Abstract
Stenosis of the ostiomeatal complex, from either the anatomical configuration or hypertrophied mucosa can cause obstruction and stagnation of secretions that may then become infected or perpetuate infection. The surgical interventions of the functional endoscopic sinus surgery are designed to remove the ostiomeatal blockage and to restore normal sinus ventilation and mucociliary function. Hence, the present study was taken up to study the variations in the ostiomeatal complex and its clinical significance. For CT analysis coronal sections of 40 paranasal sinus CT films were collected from the department of ENT. Lateral deviation of the uncinate process was more common with equal incidence in both sexes and with higher incidence on right side. Nasal septum was deviated to the right side more commonly with equal incidence in both sexes. Nearly half of the cases showed agger nasi with higher frequency in males. Concha bullosa was the least common ostiomeatal variant with higher incidence in males with equal incidence on both sides. Preoperative planning for FESS requires high resolution computed tomography (CT) to provide detailed maps, which are used for navigation and the visualization of the anatomical variants that result in sinus disease. As a result, it has become imperative for radiologist and clinicians to improve understanding of ostiomeatal unit. Keywords: Ostiomeatal complex, paranasal sinuses, sinusitis, computed tomography imaging, agger nasi.
Highlights
Throughout the history of medicine numerous attempts have been made to illuminate and examine the inside of various hollow cavities located within the body
This study re-emphasized the concept that ostiomeatal complex is the key factor in the causation of chronic sinusitis
Dua et al (2005) reported that removal of disease in ostiomeatal complex region is the basic principle of functional endoscopic sinus surgery (FESS) which is best appreciated on computed tomography (CT) scan
Summary
Throughout the history of medicine numerous attempts have been made to illuminate and examine the inside of various hollow cavities located within the body. No consensus exists to define exact anatomic descriptions of the borders and margins of the ostiomeatal complex (Stammberger & Kennedy, 1995). The concept developed by Stammberger and Kennedy was adopted defining ostiomeatal complex as a functional unit of the anterior ethmoid complex representing the final common pathway for drainage and ventilation of the frontal, maxillary and anterior ethmoid sinuses (Freitas & Boasquevisque, 2008). The blockade in the ostiomeatal complex (OMC) leads to impaired drainage of maxillary, frontal and anterior ethmoid sinuses causing chronic sinusitis. Dua et al (2005) reported that removal of disease in ostiomeatal complex region is the basic principle of functional endoscopic sinus surgery (FESS) which is best appreciated on CT scan. Stammberger and Hawke (1993) have shown that CT examination of the paranasal sinuses will provide an anatomic road map of the paranasal sinuses to identify the presence of significant anatomic abnormalities, the location and severity of the disease and exact location of the obstruction
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