Computed Tomography Based Evaluation of the Anterior Group of the Paranasal Sinuses


Abstract views: 268 / PDF downloads: 152

Authors

DOI:

https://doi.org/10.58600/eurjther.20232903-1618.z

Keywords:

Paranasal sinuses, Anatomic variations, Paranasal sinus diseases, Conchae nasales, Frontal sinuses

Abstract

Objective: The study aims to ascertain the prevalence of paranasal sinus variations among healthy adults in the Turkish population, as well as to analyze the symmetry of these variations.

Methods: The CTIs of 200 adult patients who did not have any trauma, carcinoma, tumor, surgery, or a condition that could affect the paranasal anatomy, such as chronic rhinosinusitis, were included. The prevalences of the Agger nasi cell (ANC), supraorbital ethmoid cell (SOEC), Haller's cell (HC), middle turbinate pneumatization, and frontal sinus (FS) agenesis variations in the adult Turkish population were revealed.

Results: Bilateral SOECs were found 38.5% of 200 patients, and at least 53% of patients had SOECs on one side. In 21.5% of instances, LCs were observed on both sides; in 35% of instances, they were observed on at least one side. ANCs were observed bilaterally in 68.5% of the total, the rate of patients with ANC on at least one side was 84.5%. The rate of bilaterality of the Haller cell (HC) was 24%, it was observed at least one side in 43% of the cases. Bilateral concha bullosa (CB) were observed in 19% while CB variation on at least one side was 42%. Bilateral absence of the FS was found to be 8.5%, and unilateral absence was 2.5%.

Conclusion: The most common paranasal sinus variation was ANC, while the least was FS agenesis. Bilateral inheritance was found to be most prevalent in SOEC. The findings of our study hold significance for interventional procedures involving the paranasal region.

Metrics

Metrics Loading ...

References

Ramakrishnan Y, Zammit-Maempel I, Jones NS, Carrie S (2011) Paranasal Sinus Computed Tomography Anatomy: A Surgeon’s Perspective. J Laryngol Otol. 125(11):1141-1147. https://doi.org/10.1017/S0022215111001988

Mumbuç S (2000) Endoscopic Sinus Surgery in the Treatment of Headache. Eur J Ther 2000;11(1, 2):7-10. https://doi.org/10.58600/eurjther.2000-11-1-2-902-arch

Nautiyal A, Narayanan A, Mitra D, Honnegowda TM, Sivakumar (2020) Computed Tomographic Study of Remarkable Anatomic Variations in Paranasal Sinus Region and Their Clinical Importance - A Retrospective Study. Ann Maxillofac Surg. 10(2):422-428. https://doi.org/10.4103/ams.ams_192_19

Zhang XD, Li ZH, Wu ZS, Lin W, Lin WJ, Lin, JC, Zhuang LM (2018) A Novel Three-Dimensional-Printed Paranasal Sinus–Skull Base Anatomical Model. Eur Arch Otorhilaryngol. 275(8):2045-2049. https://doi.org/10.1007/s00405-018-5051-z

Orhan M, Govsa F, Saylam C (2010) A Quite Rare Condition: Absence of Sphenoidal Sinuses. Surg Radiol Anat. 32(6), 551–553. https://doi.org/10.1007/s00276-010-0623-7

Orhan M, Govsa F, Saylam C (2010) A Surgical View of the Superior Nasal Turbinate: Anatomical Study. Eur Arch Otorhinolaryngol. 267(6):909-16. https://doi.org/10.1007/s00405-009-1169-3

Papadopoulou AM, Chrysikos D, Samolis A, Tsakotos G, Troupis T (2021) Anatomical Variations of the Nasal Cavities and Paranasal Sinuses: A Systematic Review. Cureus. 13(1):e12727. https://doi.org/10.7759/cureus.12727

Kubota K, Takeno S, Hirakawa K (2015) Frontal Recess Anatomy in Japanese Subjects and Its Effect on the Development of Frontal Sinusitis: Computed Tomography Analysis. J Otolaryngol Head Neck Surg. 44:21. https://doi.org/10.1186/s40463-015-0074-6

Kayan M, Nazıroğlu M, Turker Y (2010) Non-Metastatic Suprasellar Germinoma in A Child: Case Report. Eur J Ther. 16(1):33-5. https://doi.org/10.58600/eurjther.2010-16-1-1323-arch

Gulsen S, Tasdemir A, Mumbuç S (2021) Surgical Approach to Paranasal Sinus Osteomas: Our Experience in 22 Cases. Eur J Ther. 2021;27(4):250-5. https://doi.org/10.58600/eurjther-27-4-105

Cakur B, Sumbullu MA, Durna NB (2011) Aplasia and Agenesis of the Frontal Sinus in Turkish Individuals: A Retrospective Study Using Dental Volumetric Tomography. Int J Med Sci. 8(3), 278. https://doi.org/10.7150/ijms.8.278

Huang BY, Lloyd KM, DelGaudio JM, Jablonowski E, Hudgins PA (2009) Failed Endoscopic Sinus Surgery: Spectrum of CT Findings in the Frontal Recess. Radiographics. 29(1):177-195. https://doi.org/10.1148/rg.291085118

Turna O, Aybar MD, Karagöz Y, Tuzcu G (2014) Anatomic Variations of the Paranasal Sinus Region: Evaluation with Multidetector CT. Istanbul Med J. 15(2):104 - 109. https://doi.org/10.5152/imj.2013.74429

Owen JR MD, RG, Kuhn FA (1997) Supraorbital Ethmoid Cell. Otolaryngol Head Neck Surg. 116(2):254-261. https://doi.org/10.1016%2FS0194-59989770337-1

Stammberger HR, Kennedy DW (1995) Paranasal Sinuses: Anatomic Terminology and Nomenclature. Ann Otol Rhinol Laryngol. 104:7–16.

