Selcuk Adin, Ozcan Kursat Murat, Akdogan Ozgur, Bilal Nagihan, Dere Huseyin
Ankara Numune Educational and Research Hospital, 4th ENT Clinic, Ankara, Turkey.
J Craniofac Surg. 2008 Jan;19(1):159-64. doi: 10.1097/scs.0b013e3181577b01.
Hypoplasia and aplasia of maxillary sinus, maxillary sinus septae, ethmomaxillary sinus, superior meatus-draining maxillary sinus, and over-pneumatization are the variations of maxillary sinuses. Findings such as uncinate process abnormality, orbital enlargement, sphenomaxillary plate, canine fossa elevation, infraorbital fissure enlargement, thickening of the sinus wall and mucosal pathologies can be seen together with these variations. The aim of this study is to determine the incidence and morphology of the anatomical variations of maxillary sinus and accompanying structures. A total of 330 consecutive paranasal sinus computed tomography scans of the patients presenting with sinonasal complaints at our ENT department were assessed for maxillary sinus anatomical variations and related structures. There were 134 (20.3%) anteriorly and 17 (2.5%) posteriorly localized maxillary sinus bony septa. The position of antral septa was frequently vertical at anterior, and horizontal at posterior. We found significant correlation between the anteriorly localized maxillary sinus septa and infraorbital fissure enlargement. Maxillary sinus hypoplasia was found in 31 (4.6%) maxillary sinuses. Seven (1.0%) ethmomaxillary sinuses were assessed. Significant correlation was found between maxillary sinus hypoplasia and orbital enlargement. Presence of mucosal pathology was significant in patients with maxillary sinus septa, but there was no difference when it was compared with the mucosal pathology in the nonseptated group. There was no significant correlation between other anatomical variations and mucosal pathologies. Determining the anatomical variations of maxillary sinus and accompanying structures in patients planning endoscopic sinus surgery will significantly help with providing surgical orientation and preventing possible complications.
上颌窦、上颌窦隔、筛上颌窦、上颌窦上鼻道引流、过度气化等发育不全和发育缺失是上颌窦的变异情况。诸如钩突异常、眼眶扩大、蝶上颌板、犬齿窝抬高、眶下裂扩大、窦壁增厚和黏膜病变等表现可与这些变异同时出现。本研究的目的是确定上颌窦及其附属结构解剖变异的发生率和形态。对在我们耳鼻喉科因鼻窦疾病就诊的患者连续进行的330例鼻窦计算机断层扫描进行评估,以观察上颌窦解剖变异及相关结构。有134例(20.3%)上颌窦骨隔位于前方,17例(2.5%)位于后方。窦隔的位置在前部多为垂直,在后部多为水平。我们发现前方定位的上颌窦隔与眶下裂扩大之间存在显著相关性。31例(4.6%)上颌窦存在上颌窦发育不全。评估了7例(1.0%)筛上颌窦。发现上颌窦发育不全与眼眶扩大之间存在显著相关性。上颌窦隔患者中黏膜病变的发生率较高,但与无隔组的黏膜病变相比无差异。其他解剖变异与黏膜病变之间无显著相关性。确定计划进行鼻内镜鼻窦手术患者的上颌窦及其附属结构的解剖变异,将有助于显著提供手术方向并预防可能的并发症。