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Objective: To investigate the morphologic characteristics of the retromaxillary posterior ethmoid. Method: A total of 103 outpatients encountered in our hospital during March 2012 and December 2012,who completed paranasal sinus CT examination,were included in this study.Patients had no sinus trauma,surgery or tumor history.Their paranasal sinus CT scans were analyzed from scheduled axial and coronal plane.The incidence and imaging features of the retromaxillary posterior ethmoid were observed. Result: The retromaxillary posterior ethmoid(RMPE)was the posterior ethmoid cell that expanded along the lamina papyracea toward the infraorbital region.RMPE was located behind the posterior wall of the maxillary sinus and under the orbital floor.The occurrence rate of the RMPE was 74.3%.The ethmomaxillary septum is the bony septum the between the maxillary sinus and posterior ethmoid.Anatomical confirmation of RMPE is based mainly on the presence of the ethmomaxillary septum.RMPE is located at the back of ethmomaxillary septum.The sagittal angulation of the ethmomaxillary septum ranged from 22 to 87 degrees,with an average of(50.34±12.10)degrees. Conclusion: The ethmomaxillary septum is important for anatomic recognition of the RMPE.Accurate identification of the RMPE before ESS can help improve the removal of the posterior ethmoid sinus.

Objective: To investigate the significance of pneumatization of maxillary sinus extended into alveolar process. Method: One hundred outpatients encountered were included in this study. The pneumatizations of maxillary sinus extended into alveolar process were observed and classified. Depth of surgical procedure of maxillary sinus in different type was measured. Result: The actual depth of surgical procedure of maxillary sinus of in different types of the alveolar process pneumatization varied greatly. The actual depth of surgical procedure of maxillary sinus in type Ⅲ pneumatization of alveolar process were (32.27±3.48)mm, which were significantly deeper than type Ⅱ (28.35±3.45)mm and type Ⅰ(20.73±3.09)mm ( P < 0.05 respectively). Moreover, the actual depth of surgical procedure of maxillary sinus in type Ⅱ was also deeper than type Ⅰ( P < 0.05). Conclusion: The pneumatization of maxillary sinus extended into alveolar process can significantly affect the actual depth of the maxillary sinus in the operation of endoscopic middle meatus antrostomy, which may serve as a reference for the choice of endoscopic maxillary sinus approaches., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objective: To investigate the causes of barium aspiration,death rate and the cause of death in the upper gastrointestinal examinations,and to help the doctor selecting a reasonable method in upper gastrointestinal tract examination. Method: Two cases in our hospital was reported,and totally 25 patients in 22 articles were obtained in pubmed or google shchoolar form 1989 to 2014.Purpose of radiologic studies of the upper digestive tract,distribution of the aspirate,clinical presentation and prognosis after aspiration of the sulfate barium in literature were collected. Result: ①Aspiration of barium sulfate mainly happened in elderly patients and infant.The age of died group were older than survive group,however,there were no significant difference statistically( F =0.909, P =0.355).②The directly mortality rate associated with barium aspiration was up to 38.1% in adult,and ten patients of them(47.6%) recovered.All the infants were recovered completely form the respiratory distress cause by the aspiration of barium sulfate.③Aspiration may more likelyoccur in certain conditions involving dysphagia and esophageall obstruction by tumor or foreign body.Further,the gastro-esophageal reflux,recent esophageal surgery,eructation and vomiting may also increase the risk of aspiration of the aspiration of barium sulfate.④About 84.0% patients were with initial dyspnea,hypotension,respiratory distress or respiratory failure.A minority of patients without significant reactions,only suffered fever and cough(16.0%).⑤The deposition of barium sulphate were commonly affected both lungs(80.0%).Barium sulfates distributed in unilateral lung only were found in five patients 20.0%. Conclusion: Aspiration may easier occur in certain conditions involving dysphagia and esophageall obstruction by tumor or foreign body.Further,the gastro-esophageal reflux,recent esophageal surgery,eructation and vomiting may also increase the risk of aspiration of the aspiration of barium sulfate.Most of the patients after aspiration of barium were presented with initial dyspnea,hypotension,respiratory distress or respiratory failure.When considerable amounts of barium sulfate are aspirated into the lung leading to arterial hypoxemia and dyspnea,it is mandatory that aggressive treatment with steroids,antibiotics,respiratory physiotherapy,oxygen,and bronchoalveolar lavage is initiated without delay., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)