Anatomical Variations Associated With Maxillary Sinus Fungal Ball

Objective: We investigated the anatomical and dental factors associated with unilateral maxillary sinus fungal ball (MSFB). Also, we evaluated the effect of combinations of those factors on the incidence of MSFB. Methods: Three hundred patients were divided into MSFB, normal, and chronic rhinosinusitis (CRS) groups. We reviewed paranasal computed tomography scans for the presence of deviated nasal septum, concha bullosa (CB), Haller cells, and various dental factors. Also, we measured the ethmoid infundibulum, maxillary natural ostium, and CB. Results: Maxillary sinus fungal ball showed a more significant association with CB compared to the other 2 groups (37%, P < .05). The MSFB group had a lower rate of Haller cells than the normal group (10% vs 22%, respectively; P < .05). Also, the MSFB group had a wider maxillary sinus ostium than the normal group (7.07 ± 1.8 vs 5.48 ± 1.3 mm; P < .01). Moreover, the combination of CB and Haller cells was significantly associated with a decreased rate of the fungal ball ( P = .047, odds ratio = 0.694). The dental factors were more prevalent in the MSFB and CRS groups (73% and 75%, respectively) than in the normal group (32%, P < .001). Conclusions: Maxillary sinus fungal ball is significantly associated with CB, Haller cells, an increased maxillary sinus ostium size, and dental factors.

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Effect of Deviated Nasal Septum on Maxillary Sinus Volume and Occurrence of Sinusitis

Indian Journal of Otolaryngology and Head & Neck Surgery ◽

10.1007/s12070-018-1276-9 ◽

2018 ◽

Vol 71 (S3) ◽

pp. 1871-1875

Author(s):

Shalini Jadia ◽

Sadat Qureshi ◽

Shivali Agrawal ◽

Siddharth Gautam Singh

Keyword(s):

Maxillary Sinus ◽

Nasal Septum ◽

Deviated Nasal Septum ◽

Maxillary Sinus Volume

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ANATOMICAL VARIATIONS OF ACCESSORY MAXILLARY SINUS OSTIUM: AN ENDOSCOPIC STUDY

International Journal of Anatomy and Research ◽

10.16965/ijar.2016.504 ◽

2017 ◽

Vol 5 (1.2) ◽

pp. 3484-3490 ◽

Cited By ~ 5

Author(s):

Anukaran Mahajan ◽

◽

Anupama Mahajan ◽

Karunesh Gupta ◽

Pankaj Verma ◽

...

Keyword(s):

Maxillary Sinus ◽

Anatomical Variations ◽

Endoscopic Study ◽

Sinus Ostium

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Anatomical variations in patients with chronic sinusitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180702 ◽

2018 ◽

Vol 4 (2) ◽

pp. 428 ◽

Cited By ~ 1

Author(s):

Pragadeeswaran Kumarasekaran ◽

Rajprakash Dharmapuri Yadhava krishnan ◽

Gurumani Sriraman

Keyword(s):

Nasal Septum ◽

Chronic Sinusitis ◽

Anatomical Variation ◽

Middle Turbinate ◽

Anatomical Variations ◽

Uncinate Process ◽

Sinus Surgery ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Anatomical Variant

Background: Chronic sinusitis is repeated bouts of acute infection or persistent inflammation of the sinuses. The range of anatomic variants that can interfere with the mucociliary drainage of osteomeatal complex including concha bullosa, deviated nasal septum, uncinate process variations, ethmoid bulla, paradoxical middle turbinate, agger nasi and Haller cells. This is also important in surgeon point of view to know about detail knowledge of lateral nasal wall, paranasal sinuses, surrounding vital structures and anatomical variation. Methods: Observational case series study in which 90 cases of chronic rhinosinusitis patients attending the ENT outpatient department from November-2015 to November-2016 in Shri Sathya Sai Medical college and Hospital, who had chronic sinusitis for more than three months duration not responding to the medical line treatment and who are willing to undergo functional endoscopic sinus surgery are studied and statistically analysed. Results: In our study we found anatomical variation in 93% of chronic sinusitis patients. In our study it was observed that 52% of patients with two anatomical variation, 41% patients presented with single anatomical variation and 7% patients presented with no anatomical variation. In our study deviated nasal septum was the most common anatomical variant noted followed by unilateral concha bullosa, medialized uncinate process, paradoxical middle turbinate, haller cell and agger nasi. Conclusions: In our study it was concluded that presence of anatomical variations is common in patients with chronic sinusitis. Presence of more than one anatomical variations significantly contributes to disease process. Deviated nasal septum is the most common anatomical variation in our study followed by concha bullosa, medialized uncinate process.

