Nandita Devi Ahanthem, Malligere Basavaraju Sowbhagya, Ningombam Singh Deepak, Chungkham Sachidananda, Ashem Albert, Yumnam Ranjeeta
Dentistry Oral Medicine and Radiology, Dental College, Regional Institute of Medical Sciences, Imphal, IND.
Department of Oral Medicine and Radiology, Rajarajeshwari Dental College and Hospital, Bangaluru, IND.
Cureus. 2024 Aug 19;16(8):e67200. doi: 10.7759/cureus.67200. eCollection 2024 Aug.
The paranasal sinuses are cavities filled with air located within specific bones, namely the frontal, ethmoidal, maxillary, and sphenoidal sinuses. The ethmoidal sinus is composed of three groups: anterior, middle, and posterior, which are found on both sides. Haller cells (HC), also known as infraorbital ethmoid cells, are projections of the anterior ethmoid sinus that extend into the floor of the orbit and the upper part of the maxillary sinus. Infraorbital ethmoid cells have been associated with several disease conditions and symptoms, such as sinusitis, headaches, orofacial pain, and mucoceles. Consequently, determining the frequency and form of HC is crucial. The objective of the study was to determine the frequency, form, and clinical significance of Haller cells (HC) using cone beam computed tomography (CBCT).
This retrospective study analyzed 100 cone beam computed tomographic (CBCT) images, with an equal distribution of 50 males and 50 females from the age range of 19 to 70 years. The images were randomly selected from the CBCT archives. The participants were chosen according to the specific criteria for inclusion and exclusion established for the study. The collected data were subjected to statistical analysis utilizing the Chi-square test, independent student t-test, one-way ANOVA test, Cohen's Kappa statistics, and intraclass correlation coefficients.
The occurrence of Haller cells (HC) was found to be 73%, with 32 cases observed in males and 41 in females. Among the 73 patients with HC, 52 (71%) had unilateral HC, while 21 (28.76%) had bilateral HC. Regarding the shape of the HCs, 31 (42.46%) were teardrop-shaped, 26 (35.61%) were oval-shaped, and 16 (21.91%) were round-shaped. Additionally, out of the 73 cases of HC, 69 (94.52%) were unilocular, and four (5.47%) were multilocular. Furthermore, the average dimensions of HC were greater in males than in females, regardless of whether the cells were distributed unilaterally or bilaterally. The interobserver agreement between observers one and two showed complete consistency, and our study found that the assessment of the dimension of HC had outstanding interrater reliability.
The findings of this study indicate that CBCT is highly effective in visualizing and accurately delineating Haller cells in a significant number of patients. It is essential for oral physicians and oral radiologists to be aware of these anatomical structures to accurately identify them. This awareness will enable them to provide a comprehensive differential diagnosis for individuals experiencing orofacial pain and discomfort that may be attributed to the presence of Haller cells.
鼻窦是位于特定骨骼内充满空气的腔隙，即额窦、筛窦、上颌窦和蝶窦。筛窦由三组组成：前组、中组和后组，两侧均有。哈勒氏细胞（HC），也称为眶下筛窦细胞，是前筛窦的突起，延伸至眶底和上颌窦上部。眶下筛窦细胞与多种疾病状况和症状相关，如鼻窦炎、头痛、口面部疼痛和黏液囊肿。因此，确定HC的频率和形态至关重要。本研究的目的是使用锥形束计算机断层扫描（CBCT）确定哈勒氏细胞（HC）的频率、形态及临床意义。
这项回顾性研究分析了100张锥形束计算机断层扫描（CBCT）图像，年龄在19至70岁之间的男性和女性各50名，分布均匀。图像从CBCT存档中随机选取。根据为本研究制定的纳入和排除具体标准选择参与者。收集的数据采用卡方检验、独立样本t检验、单因素方差分析、科恩卡帕统计量和组内相关系数进行统计分析。
发现哈勒氏细胞（HC）的发生率为73%，男性观察到32例，女性观察到41例。在73例有HC的患者中，52例（71%）为单侧HC，21例（28.76%）为双侧HC。关于HC的形状，31例（42.46%）为泪滴形，26例（35.61%）为椭圆形，16例（21.91%）为圆形。此外，在73例HC病例中，69例（94.52%）为单房性，4例（5.47%）为多房性。此外，无论细胞是单侧还是双侧分布，男性HC的平均尺寸均大于女性。观察者一和观察者二之间的观察者间一致性显示完全一致，并且我们的研究发现HC尺寸评估具有出色的观察者间可靠性。
本研究结果表明，CBCT在大量患者中可视化并准确描绘哈勒氏细胞方面非常有效。口腔医生和口腔放射科医生必须了解这些解剖结构以准确识别它们。这种认识将使他们能够为可能因哈勒氏细胞存在而出现口面部疼痛和不适的个体提供全面的鉴别诊断。
