The Öhngren's line in maxillary sinus carcinoma is used to divide tumours into suprastructure and infrastructure. What is this line and what is its clinical significance?

• A A line from the medial canthus to the angle of mandible; suprastructure tumours (above this line) have a worse prognosis due to proximity to the orbit, skull base, and pterygoid plates ✓
• B A horizontal line through the floor of the maxillary sinus; infrastructure tumours have a better prognosis
• C A vertical line through the midline of the maxilla; medial tumours require total maxillectomy
• D A line from the lateral canthus to the mastoid process; posterior tumours are unresectable

Explanation

Öhngren's line is an imaginary line drawn from the medial canthus of the eye to the angle of the mandible. Maxillary sinus tumours above and behind this line (suprastructure) are in close proximity to the orbit, posterior ethmoid, pterygoid plates, infratemporal fossa, and skull base, making them technically more difficult to resect completely and conferring a significantly worse prognosis. Infrastructure tumours (below and anterior to the line) have a better prognosis as they are further from critical structures and more amenable to curative resection.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.