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Variations of Ostiomeatal Complex and its Applied Anatomy: a CT Scan Study


Affiliations
1 Dept. of Anatomy, Kasturba Medical College, Manipal. Karnataka-576104, India
2 Dept. of Anatomy, J.S.S. Medical College & Hospital, Mysore- 570015, India
3 Dept. of ENT, J.S.S. Medical College & Hospital, Mysore-570015, India
4 Dept. of Anatomy, J.J.M. Medical College, Davangere, Karnataka-577004, India
 

Stenosis of the ostiomeatal complex, from either the anatomical configuration or hypertrophied mucosa can cause obstruction and stagnation of secretions that may then become infected or perpetuate infection. The surgical interventions of the functional endoscopic sinus surgery are designed to remove the ostiomeatal blockage and to restore normal sinus ventilation and mucociliary function. Hence, the present study was taken up to study the variations in the ostiomeatal complex and its clinical significance. For CT analysis coronal sections of 40 paranasal sinus CT films were collected from the department of ENT. Lateral deviation of the uncinate process was more common with equal incidence in both sexes and with higher incidence on right side. Nasal septum was deviated to the right side more commonly with equal incidence in both sexes. Nearly half of the cases showed agger nasi with higher frequency in males. Concha bullosa was the least common ostiomeatal variant with higher incidence in males with equal incidence on both sides. Preoperative planning for FESS requires high resolution computed tomography (CT) to provide detailed maps, which are used for navigation and the visualization of the anatomical variants that result in sinus disease. As a result, it has become imperative for radiologist and clinicians to improve understanding of ostiomeatal unit.

Keywords

Ostiomeatal Complex, Paranasal Sinuses, Sinusitis, Computed Tomography Imaging, Agger Nasi
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  • Araujo SA, Martins P, Souza AS, Baracat EC and Nanni L (2004) The role of ostiomeatal complex anatomical variants in chronic rhinosinusitis. Radiol. Bras. 14, 1-9.
  • Bolger WE, Butzin CA and Parsons DS (1991) Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 101, 56-64.
  • Caughey RJ, Jameson MJ, Gross CW and Han JK (2005) Anatomic risk factors for sinus disease: fact or fiction? Am. J. Rhinol. 19(4), 334-339.
  • Davis WE, Templer J and Parsons DS (1996) Anatomy of the paranasal sinuses. Otolaryngol. Clin. North Am. 29(1), 57-91.
  • Dua K, Chopra H, Khurana AS and Munjal M (2005) CT scan variations in chronic sinusitis. Ind. J. Radiol. Imag. 15(3), 315-320.
  • Freitas AP and Boasquevisque EM (2008) Anatomical variants of the ostiomeatal complex: tomographic findings in 200 patients. Radiol. Bras. J. 41(3).
  • Jones NS (2002) CT of the paranasal sinuses: a review of the correlation with clinical, surgical and histopathological findings. Clin. Otol. 27(1), 11-17.
  • Lloyd GA (1990) CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. J Laryngol Otol. 104, 477-481.
  • Midilli R, Aladag G, Erginoz E, Karci B and Savas R (2005) Anatomic variations of the paranasal sinuses detected by computed tomography and the relationship between variations and sex. Kulak Burun Bogaz Ihtis Derg. 14(3-4), 49-56.
  • Nayak DR, Balakrishnan R and Murthy KD (2001) Functional anatomy of the uncinate process and its role in endoscopic sinus surgery. Ind. J. Otol. Head Neck Surg. 53(1), 27-31.
  • Pinas IP, Sabate J, Carmona A, Herrera CJ and Castellanos J(2000) Anatomical variations in the human paranasal sinus region studied by CT. J. Anat. 197, 221-227.
  • Polavaram R, Devaiah AK, Sakai O and Shapshay SM (2004) Anatomic variants and pearls– functional endoscopic sinus surgery. Otolaryngol. Clin. N. Am. 37, 221-242.
  • Pruna X (2003) Morpho-functional evaluation ofostiomeatal complex in chronic sinusitis by coronal CT. Eur. Radiol. 13(6), 1461-1468.
  • Sarna A, Hayman LA, Laine FJ and Taber KH (2002) Coronal imaging of the ostiomeatal unit: anatomy of 24 variants. J. Comp. Assist. Tomogr. 26(1), 153-157.
  • Scribano E, Ascenti G, Casio F, Racchiusa S, Salamone I (1993) Computerised tomography in the evaluation of anatomic variations of the ostiomeatal complex. Radiol Med( Torino). 86, 195-199
  • Stammberger H and Hawke M (1993) Essentials of endoscopic sinus surgery 1st ed. St. Louis: Mosby. pp:43.
  • Stammberger HR and Kennedy DW (1995) Paranasal sinuses: anatomic terminology and nomenclature. The anatomic terminology group. Ann. Otol. Rhinol. Laryngol. Suppl. 167, 7-16.
  • Tonai A, Baba S (1996) Anatomic variations of the bone in sinonasal CT. Acta Otolaryngol Suppl. 525, 9-13.
  • Wanamaker H (1996) Role of haller’s cell in headache and sinus disease: a case report. Otolaryngol Head Neck Surg. 114, 324-327.
  • Wang R, Jiang S and Gu R (1994) The embryonic development of the ostiomeatal complex from 8 to 40 weeks. Zhonghua Er Bi Yan Hou Ke Za Zhi. 29(3), 131-133.
  • Yousem DM (1993) Imaging of the sinonasal inflammatory disease. Radiol. 188, 303-314.
  • Zinreich SJ, Albayaram S, Benson ML, Oliverio PJ (2003) The ostiomeatal complex and functional endoscopic surgery. In: Head and neck surgery. Som PM & Curtin HD (eds.), Mosby Inc, St Louis. pp:149-173.