Kim SS, Lee JG, Kim KS, Kim HU, Chung IH, Yoon JH (2001) Computed Tomographic and Anatomical Analysis of the Basal Lamellas in the Ethmoid Sinus. Laryngoscope. 111(3):424-429. https://doi.org/10.1097/00005537-200103000-00009

Kalaiarasi R, Ramakrishnan V, Poyyamoli S (2018) Anatomical Variations of the Middle Turbinate Concha Bullosa and Its Relationship with Chronic Sinusitis: A Prospective Radiologic Study. Int Arch Otorhinolaryngol. 22, 297-302. https://doi.org/10.1055/s-0038-1625978

Gwet KL (2014) Handbook of Inter-Rater Reliability: The Definitive Guide to Measuring the Extent of Agreement Among Raters. Advanced Analytics. LLC.

Kottner J, Audige L, Brorson S, Donner A, Gajewski BJ, Hróbjartsson A (2011) Guidelines for Reporting Reliability and Agreement Studies (GRRAS) were proposed. Int J Nurs Stud. 48(6):661–71. https://doi.org/10.1016/j.ijnurstu.2011.01.016

Conger AJ (1980) Integration and Generalization of Kappas for Multiple Raters. Psychol Bull. 88(2):322–8. https://doi.org/10.1037/0033-2909.88.2.322

Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A (2004) Remarkable Anatomic Variations in Paranasal Sinus Region and Their Clinical Importance. Eur J Radiol. 50:296–302 https://doi.org/10.1016/j.ejrad.2003.08.012

Bradley DT, Kountakis SE (2004) The Role of Agger Nasi Air Cells in Patients Requiring Revision Endoscopic Frontal Sinus Surgery. Otolaryngol Head Neck Surg. 131(4):525-527. https://doi.org/10.1016/j.otohns.2004.03.038

Angelico FV Jr, Rapoport PB (2013) Analysis of the Agger Nasi Cell and Frontal Sinus Ostium Sizes Using Computed Tomography of the Paranasal Sinuses. Braz J Otorhinolaryngol. 79:285–292. https://doi.org/10.5935/1808-8694.20130052

Orhan M, Saylam CY (2009) Anatomical Analysis of the Prevalence of Agger Nasi Cell in the Turkish Population. Kulak Burun Bogaz Ihtis Derg. 19(2):82-6.

Tiwari R, Goyal R (2015) Study of Anatomical Variations on CT in Chronic Sinusitis. Indian J Otolaryngol Head Neck Surg. 67:18-20. https://doi.org/10.1007%2Fs12070-014-0734-2

Lien CF, Weng HH, Chang YC, Lin YC, Wang WH (2010) Computed Tomographic Analysis of Frontal Recess Anatomy and Its Effect on the Development of Frontal Sinusitis. Laryngoscope. 120(12):2521-2527. https://doi.org/10.1002/lary.20977

Kaplanoglu H, Kaplanoglu V, Dilli A, Toprak U, Hekimoğlu B (2013) An Analysis of the Anatomic Variations of the Paranasal Sinuses and Ethmoid Roof Using Computed Tomography. Eurasian J Med. 45(2), 115. https://doi.org/10.5152/eajm.2013.23

Yazici D (2019) The Analysis of Computed Tomography of Paranasal Sinuses in Nasal Septal Deviation. J Craniofac Surg. 30(2), e143-e147. https://doi.org/10.1097/scs.0000000000005077

Van Alyea OE (1941) Frontal Cells: An Anatomic Study of These Cells with Consideration of Their Clinical Significance. Arch Otolaryngol. 34(1):11-23. https://doi.org/10.1001/archotol.1941.00660040021003

Li M, Sharbel DD, White B, Tadros SY, Kountakis SE (2019) Reliability of the Supraorbital Ethmoid Cell vs. Keros Classification In Predicting the Course of the Anterior Ethmoid Artery. Int Forum Allergy Rhinol. 00:1-4. https://doi.org/10.1002/alr.22307

Zhang L, Han D, Ge W, Tao J, Wang X, Li Y, Zhou B (2007) Computed Tomographic and Endoscopic Analysis of Supraorbital Ethmoid Cells. Otolaryngol Head Neck Surg. 137(4):562-568. https://doi.org/10.1016/j.otohns.2007.06.737

