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Frequency of Accessory Maxillary Ostium in Patients With/Without Sinusitis, and Its Correlation with Anatomical Variations of Paranasal Sinuses: A Cone Beam Computed Tomography Study

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Abstract

This study assessed the frequency of accessory maxillary ostium (AMO) in patients with/without sinusitis and its correlation with anatomical variations using cone-beam computed tomography (CBCT). In this cross-sectional study, 244 CBCT scans were evaluated in two groups: with maxillary sinusitis having > 2 mm mucosal thickening and without max sinusitis as a normal group having normal or less than 2 mm mucosa. The CBCT scans of each group were carefully evaluated for the presence/absence of AMO, patency/obstruction of the primary maxillary ostium (PMO), and the presence of anatomical variations of the paranasal sinuses. Data were analyzed by independent t-test, Pearson Chi-square test, and Fisher’s exact test (alpha = 0.05). CBCT scans of 134 females (54.9%) and 110 males (45.1%) with a mean age of 34.16 ± 19.01 years were evaluated. The presence of AMO had no significant correlation with maxillary sinusitis (P = 0.104). The two groups had no significant difference in the frequency of Haller cell, nasal septal deviation, and concha bullosa (P > 0.05). However, the frequency of paradoxical concha (PC; P < 0.001) and bifid concha (BC; P = 0.017) was significantly higher in the normal group, and the frequency of PMO obstruction was significantly higher in the sinusitis group (P < 0.001). AMO had no significant correlation with any anatomical variation in any group (P > 0.05). Gender had a significant effect on the presence of AMO (P = 0.013). The presence of AMO had no significant correlation with maxillary sinusitis. However, its frequency was significantly higher in females in normal group and males with sinusitis. The presence of AMO had no significant correlation with anatomical variations.

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References

  1. Fernández JS, Escuredo JA, Del Rey AS, Montoya FS (2000) Morphometric study of the paranasal sinuses in normal and pathological conditions. Acta Otolaryngol 120:273–278

    Article  Google Scholar 

  2. Erdem T, Aktas D, Erdem G, Miman MC, Ozturan O (2012) Maxillary sinus hypoplasia. Rhinology 2002(40):150–153

    Google Scholar 

  3. Patil M, Manjunath KY (2012) Ostium maxillare accessorium—a morphologic study. Nat J Clin Anat 1(4):171–175

    Article  Google Scholar 

  4. Standing S, Borely NR et al (2008) Ch head and neck. In: Gray’s anatomy: the anatomical basis of clinical practice, pp 570–93

  5. Bornstein MM, Horner K, Jacobs R (2017) Use of cone beam computed tomography in implant dentistry: current concepts, indications and limitations for clinical practice and research. Periodontol 2000 73:51–72

    Article  PubMed  Google Scholar 

  6. Kumar H, Choudhry R, Kakar S (2001) Accessory maxillary ostia: topography and clinical application. J Anat Soc India 50:3–5

    Google Scholar 

  7. Wani AA, Kanotra S, Lateef M, Ahmad R, Qazi SM, Ahmad S (2009) CT scan evaluation of the anatomical variations of the ostiomeatal complex. Indian J Otolaryngol Head Neck Surg 61:163–168

    Article  PubMed  PubMed Central  Google Scholar 

  8. Soikkonen K, Ainamo A (1995) Radiographic maxillary sinus findings in the elderly.  Oral Surg Oral Med Oral Pathol Oral Radiol Endod 80:487–491

    Article  CAS  PubMed  Google Scholar 

  9. Mahajan A, Mahajan A, Gupta K, Verma P, Lalit M (2017) Anatomical variations of accessory maxillary sinus ostium: an endoscopic study. Int J Anat Res 5:3485–3490

    Google Scholar 

  10. Maillet M, Bowles WR, McClanahan SL, John MT, Ahmad M (2011) Cone-beam computed tomography evaluation of maxillary sinusitis. J Endod 37:753–757

    Article  PubMed  Google Scholar 

  11. Carmeli G, Artzi Z, Kozlovsky A, Segev Y, Landsberg R (2011) Antral computerized tomography pre-operative evaluation: relationship between mucosal thickening and maxillary sinus function. Clin Oral Implants Res 22:78–82

    Article  PubMed  Google Scholar 

  12. Brook I (2009) Sinusitis. Periodontol 2000 49:126–139

    Article  PubMed  Google Scholar 

  13. Yeung AW, Colsoul N, Montalvao C, Hung K, Jacobs R, Bornstein MM (2019) Visibility, location, and morphology of the primary maxillary sinus ostium and presence of accessory ostia: a retrospective analysis using cone beam computed tomography (CBCT). Clin Oral Investig 23:3977–3986

