Anatomical variants of the ostiomeatal complex in the paranasal sinuses

2021 ◽  
pp. 61-92
Author(s):  
Lalitha Shankar ◽  
Kate Evans ◽  
Thomas R. Marotta ◽  
Eugene Yu ◽  
Michael Hawke ◽  
...  
Keyword(s):  
Paranasal Sinuses ◽  
Anatomical Variants ◽  
Ostiomeatal Complex

scholarly journals A radiological study of anatomical variations in ostiomeatal complex in patients with chronic rhinosinusitis

2017 ◽  
Vol 3 (3) ◽  
pp. 528
Author(s):  
Rajneesh . ◽  
Rahul S.
Keyword(s):  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Intraoperative Complications ◽  
Preoperative Evaluation ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Leonardo Da Vinci ◽  
Type I ◽  
Anatomical Variants ◽  
Increased Risk

<p class="abstract"><strong>Background:</strong> In ancient times the paranasal sinuses, without any anatomical differentiation, were thought to be a system of hollow spaces through which mucus produced by the brain was drained. Leonardo da Vinci in Milano in 1489 was the first to prepare and draw anatomical specimens of the paranasal sinuses; the drawings, however, only became accessible to scientific evaluation as late as 1901.</p><p class="abstract"><strong>Methods:</strong> All adult patients (more than 20 years of age) attending the Outpatient department at ENT, diagnosed to have chronic rhinosinusitis, willing to undergoing Computed Tomographic evaluation were included in this study. Sample of 50 was selected using purposive sampling technique. All CT scans were obtained with GE Brightspeed scanner (16 slice MDCT scanner). Coronal sections were performed with the patients in prone position, with extended neck and the plane perpendicular to the infraorbitomeatal line.</p><p class="abstract"><strong>Results:</strong> Agger nasi was the most common variation seen in 72% cases followed by dwviated nasal septum in 66% patients. Other variations found were lateral attachment of uncinate process in 54%, uncinate attachment to skull base in 33%, concha bullosa in 32%, overpneumatized bulla ethmoidalis in 21%, medial attachment of unicinate process to middle turbinate in 13%, paradoxical bent middle turbinate in 11%, haller cell seen in 6%. 56% had type I frontoethmoidal cells, 29% had type II, and 15% had type III frontoethmoidal air cells.</p><p><strong>Conclusions:</strong> The presence of anatomical variants does not indicate a predisposition to sinus pathology but these variations may predispose patients to increased risk of intraoperative complications. The surgeon must pay close attention to anatomical variants in the preoperative evaluation avoid possible complications and improve success of management strategies. </p>

Rhinosinusitis

2016 ◽  
Author(s):  
Staci Reintjes ◽  
Susie Peterson
Keyword(s):  
Viral Infection ◽  
Short Duration ◽  
Paranasal Sinuses ◽  
Immunocompromised Patients ◽  
Common Complication ◽  
Autoimmune Process ◽  
Ostiomeatal Complex ◽  
Mucosal Edema ◽  
Frontal Sinuses ◽  
Nasal Passages

Rhinosinusitis is inflammation of the nasal passages and paranasal sinuses, commonly caused by allergies or viral infection. Sinusitis occurs after the development of rhinitis or inflammation of the nasal passages. Rhinitis is most commonly caused by allergens, but it also can be to the result of an infectious or autoimmune process. For rhinitis to progress to rhinosinusitis, there must be obstruction within the ostiomeatal complex, which is the draining center for the maxillary, anterior ethmoid, and frontal sinuses. History and physical exam are more specific than imaging for diagnosis. Complications arising from sinusitis can cause extensive morbidity if not recognized early. The most common complication is periorbital cellulitis arising from ethmoidal sinusitis. Evaluate for severe complications in immunocompromised patients. Adjunctive therapies to relieve nasal obstruction include medications that decrease mucosal edema as well as increase clearance of congestion. Consider avoiding antibiotics if symptoms are of short duration and are consistent with viral sinusitis.

A study of paranasal sinuses by computed tomography for etiopathological distribution and anatomical variants

2020 ◽  
Vol 14 (2) ◽  
pp. 32-35
Author(s):  
Parag Vijaysingh Patil ◽  
◽  
Rajshree Uttam Dhadve ◽  
Vinod Yadav Attarde ◽  
◽  
...  
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinuses ◽  
Anatomical Variants

Incidence of Agger Nasi cells and Haller cells in Computed Tomography of Paranasal Sinuses

2021 ◽  
Vol 23 (09) ◽  
pp. 640-645
Author(s):  
Vignesh Naachiyappan Meiyappan ◽  
◽  
Dr. Naveen Nagendran ◽  
Dr. Karthik Krishna Ramakrishnan ◽  
Dr. Sneha Yarlagadda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Paranasal Sinuses ◽  
Significant Proportion ◽  
Great Accuracy ◽  
Sinus Surgery ◽  
Imaging Features ◽  
Anatomical Variants ◽  
Medical College ◽  
Osteomeatal Complex ◽  
Study Population

