The role of anatomical variations in osteomeatal unit in the aetiology of chronic rhinosinusitis
The complexities of the nose and paranasal sinuses anatomy, as well as their multiple functions make the sinuses an interesting and rewarding topic of study especially at the region of osteomeatal complex (OMC). Congenital anomaly in this region, though rare, may create technical difficulties dur...
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| Main Author: | |
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| Format: | Thesis |
| Language: | English |
| Published: |
2008
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| Subjects: | |
| Online Access: | http://eprints.usm.my/53570/1/DR.AZILA%20BINTI%20ALIAS%20-%2024%20pages.pdf http://eprints.usm.my/53570/ |
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| Summary: | The complexities of the nose and paranasal sinuses anatomy, as well as their multiple
functions make the sinuses an interesting and rewarding topic of study especially at the
region of osteomeatal complex (OMC). Congenital anomaly in this region, though rare,
may create technical difficulties during surgery. However, the role of anatomical
variations in pathogenesis of sinusitis is still unclear.
OBJECTIVE
The aims of the study was to look into the anatomical variations in the osteomeatal
complex in chronic rhinosinusitis patients, to determine the association between bony
anatomical variations in osteomeatal complex with chronic rhinosinusitis (CRS) and to
determine· the main anatomical variations in the osteomeatal complex which are usually
depicted by computed tomography (CT) and nasoendoscopy in patients with CRS and
normal patients without CRS.
METHODOLOGY
A case control study was done in which we had reviewed the CT scan of paranasal
sinuses (HRCT) images of 240 individuals, 120 cases of CRS and another 120 patients
without CRS problem. Their paranasal sinuses CT scan obtained 1.25mm thicknesses in axial and coronal planes with high resolution technique were reviewed. The data were
analysed using Pearson ·chi Square test.
RESULT
The anatomical variations recorded were: Concha bullosa in 49 cases (40.8%) among the
CRS and 57 cases (47.5%) among patients without CRS, Paradoxical middle turbinate in
14 cases (12.0%) of CRS and 27 (23.0%) in patients without CRS, pneumatized uncinate
process were found in 3 cases (3.3%) of CRS cases while in patients without CRS 3
cases (3.3%) as well, Haller's cells (infraorbital ethmoid cell) in 61 (51.0%) cases of
CRS while 75 cases (62.0%) cases of patients without CRS, pneumatized agger nasai
cell 100 (83.0%) in CRS and 95 (79.0%) in patients without CRS, deviated nasal septum
in 67 cases (56.0%) of CRS while in patients without CRS 73 (60.8%) cases and "lastly
pneumatized septum seen in 4 (3.3%) cases of CRS and none in patients without CRS.
However 'the presence of single anatomical variation itself does not have significant
association with the genesis of CRS except for paradoxical middle turbinate and
infraorbital ethmoid cell.
CONCLUSION
The most common anatomical variation in osteomeatal complex in CRS patients are
pneumatized agger nasi cell , followed by baUer's cell, DNS, right concha bullosa, left
concha bullosa, paradoxical middle turbinate, pneumatize uncinate proces~ and lastly
septum pneumatization. And the single ~ccurence of an anatomical variant itself does not
establish the genesis of the CRS disease except for paradoxical middle turbinate and
infraorbital ethmoid cell. |
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