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An endoscopic cadaveric study: Accessory maxillary ostia

Year 2014, Volume: 41 Issue: 2, 262 - 267, 01.06.2014
https://doi.org/10.5798/diclemedj.0921.2014.02.0413

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.

References

  • Anon JB. Klimek L. Mosges R, Z. S. Computer-assisted en- doscopic sinus surgery: an international review. Otol Clin North Am 1997;30:389-401.
  • Celis L, Melcón M, Calvo F, et al. Complications of endo- scopic sinus surgery in a residency training program . Acta Otorrinolaringol Esp 2010; 61: 345−350.
  • Zinreich SJ., K. D., Rosenbaum AE., Gayler BW., et al. Pa- ranasal sinuses: CT Imaging requirements for endoscopic surgery. Radiology 1987;163:769-775.
  • Aydınlıoğlu A, D. S., Şakul BU, Keleş P, et al. Burun dış duvarı anatomisinin Endoskobik Sinüs Cerrahisi Açısından İncelenmesi. Türkiye Klinikleri Diş Hekimliği Bilimleri Dergisi. 1996;20:89-93.
  • Champsaur P, Pascal T, Vidal V, et al. Radioanatomy of the paranasal sinuses. J Radiol 2003;84:885-900.
  • Tür A. [Sinüs Hastalıkları Özkarakaş H, Yıldırım N. İstanbul; Nobel Tıp Kitabevleri; 2003;8:57-68.
  • Genc S., O. M., Titiz A, Unal A . Development of maxillary accessory ostium following sinusitis in rabbits. Rhinology 2008;46:121-124.
  • Joe JK, HoSY, Yanagisawa E. Documentation of variations in sinonasal anatomy by intraoperative nasal endoscopy . Laryngoscope 2000;110:229-235.
  • Jones NS. CT of the paranasal sinuses: A review of the corre- lation with clinical, surgical and histopathological findings. Clin Otolaryngol Allied Sci 2002; 27:11-17.
  • Lang J. Clinical anatomy of the nose, nasal cavity and pa- ranasal sinuses. New York, Thieme Medical Publishers Inc. 1989;25:57-69.
  • May MS, Korzec K. The location of the maxillary os and its importance to the endoscopic sinus surgeon. Laryngoscope 1990;100:1037-1042.
  • Kuma RH, Kaka RS. Accessory Maxillary Ostia: Topogra- phy and Clinical Application. J Anat Soc India. 2001;50:3- 5.
  • Jog M, M. GW. How frequent are accessory sinus ostia? J Laryngol Otol. 2003;117:270-272.
  • Youngs R., E. K., Watson M. Paranasal Sinuses A Hand- book of Applied Surgical Anatomy 2006;135:339
  • Matthews BL, Burke AJ. Recirculation of mucus via acces- sory ostia causing chronic maxillary sinus disease. Otolar- yngol Head Neck Surg 1997;117:422-423.
  • Balasubramanian T. Advanced anatomy of lateral nasal wall: For the endoscopic sinus surgeon. Otolaryngol Online J Rhinol 2012;2:4-9.
  • Stammberger H. Functional Endoscopic Sinus Surgery. The Messerklinger technique. Philadelphia, B.C. Decker, 1990;247:63-76.
  • Wilkerson WW. Antral window in the middle meatus. Arch Ophthalmol 1949;49:463-489 .
  • Kennedy DW. The functional endoscopic approach to in- flammatory sinus disease: currentperspectives and tech- nique modifications. Am J Rhinol 1988;2:89-96.
  • Zinreich SJ. Paranasal sinüs imaging. Otolaryngol Head Neck Surg 1990;103:863-869.
  • Kane KJ. Recirculation of mucus as a cause of persistent sinusiti . Am J Rhinol 1997;11:361-369.
  • Myerson MC. The natural orifice of the maxillary sinus: I . Anatomic Studies Arch Otolaryngol Head Neck Surg 1932;15:80-91.
  • Schaeffer JP. The lateral wall of the cavum nasi in man, with especial reference to the various developmental stages. J Morphology 1910;21:613-707.
  • Van Alyea OE. Ostium maksillare: anatomic study of its surgical accessibility. Arch Otolaryng Head and Neck Surg. 1936;24:552-569.
  • Porter GT, Quinn FB. Paranasal Sinuses: Anatomy and Function. The University of Texas Medical Branch (UTMB), Department of Otolaryngology, Galveston TX January Grand Rounds presentation. 2002;1:1-3.
  • Salman SD. Complications of endoscopic sinus surgery. Am J Otolaryngol 1991;12:326-328.
  • Van Alyea OE. Management of chronic sinus disease. Ann Otol Rhinol & Laryngol 1945;54:443-457 .
  • Earwaker J. Anatomic variants in sinonasal CT. Radio- Graphics 1993;13:381-415.
  • Chung SK, Na DG. Mucus circulation between accessory ostium and natural ostium of maxillary sinus. J Laryngol & Otology 1999;113:865-867.
  • Prasanna LC. The location of maxillary sinus ostium and its clinical application. Indian J Otolaryngol Head Neck Surg 2010;62:335-337.

