":"Onodi A","year":"1911"},{"key":"e_1_2_8_9_1","volume-title":"The Nose, Paranasal Sinuses, Nasolacrimal Passageways, and Olfactory Organ in Man: A Genetic, Developmental, and Anatomico\u2010Physiological Consideration","author":"Schaeffer JP","year":"1920"},{"key":"e_1_2_8_10_1","first-page":"40","volume-title":"Functional Endoscopic Sinus Surgery: The Messerklinger Technique","author":"Stammberger H","year":"1991"},{"key":"e_1_2_8_11_1","first-page":"582","volume-title":"Steadman's Medical Dictionary","year":"1982"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1941.00660040021003"},{"key":"e_1_2_8_13_1","volume-title":"Normale und pathologis\u2010che Anatomie der Nasenh\u00f6hle und ihrer pneumatischen Anh\u00e4nge","author":"Zuckerkandl E","year":"1882"},{"key":"e_1_2_8_14_1","volume-title":"Anatomie normale et pathologie des fosses nasales et de leurs annexes pneumatiques","author":"Zuckerkandl E","year":"1895"}],"container-title":["Clinical Anatomy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23347","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ca.23347","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ca.23347","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T13:03:28Z","timestamp":1737119008000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ca.23347"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,21]]},"references-count":13,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1002\/ca.23347"],"URL":"https:\/\/doi.org\/10.1002\/ca.23347","archive":["Portico"],"relation":{},"ISSN":["0897-3806","1098-2353"],"issn-type":[{"value":"0897-3806","type":"print"},{"value":"1098-2353","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,21]]},"assertion":[{"value":"2018-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}