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This study aimed to investigate gender-specific differences in feasibility of PLWA. A consecutive series of paranasal computed tomography scans from 50 females (n\u2009=\u2009100) and 50 males (n\u2009=\u2009100) were retrospectively analyzed. The primary outcome measure was the antero-posterior length of the bony pre-lacrimal window (BPLWA). The secondary outcome measure was the distribution of Simmen\u2019s PLWA feasibility types (major, moderate and minor surgical effort). On average, males had a 1.5\u00a0mm (95% CI 0.8\u20132.2) significantly higher BPLW length in comparison to females [t(198)\u2009=\u20094.4,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001]. The requirement of major surgical effort occurred 29% more frequently in females [\u03c7<jats:sup>2<\/jats:sup>(1)\u2009=\u200917.7,<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001], whereas the necessity of moderate surgical effort was 21% more prevalent in males [\u03c7<jats:sup>2<\/jats:sup>(1)\u2009=\u20098.8,<jats:italic>p<\/jats:italic>\u2009=\u20090.003]. The need of only minor surgical effort was twice as high in males compared to females [\u03c7<jats:sup>2<\/jats:sup>(1)\u2009=\u20093,<jats:italic>p<\/jats:italic>\u2009=\u20090.081]. Our data indicates that females require more significant surgical effort during a PLWA to gain access to the maxillary sinus. These results are highly informative as a high amount of bone removal and nasolacrimal duct dislocation are associated with a higher likelihood of complications.<\/jats:p>","DOI":"10.1038\/s41598-021-87447-w","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T10:13:19Z","timestamp":1617876799000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Gender-specific differences in feasibility of pre-lacrimal window approach"],"prefix":"10.1038","volume":"11","author":[{"given":"A.","family":"Andrianakis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Moser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Wolf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Kiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Holzmeister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Andrianakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. 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