Endoskopik kadavra çalışması: Aksesuar maksiller ostium

Year 2014, Volume: 41 Issue: 2, 262 - 267, 01.06.2014
https://doi.org/10.5798/diclemedj.0921.2014.02.0413

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.

References

  • Anon JB. Klimek L. Mosges R, Z. S. Computer-assisted en- doscopic sinus surgery: an international review. Otol Clin North Am 1997;30:389-401.
  • Celis L, Melcón M, Calvo F, et al. Complications of endo- scopic sinus surgery in a residency training program . Acta Otorrinolaringol Esp 2010; 61: 345−350.
  • Zinreich SJ., K. D., Rosenbaum AE., Gayler BW., et al. Pa- ranasal sinuses: CT Imaging requirements for endoscopic surgery. Radiology 1987;163:769-775.
  • Aydınlıoğlu A, D. S., Şakul BU, Keleş P, et al. Burun dış duvarı anatomisinin Endoskobik Sinüs Cerrahisi Açısından İncelenmesi. Türkiye Klinikleri Diş Hekimliği Bilimleri Dergisi. 1996;20:89-93.
  • Champsaur P, Pascal T, Vidal V, et al. Radioanatomy of the paranasal sinuses. J Radiol 2003;84:885-900.
  • Tür A. [Sinüs Hastalıkları Özkarakaş H, Yıldırım N. İstanbul; Nobel Tıp Kitabevleri; 2003;8:57-68.
  • Genc S., O. M., Titiz A, Unal A . Development of maxillary accessory ostium following sinusitis in rabbits. Rhinology 2008;46:121-124.
  • Joe JK, HoSY, Yanagisawa E. Documentation of variations in sinonasal anatomy by intraoperative nasal endoscopy . Laryngoscope 2000;110:229-235.
  • Jones NS. CT of the paranasal sinuses: A review of the corre- lation with clinical, surgical and histopathological findings. Clin Otolaryngol Allied Sci 2002; 27:11-17.
  • Lang J. Clinical anatomy of the nose, nasal cavity and pa- ranasal sinuses. New York, Thieme Medical Publishers Inc. 1989;25:57-69.
  • May MS, Korzec K. The location of the maxillary os and its importance to the endoscopic sinus surgeon. Laryngoscope 1990;100:1037-1042.
  • Kuma RH, Kaka RS. Accessory Maxillary Ostia: Topogra- phy and Clinical Application. J Anat Soc India. 2001;50:3- 5.
  • Jog M, M. GW. How frequent are accessory sinus ostia? J Laryngol Otol. 2003;117:270-272.
  • Youngs R., E. K., Watson M. Paranasal Sinuses A Hand- book of Applied Surgical Anatomy 2006;135:339
  • Matthews BL, Burke AJ. Recirculation of mucus via acces- sory ostia causing chronic maxillary sinus disease. Otolar- yngol Head Neck Surg 1997;117:422-423.
  • Balasubramanian T. Advanced anatomy of lateral nasal wall: For the endoscopic sinus surgeon. Otolaryngol Online J Rhinol 2012;2:4-9.
  • Stammberger H. Functional Endoscopic Sinus Surgery. The Messerklinger technique. Philadelphia, B.C. Decker, 1990;247:63-76.
  • Wilkerson WW. Antral window in the middle meatus. Arch Ophthalmol 1949;49:463-489 .
  • Kennedy DW. The functional endoscopic approach to in- flammatory sinus disease: currentperspectives and tech- nique modifications. Am J Rhinol 1988;2:89-96.
  • Zinreich SJ. Paranasal sinüs imaging. Otolaryngol Head Neck Surg 1990;103:863-869.
  • Kane KJ. Recirculation of mucus as a cause of persistent sinusiti . Am J Rhinol 1997;11:361-369.
  • Myerson MC. The natural orifice of the maxillary sinus: I . Anatomic Studies Arch Otolaryngol Head Neck Surg 1932;15:80-91.
  • Schaeffer JP. The lateral wall of the cavum nasi in man, with especial reference to the various developmental stages. J Morphology 1910;21:613-707.
  • Van Alyea OE. Ostium maksillare: anatomic study of its surgical accessibility. Arch Otolaryng Head and Neck Surg. 1936;24:552-569.
  • Porter GT, Quinn FB. Paranasal Sinuses: Anatomy and Function. The University of Texas Medical Branch (UTMB), Department of Otolaryngology, Galveston TX January Grand Rounds presentation. 2002;1:1-3.
  • Salman SD. Complications of endoscopic sinus surgery. Am J Otolaryngol 1991;12:326-328.
  • Van Alyea OE. Management of chronic sinus disease. Ann Otol Rhinol & Laryngol 1945;54:443-457 .
  • Earwaker J. Anatomic variants in sinonasal CT. Radio- Graphics 1993;13:381-415.
  • Chung SK, Na DG. Mucus circulation between accessory ostium and natural ostium of maxillary sinus. J Laryngol & Otology 1999;113:865-867.
  • Prasanna LC. The location of maxillary sinus ostium and its clinical application. Indian J Otolaryngol Head Neck Surg 2010;62:335-337.
There are 30 citations in total.