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  • Variations of Ostiomeatal Complex and its Applied Anatomy: a CT Scan Study

Abstract Views: 742  |  PDF Views: 370

Authors

H. Mamatha
Dept. of Anatomy, Kasturba Medical College, Manipal. Karnataka-576104, India
N. M. Shamasundar
Dept. of Anatomy, J.S.S. Medical College & Hospital, Mysore- 570015, India
M. B. Bharathi
Dept. of ENT, J.S.S. Medical College & Hospital, Mysore-570015, India
L. C. Prasanna
Dept. of Anatomy, J.J.M. Medical College, Davangere, Karnataka-577004, India

Abstract


Stenosis of the ostiomeatal complex, from either the anatomical configuration or hypertrophied mucosa can cause obstruction and stagnation of secretions that may then become infected or perpetuate infection. The surgical interventions of the functional endoscopic sinus surgery are designed to remove the ostiomeatal blockage and to restore normal sinus ventilation and mucociliary function. Hence, the present study was taken up to study the variations in the ostiomeatal complex and its clinical significance. For CT analysis coronal sections of 40 paranasal sinus CT films were collected from the department of ENT. Lateral deviation of the uncinate process was more common with equal incidence in both sexes and with higher incidence on right side. Nasal septum was deviated to the right side more commonly with equal incidence in both sexes. Nearly half of the cases showed agger nasi with higher frequency in males. Concha bullosa was the least common ostiomeatal variant with higher incidence in males with equal incidence on both sides. Preoperative planning for FESS requires high resolution computed tomography (CT) to provide detailed maps, which are used for navigation and the visualization of the anatomical variants that result in sinus disease. As a result, it has become imperative for radiologist and clinicians to improve understanding of ostiomeatal unit.

Keywords


Ostiomeatal Complex, Paranasal Sinuses, Sinusitis, Computed Tomography Imaging, Agger Nasi

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DOI: https://doi.org/10.17485/ijst%2F2010%2Fv3i8%2F29907