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CT Evaluation of Anatomical Variations in Osteomeatal Complex in Patients with Deviated Nasal Septum

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v21i2.27646 ◽

2016 ◽

Vol 21 (2) ◽

pp. 90-93

Author(s):

Mirza Aneesa ◽

Sajad Majid Qazi ◽

Aijazul Haq

Keyword(s):

Paranasal Sinuses ◽

Nasal Septum ◽

Complex Disease ◽

Anatomical Variation ◽

Middle Turbinate ◽

Inferior Turbinate ◽

Anatomical Variations ◽

Lateral Nasal Wall ◽

Deviated Nasal Septum ◽

Osteomeatal Complex

Background:The presence of septal deviation has been positively associated with sinus disease, especially osteomeatal complex disease and anterior and posterior ethmoid disease.Computerized tomographic imaging (CT) of the paranasal sinuses has become a widely accepted tool for assessing the paranasal sinuses (PNS) and providing a detailed anatomy of the lateral nasal wall.Objective:The objective of the study was to identify the anatomical variations of lateral nasal wall and paranasal sinuses in patients with Deviated nasal septum.Methods:Computerized tomographic (CT) examination was carried out using the bone algorithm in the coronal plane in 40 patients who met the inclusion criteriain the Postgraduate Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital an associated Hospital of Government Medical College, Srinagar from March 2011 to May 2012.Results:In our study, CT Nose and PNS revealed Deviated nasal septum in 40 (100%) patients, Hypertrophied Inferior turbinate in 11 (27.50%) patients, Concha bullosa in 5 (12.50%) patients, Paradoxical Middle turbinate in 8 (20%) patients, Everted Hypertrophied Uncinate in 2 (5%) patients, Aggernasi cells in 4 (10%) patients, Haller cells in 3 (7.50%) patients and Onodi cells in 2 (5%) patients.Conclusion:The most common anatomical variation associated with deviated nasal septum was Hypertrophied Inferior turbinate and the least encountered variation was Everted Hypertrophied Uncinate and Onodi cells. The CT scan provides supplementary clinical data to the history and endoscopic examination and assists in directing surgical treatment to the affected areas.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 90-93

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Factors influencing the sinus membrane thickness in edentulous regions: a cone-beam computed tomography study

International Journal of Implant Dentistry ◽

10.1186/s40729-021-00298-y ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Motohiro Munakata ◽

Kikue Yamaguchi ◽

Daisuke Sato ◽

Naoko Yajima ◽

Noriko Tachikawa

Keyword(s):

Maxillary Sinus ◽

Nasal Septum ◽

Tooth Extraction ◽

Factors Associated ◽

Septum Deviation ◽

Nasal Septum Deviation ◽

Sinus Floor Augmentation ◽

Maxillary Sinus Floor ◽

Sinus Floor ◽

Maxillary Sinus Floor Augmentation

Abstract Background During implant treatment in the maxillary molar area, maxillary sinus floor augmentation is often performed to ameliorate the reduced alveolar bone height attributable to bone remodeling and pneumatization-induced expansion of the maxillary sinus. However, this augmentation may cause complications such as misplaced implants, artery damage, and maxillary sinus mucosal perforation; infections like maxillary sinusitis; and postsurgical complications such as bone graft leakage and postoperative nasal hemorrhaging. To reduce the complications during maxillary sinus floor augmentation and postoperative infections, we performed retrospective investigations of various systemic and local factors that influence pre-operative sinus mucosal thickness (SMT) by using cone-beam computed tomography (CBCT). Subjects included patients who underwent maxillary sinus floor augmentation in an edentulous maxillary molar area with a lateral approach. Pre-operative SMT, existing bone mass, and nasal septum deviation were measured using CBCT images. Relationships between SMT and the following influencing factors were investigated: (1) age, (2) sex, (3) systemic disease, (4) smoking, (5) period after tooth extraction, (6) reason for tooth extraction, (7) residual alveolar bone height (RBH), (8) sinus septa, and (9) nasal septum deviation. Correlations were also investigated for age and RBH (p < 0.05). Results We assessed 35 patients (40 sinuses; 11 male, 24 female). The average patient age was 58.90 ± 9.0 years (males, 57.9 ± 7.7 years; females, 59.9 ± 9.4 years; age range, 41–79 years). The average SMT was 1.09 ± 1.30 mm, incidence of SMT > 2 mm was 25.0%, incidence of SMT < 0.8 mm was 50.0%, and the average RBH was 2.14 ± 1.02 mm. The factors that influenced SMT included sex (p = 0.0078), period after tooth extraction (p = 0.0075), reason for tooth extraction (p = 0.020), sinus septa (p = 0.0076), and nasal septum deviation (p = 0.038). Conclusions Factors associated with higher SMT included male sex, interval following tooth extraction < 6 months, periapical lesions, sinus septa, and nasal septum deviation. Factors associated with SMT > 2 mm were sex and reason for tooth extraction, while factors associated with SMT < 0.8 mm were time following tooth extraction and nasal septum deviation. Despite the limitations of this study, these preoperative evaluations may be of utmost importance for safely conducting maxillary sinus floor augmentation.