Details

Primary Language Turkish
Journal Section Research Articles
Authors

Alper Sindel This is me

Murat Turhan This is me

Eren Ogut

Mehmet Akdağ This is me

Aslı Bostancı This is me

Muzaffer Sindel This is me

Publication Date June 1, 2014
Submission Date March 2, 2015
Published in Issue Year 2014 Volume: 41 Issue: 2

Cite

APA Sindel, A., Turhan, M., Ogut, E., Akdağ, M., et al. (2014). Endoskopik kadavra çalışması: Aksesuar maksiller ostium. Dicle Tıp Dergisi, 41(2), 262-267. https://doi.org/10.5798/diclemedj.0921.2014.02.0413
AMA Sindel A, Turhan M, Ogut E, Akdağ M, Bostancı A, Sindel M. Endoskopik kadavra çalışması: Aksesuar maksiller ostium. diclemedj. June 2014;41(2):262-267. doi:10.5798/diclemedj.0921.2014.02.0413
Chicago Sindel, Alper, Murat Turhan, Eren Ogut, Mehmet Akdağ, Aslı Bostancı, and Muzaffer Sindel. “Endoskopik Kadavra çalışması: Aksesuar Maksiller Ostium”. Dicle Tıp Dergisi 41, no. 2 (June 2014): 262-67. https://doi.org/10.5798/diclemedj.0921.2014.02.0413.
EndNote Sindel A, Turhan M, Ogut E, Akdağ M, Bostancı A, Sindel M (June 1, 2014) Endoskopik kadavra çalışması: Aksesuar maksiller ostium. Dicle Tıp Dergisi 41 2 262–267.
IEEE A. Sindel, M. Turhan, E. Ogut, M. Akdağ, A. Bostancı, and M. Sindel, “Endoskopik kadavra çalışması: Aksesuar maksiller ostium”, diclemedj, vol. 41, no. 2, pp. 262–267, 2014, doi: 10.5798/diclemedj.0921.2014.02.0413.
ISNAD Sindel, Alper et al. “Endoskopik Kadavra çalışması: Aksesuar Maksiller Ostium”. Dicle Tıp Dergisi 41/2 (June 2014), 262-267. https://doi.org/10.5798/diclemedj.0921.2014.02.0413.
JAMA Sindel A, Turhan M, Ogut E, Akdağ M, Bostancı A, Sindel M. Endoskopik kadavra çalışması: Aksesuar maksiller ostium. diclemedj. 2014;41:262–267.
MLA Sindel, Alper et al. “Endoskopik Kadavra çalışması: Aksesuar Maksiller Ostium”. Dicle Tıp Dergisi, vol. 41, no. 2, 2014, pp. 262-7, doi:10.5798/diclemedj.0921.2014.02.0413.
Vancouver Sindel A, Turhan M, Ogut E, Akdağ M, Bostancı A, Sindel M. Endoskopik kadavra çalışması: Aksesuar maksiller ostium. diclemedj. 2014;41(2):262-7.

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