Paradoxical Middle Turbinate Research Articles

The relationship between anatomic variations of paranasal sinuses and chronic sinusitis in children

Conclusions. Anatomical variations in the nose and paranasal sinuses are common in children. Due to the absence of a definitive relationship between anatomical variations and sinus disease, local, systemic or environmental factors appear to be more significant in pediatric sinusitis than the anatomic variations. Objective. Chronic sinusitis is increasing in the pediatric population. Following the initial reports of functional endoscopic sinus surgery (FESS) for children, the majority of patients undergoing this procedure have experienced improved quality of life. Thus, we need to know the precise anatomy and anatomical variations of the nose, as well as the relationship between such anatomy and chronic sinusitis. Patients and methods. To determine the extent and distribution of disease, as well as associated anatomic abnormalities, computed tomography (CT) scans were performed on 113 children with persistent symptoms of sinusitis after failure of medical therapies. Results. The maxillary sinus was the most commonly involved sinus, followed by the ethmoid, sphenoid, and frontal sinuses. There was no relationship between age and severity of sinusitis. Agger nasi cell was the most common anatomical variation, followed by septal deviation, Haller cell, concha bullosa, paradoxical middle turbinate, and Onodi cell. The prevalence of septal deviation increased with age. There was no significant relationship between the sinusitis and anatomic variations.

Sinusitis crónica y prevalencia de la concha bullosa

Introducción: la neumatización del etmoides es un evento de alta complejidad y variabilidad, que se refleja en la existencia de estructuras etmoidales tales como la concha bullosa (CB), cornete medio paradójico, celdillas de Haller y bulla etmoidal prominente entre otras. Existen estadísticas foráneas referentes a la incidencia y prevalencia de estas variantes de neumatización, pero en nuestro medio carecemos de datos al respecto. El presente trabajo tiene como objetivo general establecer la prevalencia de CB en tomografias computarizadas (TAC) de cara y de manera anexa observar si existe relación entre la existencia de CB y sinusitis crónica.Materiales y métodos: se evaluaron las TAC de cara de 118 pacientes mayores de 18 años entre noviembre de 2002 y octubre de 2003 en un estudio descriptivo mixto. Se detalló en ellas la presencia de concha bullosa, setpodesviación, celdillas de Haller y bulla etmoidal prominente así como la existencia o ausencia de sinusitis crónica concomitante.Resultados: se estableció una prevalencia de CB en la muestra de 27 %, unilateral 18 %, bilateral 9 %, derecha 11% e izquierda 7 %. Además de lo anterior, el estudio demostró que no hay en esta muestra una relación estadísticamente significativa entre la CB y sinusitis crónica, pero llama la atención la presencia de infección crónica al tomar en cuenta la septodesviación asociada con la existencia de CB contralateral. Conclusión: la prevalencia de CB en el presente estudio es similar a datos establecidos en poblaciones foráneas, con prevalencia de 27 %. El presente estudio no halló una relación positiva entre la existencia de CB y sinusitis crónica.

Sinugenic Headache and Nasal Endoscopy.

This paper presents an evaluation and results of a study conducted on 62 patients out of 140 cases of chronic headache seen in ENT OPD. 32 patients were taken up for minimal endoscopic surgery. 23 cases (72%) have shown significant relief from headache over a period of 6 months or more. 11 cases showed anatomical / pathological variations at the ethmoidalis infundibulum, the commonest cause being enlarged bulla ethmoidalis followed by minimal polyps/polypoidal mucosa at the frontal recess area. Other causes are hyperplastic sinusitis, high posterior septal deviation, large middle turbinate, paradoxical middle turbinate and concha bullosa.