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Endoscopic Sinus Surgery with Antrostomy Has Better Early Endoscopic Recovery in Comparison to the Ostium-Preserving Technique

ISRN Otolaryngology ◽

10.5402/2012/189383 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Annika Luukkainen ◽

Jyri Myller ◽

Tommi Torkkeli ◽

Markus Rautiainen ◽

Sanna Toppila-Salmi

Keyword(s):

Maxillary Sinus ◽

Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Radiologic Findings ◽

Ostiomeatal Complex ◽

Middle Meatal Antrostomy ◽

Computed Tomography Scans ◽

Endoscopic Score ◽

Sinus Ostium

Background. Endoscopic sinus surgery (ESS) is considered for chronic rhinosinusitis (CRS) after failure of conservative therapy. Objective. The aim of this study was to evaluate endoscopically ostium patency and mucosal recovery after ESS, with either maxillary sinus ostium-preserving or -enlarging techniques. Materials and Methods. Thirty patients with non-polypous CRS were enrolled. Uncinectomy-only and additional middle meatal antrostomy were randomly and single-blindly performed for each side. Pre- and postoperative endoscopic scores were semi-quantitatively determined according to findings in the ostiomeatal complex area. Adhesions, maxillary sinus mucosal swelling, secretions, and ostium obstruction were also endoscopically evaluated. In addition, symptoms were asked and computed tomography scans were taken preoperatively and 9 months postoperatively. Results. At 16 days postoperatively, a better endoscopic score and a less obstructed ostium were found with antrosomy. At 9 months postoperatively the endoscopic score improved significantly and identically with both procedures, however, obstructed ostia and sinus mucosal swelling/secretions were insignificantly more frequently found on the uncinectomy-only side. Endoscopic and radiologic findings of the maxillary sinus mucosa and ostium correlated significantly 9 months postoperatively. Conclusion. There was a good long-term mucosal recovery with both surgical procedures. In terms of early mucosal recovery and ostium patency, antrostomy might be slighly superior.

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Role of Sinonasal Anatomic Variations in the Development of Maxillary Sinusitis: A Cone Beam CT Analysis

The Open Dentistry Journal ◽

10.2174/1874210601711010367 ◽

2017 ◽

Vol 11 (1) ◽

pp. 367-374 ◽

Cited By ~ 5

Author(s):

Leila Khojastepour ◽

Abdolaziz Haghnegahdar ◽

Negar Khosravifard

Keyword(s):

Maxillary Sinus ◽

Paranasal Sinuses ◽

Maxillary Sinusitis ◽

Cone Beam Ct ◽

Anatomical Variations ◽

Uncinate Process ◽

Inflammatory Status ◽

The Status ◽

Ct Analysis ◽

Sinus Ostium

Background:Several anatomical variations can lead to the inflammation of the paranasal sinuses; therefore, surgeons should be familiar with these variations and their impacts on the status of the paranasal sinuses.Objectives:The present study aimed to determine the prevalence of Haller cells and its association with patients’ sex and age. Furthermore, the relationships between the presence and size of Haller cells, deviation of the uncinate process and size of the maxillary sinus ostium with the occurrence of maxillary sinusitis were investigated.Materials/ Patients and Methods:120 coronal CBCT images were retrieved and analyzed. Statistical analysis of the data was performed by means of Mann - Whitney, χ2and T tests.Results:There were statistically significant associations between the presence and surface area of Haller cells and the occurrence of ipsilateral maxillary sinusitis. Neither the angulation of the uncinate process nor the size of the maxillary sinus ostium significantly correlates with the formation of maxillary sinusitis.Conclusion:Haller cells can interfere with the normal drainage of the maxillary sinus and result in sinusitis. In contrast, diameter of the sinus ostium and deviation of the uncinate process do not influence the inflammatory status of the maxillary sinus significantly.

