In carcinoma of the maxillary sinus, Ohngren's line is best described as an imaginary plane connecting which two landmarks, and what is its prognostic significance?

• A Outer canthus to tragus; growths below it carry a worse prognosis
• B Medial canthus to angle of mandible; growths above and behind it carry a worse prognosis ✓
• C Medial canthus to angle of mandible; growths below and in front of it carry a worse prognosis
• D Tragus to nasal ala; the plane separates operable from inoperable disease

Explanation

Ohngren's line runs from the medial canthus of the eye to the angle of the mandible, dividing the antrum into an anteroinferior and a superoposterior compartment. Growths arising above or behind this plane invade the ethmoids, orbit, pterygopalatine fossa and skull base earlier and therefore have a poorer outlook than anteroinferior tumours. This classic concept still guides assessment of resectability in maxillectomy planning.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.