Estudo das variações anatômicas do meato médio de doentes com queixas nasais através da nasofibroscopia flexível

Padronizando a nasofibroscopia flexível detalhada, podemos avaliar as variações anatômicas de estruturas do complexo ostiomeatal, tais como, agger nasi, processo uncinado, bula etmoidal e concha nasal média. OBJETIVO: Avaliar as variações anatômicas em relação ao sexo, lado acometido e entre diferentes faixas etárias de acordo com o desenvolvimento e pneumatização do etmóide. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: No presente trabalho, foram estudados 500 doentes com queixas nasais (1000 meatos médios). RESULTADOS E CONCLUSÕES: As conchas nasais médias globosas, extensiva e bulbosa, foram as variações anatômicas mais freqüentes, seguidas pelo agger nasi hipertrofiado, concha nasal média paradoxal e processo uncinado angulado ou projetado medialmente. O agger nasi, a concha média globosa extensiva, concha nasal média paradoxal, o processo uncinado angulado ou projetado medialmente e a bula etmoidal hipertrofiada tendem a ser bilaterais, enquanto a concha média globosa bulbosa tende a ser unilateral. Houve correlação significante entre a prevalência do agger nasi hipertrofiado e das conchas nasais médias globosas tipo extensiva e bulbosa ipsilateralmente. Houve correlação significante entre a prevalência da concha nasal média globosa tipo extensiva e da concha nasal média globosa tipo bulbosa contralateralmente. Não houve correlação significativa entre a prevalência das variações anatômicas do agger nasi, processo uncinado, bula etmoidal e concha nasal média isoladamente ou associadas, em relação ao sexo.

Paranasal sinus computed tomographic findings of children with chronic cough

Objective: Chronic cough is a frequent problem in the practice of clinical pediatrics, and sinusitis is a common etiologic factor. In this study, our aim was to determine the prevalence of sinus abnormalities in pediatric patients presenting with chronic cough. Methods: Forty-two patients, ranging from 3 to 16 years of age from both sexes completed the study. Paranasal sinuses were examined by coronal paranasal sinus limited computed tomographic scan. The CT scan findings were categorized as no disease, minimal, moderate and severe sinusitis. Results: The most frequent symptoms after cough were rhinorrhea, sniffling, and halitosis. We found sinus abnormalities in 66.6% and no abnormality in 33.3% of the children. Age and sex were not important factors in sinus disease. There was no correlation between sinus findings and any of symptoms. The most common anatomical abnormalities were concha bullosa, paradoxical middle turbinate, Haller's cells, and deviated nasal septum. These abnormalities were not correlated with sinus disease. Conclusion: Paranasal sinus abnormalities are common among pediatric patients with chronic cough and imaging studies of the sinuses should be considered in these children.

Anatomic variants of the paranasal sinuses and their implications for sinusitis

Obstruction of the ostiomeatal complex is a key feature in the development of sinusitis. Numerous bony variants may cause obstruction of these pathways due to their position. The most common variants include nasal septal deviation, concha bullosa, paradoxical middle turbinate, agger nasi cells, Haller cells, and uncinate deviation. The role of these anomalies in the etiology of sinusitis is discussed.

CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations

The frequency of concha bullosa, paradoxical middle turbinate, and septal deviation on coronal computed tomographic scans evaluating sinus disease is known, but the incidence in normal subjects is unknown. We compared 100 consecutive scans performed for evaluation of sinus disease with 82 consecutive scans performed for evaluation of orbital pathology. Patients with sinus disease had significantly more frequent findings of disease in the osteomeatal complex and all sinuses. Concha bullosa was more common in patients with sinus disease (p less than 0.05), as was septal deviation (p less than 0.01). Paradoxical turbinate was equally common. Concha bullosa was associated with anterior ethmoid disease (p less than 0.04). Septal deviation was associated with osteomeatal complex disease (p less than 0.01) and with anterior (p less than 0.04) and posterior (p less than 0.04) ethmoid disease. Paradoxical turbinate was not associated with sinus abnormalities. These data imply a possible causal relationship between concha bullosa or septal deviation and sinus disease.