Accessory Ostium of the Maxillary Sinus and Its Impact on Sinusitis

Abstract

Background: One of the anatomical variations in the maxillary sinus is the accessory ostium (AO). In the nasal cavity, the lateral wall’s vertical plane is parallel to the form of the AO, which is round or oval in appearance. During a nasal endoscopic examination, AO may be seen in contrast to the normal ostium of the maxillary sinus, which is hidden behind the uncinate process. Methods: The search for recent research articles on AO of the maxillary sinus was done with databases Scopus, PubMed, Medline, and Google Scholar. This review article discusses the prevalence, development, endoscopic examination, clinical significance, surgical importance, relationship with chronic sinusitis, and its management. Results: AO may interfere with ventilation and drainage of the maxillary sinus. Hence, it is important to evaluate the anatomical features of the AO for its relationship with sinus pathology. The development of maxillary sinusitis may be significantly impacted by the anatomical variance known as AO of the maxillary sinus. The middle meatus’s posterior nasal fontanelle is where AO is most frequently observed. The possible mechanism for the formation of AO is obstruction of the natural ostium of the maxillary sinus by sinusitis or due to anatomical and pathological factors in the middle meatus leading to rupture of membranous regions such as fontanelle. Conclusion: Clinicians must have adequate knowledge regarding the anatomical variations of the AO. It frequently appears in the fontanelle, the membranous portion of the middle meatus’ lateral nasal wall that is between the uncinate process and inferior meatus.