Haller’s cells in the practice of an otorhinolaryngologist

Haller’s cells are infraorbital ethmoidal cells located along the inferior wall of the orbit. They were first described by Albrecht von Haller in 1743 and were subsequently named after him. The reported prevalence of these cells varies significantly from 2.7% to 45.1%. They are a variant of the normal anatomical structure of the paranasal sinuses. These cells are often incidental findings on computed tomography (CT) of the nasal cavity and paranasal sinuses. Haller’s cells may predispose patients to maxillary sinusitis and may complicate maxillary sinus surgery. In addition, isolated inflammation of these cells with a mucocele formation is possible. A case of cholesterol granuloma of Haller’s cell was also described in the literature. Notably, a relationship exists between the presence of infraorbital ethmoidal cells and the descending course of the infraorbital canal and the presence of dehiscence of the lower orbital wall. However, resecting these cells is at risk of orbital damage. Haller’s cells are identified using CT; on coronal sections, they appear as clearly defined round, oval, or teardrop-shaped formations with clear smooth boundaries, located medial to the infraorbital foramen. Large cells blocking the ethmoidal infundibulum and predisposing to the development of maxillary sinusitis and Haller cell inflammation require surgical treatment. In these cases, endoscopic resection is the method of choice. Rhinosurgeons should be aware of the possible risks involved in the removal of Haller’s cells and manipulations in this area. Preoperatively, CT scans must be reviewed to identify features of the paranasal sinus structure and carefully plan the surgery.