Comer BT, Kincaid NW, Kountakis SE (2013) The Association Between Supraorbital Ethmoid Air Cells and Orbital Proptosis in Patients with Chronic Rhinosinusitis. Int Forum Allergy Rhinol. 3(2):147-9. https://doi.org/10.1002/alr.21073

Zhao H, Li Y, Xue H, Deng ZH, Liang WB, Zhang L (2021) Morphological Analysis of Three-Dimensionally Reconstructed Frontal Sinuses from Chinese Han Population Using Computed Tomography. Int J Legal Med. 135(3):1015–1023. https://doi.org/10.1007/s00414-020-02443-5

Elvan O, Esen K, Celikcan HD, Tezer MS, Özgür A (2019) Anatomic Variations of Paranasal Region in Migraine. J Craniofac Surg. 30(6):e529–e532. https://doi.org/10.1097/scs.0000000000005480

Bašić N, Bašić V, Jukić T, Bašić M, Jelić M, Hat J (1999) Computed Tomographic Imaging to Determine the Frequency of Anatomical Variations in Pneumatization of the Ethmoid Bone. Eur Arch Oto-Rhino-Laryngol. 256(2), 69-71. https://doi.org/10.1007/s00405-020-06304-0

Nedunchezhian K, Aswath N, Amudhan A (2018) Quest for Haller Cells: A Digital Orthopantomography study. Indian J Dent Res. 29(2):181-185. https://doi.org/10.4103/ijdr.IJDR_65_17

Chaudhari RS, Sagar K, Sagar N, Sanjeev O, Abhay K, Pratik P (2019) Prevalence of Haller’s Cells: A Panoramic Study. Ann Maxillofac Surg. 9(1):72–77. https://doi.org/10.4103/ams.ams_10_19

Adaki S, Karagir A, Shah K, Adaki R (2021) Prevalence of Haller Infraorbital Ethmoidal Cells on Panoramic Radiograph – A prospective study. J Indian Acad Oral Med Radiol. 33:195-9. https://doi.org/10.4103/jiaomr.jiaomr_166_20

Mathew R, Omami G, Hand A, Fellows D, Lurie A (2013) Cone Beam CT Analysis of Haller Cells: Prevalence and Clinical Significance. Dentomaxillofac Radiol. 42(9):20130055. https://doi.org/10.1259/dmfr.20130055

Wanamaker HH (1996) Role of Haller’s Cell in Headache and Sinus Disease: A Case Report. Otolaryngol Head Neck Surg. 114:324-7. https://doi.org/10.1016/s0194-5998(96)70196-1

Ahmad M, Khurana N, Jaberi J, Sampair C, Kuba RK (2006) Prevalence of Infraorbital Ethmoid (Haller’s) Cells on Panoramic Radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 101(5):658–661. https://doi.org/10.1016/j.tripleo.2005.08.035

Bolger WE, Parsons DS, Butzin CA (1991) Paranasal Sinus Bony Anatomic Variations and Mucosal Abnormalities: CT Analysis for Endoscopic Sinus Surgery. Laryngoscope. 101(1):56-64. https://doi.org/10.1288/00005537-199101000-00010

Swain SK (2021) Middle Turbinate Concha Bullosa and Its Relationship with Chronic Sinusitis: A Review. Int J Otorhinolaryngol Head Neck Surg. 7(6):1062-67. https://dx.doi.org/10.18203/issn.2454-5929.ijohns20212136

Calvo-Henríquez C, Ruano-Ravina A, Martinez-Capoccioni G, Huaranca M, Lattomus K, Martin-Martin C (2018) The Lamellar Cell: A Radiological Study and A New Classification Proposal. Eur Arch Otorhinolaryngol. 275(11):2713-2717. https://doi.org/10.1007/s00405-018-5111-4

Aydinlioglu A, Kavakli A, Erdem S (2003) Absence of Frontal Sinus in Turkish Individuals. Yonsei Med J. 30;44(2):215-8. https://doi.org/10.3349/ymj.2003.44.2.215.

Danesh-Sani SA, Bavandi R, Esmaili M (2011) Frontal Sinus Agenesis Using Computed Tomography. J Craniofac Surg. 22(6):e48-e51. https://doi.org/10.1097/SCS.0b013e318231e26c

Friedman M, Bliznikas D, Vidyasagar R, Landsberg R (2004) Frontal Sinus Surgery 2004: Update of Clinical Anatomy and Surgical Techniques. Oper Tech Otolayngol Head Neck Surg. 15(1):23-31. https://doi.org/10.1053/j.otot.2004.02.004

Harris AM, Wood, RE, Nortjé CJ, Thomas, CJ (1987) Gender and Ethnic Differences of the Radiographic Image of the Frontal Region. J Forensic Odontostomatol. 5(2), 51–57.

Downloads

Published

2023-06-13

How to Cite

Yaprak, F., Çoban, İstemihan, Sarıoğlu, O., Özer, M. A., & Govsa, F. (2023). Computed Tomography Based Evaluation of the Anterior Group of the Paranasal Sinuses. European Journal of Therapeutics, 29(3), 341–351. https://doi.org/10.58600/eurjther.20232903-1618.z

Issue

Section

Original Articles

Categories