    Article  PubMed  Google Scholar 

  14. Matthews BL, Burke AJ (1997) Recirculation of mucus via accessory ostia causing chronic maxillary sinus disease. Otolaryngol Head Neck Surg 117:422–423

    Article  CAS  PubMed  Google Scholar 

  15. Frosini P, Picarella G, De Campora E (2009) Antrochoanal polyp: analysis of 200 cases. Acta Otorhinolaryngol Ital 21:29

    Google Scholar 

  16. Joe JK, Ho SY, Yanagisawa E (2000) Documentation of variations in sinonasal anatomy by intraoperative nasal endoscopy. Laryngoscope 110:229–235

    Article  CAS  PubMed  Google Scholar 

  17. Jones NS (2002) CT of the paranasal sinuses: a review of the correlation with clinical, surgical and histopathological findings. Clin Otolaryngol Allied Sci 27:11–17

    Article  CAS  PubMed  Google Scholar 

  18. Sindel A, Turhan M, Ogut E, Akdag M, Bostancı A, Sindel M (2014) An endoscopic cadaveric study: accessory maxillary ostia. Dicle Med J 41:262–267

    Article  Google Scholar 

  19. Mladina R, Vuković K, Poje G (2009) The two holes syndrome. Am J Rhinol Allergy 23:602–604

    Article  PubMed  Google Scholar 

  20. Capelli M, Gatti P (2016) Radiological study of maxillary sinus using CBCT: relationship between mucosal thickening and common anatomic variants in chronic rhinosinusitis. J Clin Diagnostic Res 10:07–10

    Google Scholar 

  21. Arslan İB, Uluyol S, Demirhan E, Kozcu SH, Pekçevik Y, Çukurova İ (2017) Paranasal sinus anatomic variations accompanying Maxillary Sinus Retention cysts: a radiological analysis. Turk Arch Otorhinol 55:162–165

    Article  Google Scholar 

  22. Hung K, Montalvao C, Yeung AW, Li G, Bornstein MM (2020) Frequency, location, and morphology of accessory maxillary sinus ostia: a retrospective study using cone beam computed tomography (CBCT). Surg Radiol Anat 42:219–228

    Article  PubMed  Google Scholar 

  23. Başer E, Sarıoğlu O, Arslan İB, Çukurova İ (2020) The effect of anatomic variations and maxillary sinus volume in antrochoanal polyp formation. Eur Arch Otorhinol 277:1067–1072

    Article  Google Scholar 

  24. Shetty S, Al Bayatti SW, Al-Rawi NH, Samsudin R, Marei H, Shetty R, Abdelmagyd HA, Reddy S (2021) A study on the association between accessory maxillary ostium and maxillary sinus mucosal thickening using cone beam computed tomography. Head Face Med 17:1–10

    Article  Google Scholar 

  25. Orhan K, Aksoy S, Bayindir H, Berberoğlu A, Seker E (2012) Cone beam CT evaluation of maxillary sinus septa prevalence, height, location and morphology in children and an adult population. Med Princ Pract 22:47–53

    Article  PubMed  PubMed Central  Google Scholar 

  26. Aksoy U, Orhan K (2019) Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study. Clin Oral Investig 23:123–131

    Article  PubMed  Google Scholar 

  27. Soylemez UP, Atalay B (2021) Investigation of the accessory maxillary ostium: a congenital variation or acquired defect? Dentomaxillofac Radiol 50:570–575

    Google Scholar 

  28. Lu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X, Zheng G, Wang H, Huang D (2012) Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. J Endod 38:1069–1074

    Article  PubMed  Google Scholar 

  29. Serindere G, Gunduz K, Avsever H (2022) The relationship between an Accessory Maxillary Ostium and variations in structures adjacent to the Maxillary Sinus without polyps. Int Arch Otorhinolaryngol 26:548–555

    Article  Google Scholar 

  30. Bani-Ata M, Aleshawi A, Khatatbeh A, Al-Domaidat D, Alnussair B, Al-Shawaqfeh R, Allouh M (2020) Accessory Maxillary Ostia: prevalence of an Anatomical Variant and Association with chronic sinusitis. Int J Gen Med 13:163–168

    Article  PubMed  PubMed Central  Google Scholar 

  31. Yenigun A, Fazliogullari Z, Gun C, Uysal II, Nayman A, Karabulut AK (2016) The effect of the presence of the accessory maxillary ostium on the maxillary sinus. Eur Arch Otorhinolaryngol 273:4315–4319