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A clinico-radiological study of anatomical variations of nose and para-nasal sinuses in chronic rhinosinusitis patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182709 ◽

2018 ◽

Vol 4 (4) ◽

pp. 1040

Author(s):

Daya Shankar ◽

Sunil Kumar ◽

H.P. Singh ◽

Veerendra Verma ◽

Anupam Mishra

Keyword(s):

Ct Scan ◽

Nasal Septum ◽

Anatomical Variations ◽

Uncinate Process ◽

Sinus Surgery ◽

Nasal Endoscopy ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Nasal Sinus ◽

Female Ratio

Background: There are a lot of anatomical variations in para-nasal sinuses that are responsible for various sinus pathologies. CT scan of paranasal sinuses prior to functional endoscopic sinus surgery has become extremely important to know the anatomy and its variations to avoid complications during surgery.Methods: This study was performed in 100 patients at King George’s Medical University, Lucknow UP, India to compare the anatomical variations between nasal endoscopy and CT scan findings. The outcome measures were deviated nasal septum, paradoxical middle turbinate, concha bullosa, medialized/lateralised uncinate process, pneumatized uncinate process, large ethmoid bulla, accessory ostium, Agger nasii cells, Haller’s cells and Onodi cells. Results: In this study the age of the patients were 30.00±9.56 yrs. with male to female ratio 1.9:1. Deviated nasal septum was the most common anatomical abnormality (70%) followed by large bulla ethmoidalis 17%. Occurrence of different types of special cells were studied which are better visualized on coronal CT scan images. Among these cells Agger nasi was the most common variety (15%) followed by Haller’s cells (11%) and Onodi cell (3%). Concha bullosa was present in 8%.Conclusions: The importance of CT and nasal endoscopy can be seen in patients with persistent symptoms to identify the anatomical variations that may responsible for the development of chronic sinus disease. In cases of sinusitis patients all the para-nasal sinus should be properly investigated to avoid complications.

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Ct Evaluation of Anatomical Variations In Osteomeatal Complex in Patients with Deviated Nasal Septum

International Journal of Scientific Research ◽

10.15373/22778179/sep2013/156 ◽

2012 ◽

Vol 2 (9) ◽

pp. 17-18

Author(s):

Dr Mirza Aneesa Afzal ◽

◽

Dr Aijaz ul Haq ◽

Dr Sajad Majid Qazi

Keyword(s):

Nasal Septum ◽

Anatomical Variations ◽

Deviated Nasal Septum ◽

Osteomeatal Complex ◽

Ct Evaluation

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The degree of concha bullosa pneumatization and its association with severity of deviated nasal septum in patients of southern region in Saudi Arabia

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20211562 ◽

2021 ◽

Vol 7 (5) ◽

pp. 717

Author(s):

Musleh Mubarki ◽

Radeif Shamakhi ◽

Ramzi Daghriri ◽

Ali Alzarei ◽

Khaled Hakami

Keyword(s):

Computed Tomography ◽

Saudi Arabia ◽

Sample Size ◽

Nasal Septum ◽

Southern Region ◽

Ct Scans ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Computed Tomography Scans ◽

Severe Type

Background: To determine the degree of concha bullosa pneumatization and its association with deviated nasal septum in patients of southern region in Saudi Arabia.Methods: This study used a retrospective radiological design to analyze computed tomography scans of 117 patients aged between 18 and 80 years of southern region in Saudi Arabia were used in this study. Patients with altered anatomy (iatrogenic or pathological) were excluded, CT scans were analysed to determine. The degree of concha bullosa and its association with deviated nasal septum in patients of southern region in Saudi Arabia, and the correlation between them.Results: Forty percent (40%) cases were male and sixty percent (60%) were female. Concha bullosa (CB) were found in 17(14.5%) cases, of which 4 cases (23%) were bilateral and 13(76%) were unilateral. 7(53%) of unilateral cases were on right side, 6(47%) on left side. From all CB patients in this sample size, 15 (88%) cases have deviated nasal septum that range from mild to severe type whereas 2(12%) cases have no deviated nasal septum. Only 1 of those patients with severe deviated nasal septum has extensive type of concha bullosa.Conclusions: Our findings revealed that there is no relationship between degree of pneumatization of CB and severity of deviated nasal septum.

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