An endoscopic cadaveric study: Accessory maxillary ostia

Abstract

Objective: Endoscopy is now being used for diagnosis and surgical treatment of disorders of the nose and paranasal sinuses. Direct observations of mucociliary clearance patterns have shown that there are clear cut pathways in the sinuses, with secretions always trying to leave through the natural ostia.' Maxillar ostia is exists behind the upper part of the medial wall and often at intersection region of the rear lower infindubulum and lower front surface of the ethmoid bulla. Accessory ostium exists at the 25-30% of the general population instead of the natural ostium. There are some features that differentiate the accessory ostium and natural ostium. Methods: To determine the incidence and location of the accessory ostium 29 fromaldehyde fixed adult cadaver was examined with endoscope. Results: The accessory ostium is encountered at 8 cases (13.8%). These are located at rare-middle, front-middle and rear in 2 (0.03%), 3 (0.05%), 3 (0.05%) cases respectively. Recognition of the maxillary ostia is tedious while performing endoscopic procedures which accounts for a high rate of orbital complications for a novice performing surgery in this region. Conclusion: It is therefore imperative to know the landmarks in this regions which may be obliterated by disease. Radiologist should be aware of this entity as it can appear as communication between the maxillary sinus and nasal cavity on sinus imaging examinations.

Keywords

• Accessory maxillary ostia, endoscopic study, cadaveric study

Endoskopik kadavra çalışması: Aksesuar maksiller ostium

Abstract

Amaç: Endoskopi burun ve paranazal sinüs hastalıklarının teşhisi ve cerrahi tedavisi için kullanılmaktadır. Direkt gözlem; sekresyonun mukosiliyer açıklıktan her zaman doğal ostium\'a doğru olduğunu göstermiştir. Maksiller sinüs ostiumu medial duvarın arka üst bölümünde, sıklıkla da infindibulum alt arka yarısı ile etmoid bullanın ön alt yüzeyinin kesişme bölgesindedir. Gerçek ostium dışında genel popülasyonun %25-30 kadarında aksesuar ostiuma rastlanır. Yöntemler: Aksesuar ostium\'un lokasyonunu ve insidansını saptamak için formaldehitle fikse edilmiş 29 erişkin kadavrası endoskopla incelendi. Bulgular: Aksesuar ostium 8 vakada görüldü (13,8%). Bunların lokalizasyonu sırasıyla ortaya yakın, ön-orta ve arka [2 (0,03%), 3 (0,05%), 3 (0,05%)] olarak bulundu. Sonuç: Endoskopik işlemleri uygularken maksiller ostium\'u tanımlamak bu bölgedeki cerrahi uygulamalardaki orbital komplikasyonlar için yüksek bir önem taşır. Hastalık nedeni ile oblitere olabileceği için bu bölgedeki belirli noktaları bilmek şarttır. Sinüs görüntülenme yöntemlerinde maksiller sinüsle burun boşluğu arasında iletişim varmış gibi görünebilir bu nedenle radyolog aksesuar maksiller ostium\'un olabileceğinin farkında olmalıdır.

Keywords

• Aksesuar maksiller ostium, endoskopik çalışma, kadavra çalışması

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