    Article  PubMed  Google Scholar 

  32. Özcan İ, Göksel S, Çakır-Karabaş H, Ünsal G (2021) CBCT analysis of haller cells: relationship with accessory maxillary ostium and maxillary sinus pathologies. Oral Radiol 37:502–506

    Article  PubMed  Google Scholar 

  33. Varadharajan R, Sahithya S, Venkatesan R, Gunasekaran A, Suresh S (2020) An endoscopic study on the prevalence of the accessory maxillary ostium in chronic sinusitis patients. Int J Otorhinolaryngol Head Neck Surg 6:40–44

    Article  Google Scholar 

  34. Na Y, Kim K, Kim SK, Chung SK (2012) The quantitative effect of an accessory ostium on ventilation of the maxillary sinus. Respir Physiol Neurobiol 181:62–73

    Article  PubMed  Google Scholar 

  35. Jankowski R, Nguyen DT, Poussel M, Chenuel B, Gallet P, Rumeau C, Sinusology (2016) Eur Ann Otorhinolaryngol Head Neck Dis 133:263–268

    Article  CAS  PubMed  Google Scholar 

  36. Gutman M, Houser S (2003) Iatrogenic maxillary sinus recirculation and beyond. Ear Nose Throat J 82:61–63

    Article  PubMed  Google Scholar 

  37. Guerra-Pereira I, Vaz P, Faria-Almeida R, Braga AC, Felino A (2015) CT maxillary sinus evaluation-a retrospective cohort study. Med Oral Patol Oral Cir Bucal 20:419–426

    Article  Google Scholar 

  38. Pokorny A, Tataryn R (2013) Clinical and radiologic findings in a case series of maxillary sinusitis of dental origin. Int Forum Allergy Rhinol 3:973–979

    Article  PubMed  Google Scholar 

  39. Schiller JS, Lucas JW, Peregoy JA (2012) Summary health statistics for U.S. adults: National Health interview Survey, 2011. Vital Health Stat 10:1–218

    Google Scholar 

  40. Hastan D, Fokkens WJ, Bachert C, Newson RB, Bislimovska J, Bockelbrink A, Bousquet PJ, Brozek G, Bruno A, Dahlén SE, Forsberg B (2011) Chronic rhinosinusitis in Europe–an underestimated Disease. A GA2LEN study. Allergy 66:1216–1223

    Article  CAS  PubMed  Google Scholar 

  41. Stallman JS, Lobo JN, Som PM (2004) The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol 25:1613–1618

    PubMed  PubMed Central  Google Scholar 

  42. Som PM, Curtin HD (2011) Head and neck imaging: expert consult-online and print, 5th edn. Elsevier Health Sciences, Amsterdam, pp 99–251

    Book  Google Scholar 

  43. Shin HS (1986) Clinical significance of unilateral sinusitis. J Clin Diagnostic Res 1:69–74

    CAS  Google Scholar 

  44. Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ (1991) CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg 104:480–483

    Article  CAS  PubMed  Google Scholar 

  45. Fadda GL, Rosso S, Aversa S, Petrelli A, Ondolo C, Succo G (2012) Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis. Acta Otorhinolaryngol 32:244–251

    CAS  Google Scholar 

  46. Bolger WE, Butzin CA, Parsons DS (1991) Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 101:56–64

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We would like to thank Dr. Mohammad Ebrahim Ghafari for his help in statistical analysis.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Maxillofacial Radiology, Guilan University of Medical Sciences, End of Professor Samii Blvd, Rasht, 41941-73774, Iran

    Faezeh Kashi & Zahra Dalili Kajan

  2. Department of Maxillofacial Radiology, Dental Sciences Research Center, Guilan University of Medical Sciences, Rasht, Iran

    Zahra Dalili Kajan

  3. Department of Maxillofacial Radiology, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran

    Soophia Yaghoobi & Negar Khosravifard

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  1. Faezeh Kashi
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Correspondence to Zahra Dalili Kajan.

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Kashi, F., Dalili Kajan, Z., Yaghoobi, S. et al. Frequency of Accessory Maxillary Ostium in Patients With/Without Sinusitis, and Its Correlation with Anatomical Variations of Paranasal Sinuses: A Cone Beam Computed Tomography Study. Indian J Otolaryngol Head Neck Surg 76, 1645–1654 (2024). https://doi.org/10.1007/s12070-023-04376-y

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