Evaluation of osteomeatal complex anomalies and maxillary sinus diseases using cone beam computed tomography

Abstract

Introduction: Although obstruction of osteomeatal area was not accepted as an important factor in the pathogenesis of sinus infections for years, recent studies point out the importance of this area. For the maintenance of normal functions of paranasal sinuses, ventilation and drainage of this area is necessary. The purpose of this study was to determine the effect of anomalies of the osteomeatal area on sinus diseases. Methods: This study included cone beam computed tomography scans of 200 patients. Osteomeatal area anomalies were classified as concha bullosa, septal deviation, paradox middle concha, deviation of uncinate process, uncinate bulla, Haller cells and Agger nasi cells. Ethmoid infundibulum and presence of sinus pathologies were recorded. Results: Pathologies were not determined in 243 (60.8%) of the evaluated 400 sinuses while detected in 157 (39.3%) sinuses. Pathologies were found to be more frequent in males than females (p<0.05). Sinus diseases were more prevalent in patients with an obstructed ethmoid infundibulum (p<0.05). Septum deviation was found in 64.5%, concha bullosa in 47%, Haller cells in 17%, paradox middle concha in 8%, deviation of uncinate process in 5.5%, over pneumatisation of agger nasi in 5%, and uncinate bulla in 5% of the investigated patients. Although we found a statistically significant link between ethmoid infundibulum clarity and pathology presence; there was no statistically significant relationship between sinus pathologies and evaluated anomalies. Conclusion: Although we found no relationship between these anomalies and sinus diseases, further studies including the dimensions of the osteomeatal area anomalies will be helpful to determine the effect of these anomalies on sinus diseases.