2023, Number 2
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Acta de Otorrinolaringología CCC 2023; 51 (2)
Association between anatomical variants of the osteomeatal complex and inflammatory sinus pathology: case-control study
Mora-Ramírez JC, Gutiérrez-Guauque OA, Prada-Mancilla WA, La Rota-Moscoso G
Language: Spanish
References: 20
Page: 116-122
PDF size: 243.10 Kb.
ABSTRACT
Introduction: Sinonasal anatomical variants can be a frequent cause of chronic
in- fections, so it is important to identify them in daily practice.
Objective: To
determine the association between the anatomical variants of the osteomeatal
complex (OCM) and the development of sinonasal inflammatory pathologies.
Materials and methods: Case-control study, a sample of 226 patients is analyzed
identifying the anatomical variants of OCM in computed tomography of the paranasal
sinuses and their clinical correlation.
Results: 51.9% presented imaging
findings indicative of sinonasal in- flammatory disease, 19.8% reported symptoms
suggestive of sinusitis in the clinical history. The most affected paranasal sinuses
were: maxillary (46.9%) and ethmoid (23%). The most frequent anatomical
variants were Agger Nasi cells (50.2%) and septal deviation (46.2%). The lateral
insertion of the uncinate process (
p=0.015) was a statistically significant variable,
more frequent on the left side (
p=0.018, odds ratio [OR]=4.078, 95% confidence
interval [CI]=1.3-12.6).
Discussion: The incidence of the most frequent anatomical
variants in the literature was confirmed, however not correlated with the
clinical findings for the series of patients studied in compari- son with other studies.
There is a high relationship between the lateral insertion of the uncinate
process and rhinosinusitis findings that are scarcely documented in the medical
literature.
Conclusion: More studies are required on predictive models in larger
population samples and tomographic reading protocols focused on different anatomical
variants of the uncinate process
REFERENCES
Whyte A, Boeddinghaus R. The maxillary sinus: physiology,development and imaging anatomy. Dentomaxillofac Radiol. 2019;48(8):20190205. doi: 10.1259/dmfr.20190205
Eloy P, Nollevaux M, Bertrand B. Fisiología de los senosparanasales. EMC-Otorrinolaringología. 2005;34(3):1-11. doi:10.1016/S1632-3475(05)44285-X
Padopoulou A, Chrysikos D, Samolis A, Tsakotos G, TroupisT. Anatomical Variations of the Nasal Cavities and ParanasalSinuses: A Systematic Review. Cureus. 2021;13(1):e12727.doi: 10.7759/cureus.12727
Sivasli E, Şirikçi A, Bayazýt Y, Gümüsburun E, Erbagci H,Bayram M, et al. Anatomic variations of the paranasal sinusarea in pediatric patients with chronic sinusitis. Surg RadiolAnat. 2002;24(6):399-404. doi: 10.1007/s00276-002-0074-x
Langman J, DeCaro R, Galli S, Sadler T. Embriologia medica deLangman. Milano: Edra Masson; 2020.
Vaid S, Vaid N. Normal Anatomy and Anatomic Variants of theParanasal Sinuses on Computed Tomography. NeuroimagingClin N Am. 2015;25(4):527-48. doi: 10.1016/j.nic.2015.07.002
Dasar U. Evaluation of variations in sinonasal region withcomputed tomography. World J Radiol. 2016;8(1):98. doi:10.4329/wjr.v8.i1.98
Chao T. Uncommon anatomic variations in patients withchronic paranasal sinusitis. Otolaryngol Head Neck Surg.2005;132(2):221-25. doi: 10.1016/j.otohns.2004.09.132
Kantarci M, Karasen R, Alper F, Onbas O, Okur A, Karaman A.Remarkable anatomic variations in paranasal sinus region andtheir clinical importance. Eur J Radiol. 2004;50(3):296-02. doi:
10.1016/j.ejrad.2003.08.01210. Shpilberg K, Daniel S, Doshi A, Lawson W, Som P. CT ofAnatomic Variants of the Paranasal Sinuses and Nasal Cavity:Poor Correlation With Radiologically Significant Rhinosinusitisbut Importance in Surgical Planning. AJR Am J Roentgenol.2015;204(6):1255-260. doi: 10.2214/ajr.14.13762
Reilly J. The Sinusitis Cycle. Otolaryngol Head Neck Surg.1990;103(5):856-62. doi: 10.1177/01945998901030s504
Devaraja K, Doreswamy S, Pujary K, Ramaswamy B, PillaiS. Anatomical Variations of the Nose and Paranasal Sinuses:A Computed Tomographic Study. Indian J Otolaryngol HeadNeck Surg. 2019;71(S3):2231-240. doi: 10.1007/s12070-019-01716-9
Mokhasanavisu V, Singh R, Balakrishnan R, KadavigereR. Ethnic Variation of Sinonasal Anatomy on CT Scan andVolumetric Analysis. Indian J Otolaryngol Head Neck Surg.2019;71(S3):2157-164. doi: 10.1007/s12070-019-01600-6
Badia L, Lund VJ, Wei W, Ho WK. Ethnic variation in sinonasalanatomy on CT-scanning. Rhinology. 2005;43(3):210-14.
Qureshi M, Usmani A. A CT-Scan review of anatomicalvariants of sinonasal region and its correlation with symptomsof sinusitis (nasal obstruction, facial pain and rhinorrhea). PakJ Med Sci. 2020;37(1):195-200. doi: 10.12669/pjms.37.1.3260
Kaya M, Çankal M, Gumusok F, Apaydin N, Tekdemir I. Roleof anatomic variations of paranasal sinuses on the prevalence ofsinusitis: Computed tomography findings of 350 patients. NigerJ Clin Pract. 2017;20(11):1481. doi: 10.4103/njcp.njcp_199_16
Güngör G, Okur N, Okur E. Uncinate Process Variations andTheir Relationship with Ostiomeatal Complex: A Pictorial Essayof Multidedector Computed Tomography (MDCT) Findings.Pol J Radiol. 2016;81:173-80. doi: 10.12659/pjr.895885
Valladares L, Arboleda A, Peña E, Granados A. Variacionesanatómicas del proceso uncinado en tomografía computadamultidetector en pacientes con rinosinusitis crónica. Rev Argentde Radiol. 2014;78(2):82-8. doi: 10.1016/j.rard.2014.06.004
Srivastava M, Tyagi S. Role of Anatomic variations of UncinateProcess in Frontal Sinusitis. Indian J Otolaryngol Head NeckSurg. 2015;68(4):441-44. doi: 10.1007/s12070-015-0932-6
Tuli IP, Sengupta S, Munjal S, Kesari SP, Chakraborty S.Anatomical variations of uncinate process observed in chronicsinusitis. Indian J Otolaryngol Head Neck Surg. 2012;65(2):157-61. doi 10.1007/s12070-012-0612-8