Introduction Agger nasi and haller cells are few of the common anatomical variants of Paranasal Sinuses (PNS) . They can cause obstruction of osteomeatal complex and frontal recess and can cause refractive sinusitis. Also these variants can lead to complications during procedures like Functional Endoscopic Sinus Surgery (FESS). Hence, complete knowledge about these variants and imaging features help in early diagnosis and also helps in avoiding complications during surgery. Materials and Method A retrospective study of 100 patients conducted during the period from January 2021- April 2021 in Saveetha Medical College and Hospital. All the patients included in the study were referred from the department of otorhinolaryngology for Computed Tomography of PNS. All the images were individually analysed and evaluated for occurrence of Agar Nasi cells and Haller cell variants. Results Out of the study population of 100 patients, 56% of the patients were observed for Agger Nasi cells and 19% of the patients were observed for Haller cells. Conclusion Our study concludes that agger nasi and haller cells are found in a significant proportion of the study population. Hence, Identifying these anatomical variants with great accuracy will help in diagnosing and appropriate management of refractive sinusitis and also be critical in supporting surgeons in tailoring surgery for patients when done preoperatively and thereby avoid fatal complications during procedures (1).

scholarly journals Assessing the prevalence of paranasal sinuses anatomical variants in patients with sinusitis using Cone Beam Computer Tomography

2016 ◽  
Vol 89 (3) ◽  
pp. 423-429 ◽  
Author(s):  
Raluca Ancuta Roman ◽  
Mihaela Hedeşiu ◽  
Mirela Gersak ◽  
Floarea Fidan ◽  
Grigore Băciuț ◽  
...  
Keyword(s):  
Paranasal Sinuses ◽  
Clinical Symptoms ◽  
Uncinate Process ◽  
Cone Beam ◽  
Radiology Department ◽  
Control Group ◽  
Concha Bullosa ◽  
Positive Group ◽  
Anatomical Variants ◽  
Number Of Patients

Background and aims: To asses, by using the Cone Beam CT (CBCT) reformatted images, the presence of anatomical variants of the sinonasal cavities and to determine the correlation of these variations with the onset of maxillary sinus inflammations.Method: The study is a retrospective one and consists of the investigation of 130 patients with CBCT imaging, patients that were referred to the Maxillo-Facial Clinic, Radiology Department of the Iuliu Hatieganu University of Medicine and Pharmacy in Cluj-Napoca, for clinical symptoms of sinusitis within a period of 24 months. The images were analyzed for the presence of different anatomical variations and sinus inflammation. The CBCT images were obtained using a NewTom 3G scanner and the data acquired were statistically analyzed using Chi-square test, Odds ratio data and confidence intervals, with a determined p<0.05 considered to be statistically significant.Results: The anatomical variants were detected both in the inflammation and control group. From the spectrum of variations concha bullosa, deviation of uncinate process and asymmetrical ethmoid roof presented significant association with sinusitis. The deviated position of the uncinate process appeared in more than 50% of patients in the positive group [OR=2.55] compared with a third of the control group. Concha bullosa was observed in 31% cases, 23% in the control group and 34% in the positive group [OR=1.73]. Haller cells showed a small difference between groups [OR=1.14] whereas the ethmoid roof asymmetry was evidently more prevalent in the inflammation group.Conclusion: The anatomical variants of the paranasal sinuses are not incidental, being found in a large number of patients and may be a predisposing factor in the onset and recurrence of sinuses inflammation. The CBCT technique, due to the finest multiplanar reconstruction, permits a very good pre-therapeutic assessment of these predisposing conditions.

Modern Imaging of Paranasal Sinuses and the Role of Limited Sinus Computerized Tomography; Considerations of Time, Cost and Radiation

1994 ◽  
Vol 73 (8) ◽  
pp. 532-546 ◽  
Author(s):  
Mahmood F. Mafee
Keyword(s):  
Paranasal Sinuses ◽  
Imaging Systems ◽  
Sinus Surgery ◽  
Radiology Department ◽  
Resonance Imaging ◽  
Complex Motion ◽  
Advantages And Disadvantages ◽  
Ostiomeatal Complex ◽  
Magnetic Resonance Imaging Mri

The modern diagnostic radiology department is equipped with a variety of medical imaging systems that can be used for evaluation of diseases of the sinonasal cavities. Each has advantages and disadvantages. The imaging examinations of the paranasal sinuses may include conventional films, complex motion tomography, computed tomography (CT) and magnetic resonance imaging (MRI). The indications for these imaging methods are reviewed, along with a discussion on the role of imaging for endoscopic sinus surgery. A summary of CT anatomy relating to the ethmoidal sinuses and ostiomeatal complex is given, as is a review of the risk of radiation for radiologic sinus imaging.

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