Prevalence of pneumatized uncinate process and accompanying neighboring variations

Yıl 2016, Cilt: 26 Sayı: 4, 195 - 200, 10.09.2016

Alper Yenigün Cihat Gün İsmihan İlknur Uysal Musa Kemal Keleş Alaaddin Nayman Ahmet Kağan Karabulut

Öz

Objectives: This study aims to investigate the prevalence of uncinate process UP pneumatization and also to investigate the association of UP pneumatization with concurrent morphological variations in neighboring structures and the presence of maxillary sinusitis. Patients and Methods: This was a retrospective study where coronal computed tomography scans of 1,500 UPs in 750 patients 483 males, 267 females; mean age 36.3±14.7 years; range 7 to 84 years were examined to determine the prevalence of UP pneumatization and to assess any concurrent neighboring anatomical structures and the presence of maxillary sinusitis between January 2013 and June 2013. Results: Uncinate process pneumatization was identified in a total of 6.26% of our patients with 1.60% being bilateral, 2.53% on the right only, and 2.13% on the left side only. Other than concurrent occurrences of right maxillary sinus septa p=0.046 , growth of the right ethmoidal bulla p=0.044 and presence of maxillary sinusitis right side: p=0.046, left side: p=0.035 were seen. Conclusion: We detected a 6.2% prevalence of UP pneumatization in our study group. An abnormally sized and over-pneumatized UP can cause narrowing of the infundibulum and impaired sinus drainage. Such functional blockage can lead to recurrent maxillary sinusitis, stuffiness, and decreased olfaction.

Anahtar Kelimeler

Computed tomography, paranasal sinus, pneumatized, sinusitis, uncinate process

Pnömatize unsinat proses prevalansı ve komşu varyasyonlar ile birlikteliği

Öz

Amaç: Bu çalışmada pnömatizasyon unsinat proses UP prevalansı ve UP pnömatizasyonun komşu yapılarda eşzamanlı morfolojik varyasyonları ve maksiller sinüzit varlığı ile ilişkisi araştırıldı.Hastalar ve Yöntemler: Bu retrospektif çalışmada, Ocak 2013 - Haziran 2013 tarihleri arasında, 750 hastanın 483 erkek, 267 kadın; ort. yaş 36.3±14.7 yıl; dağılım 7-84 yıl 1500 UP koronal bilgisayarlı tomografi taramaları, UP pnömatizasyonu prevalansını belirlemek ve herhangi bir eşzamanlı komşu anatomik yapıyı ve maksiller sinüzit varlığını değerlendirmek üzere incelendi.Bulgular: Unsinat proses pnömatizasyonu, hastalarımızın %1.60’ında iki taraflı, %2.53’ünde yalnız sağ tarafta ve %2.13’ünde yalnız sol tarafta olmak üzere toplam %6.26’sında tespit edildi. Sağ maksiller sinus septanın p=0.046 eşzamanlı oluşumu dışında, sağ etmoidal bulla büyümesi p=0.044 ve maksiller sinüzit varlığı sağ taraf: p=0.046, sol taraf: p=0.035 görüldü.Sonuç: Çalışma grubumuzda %6.2 UP pnömatizasyon prevalansı tespit edildi. Anormal büyüklükte ve aşırı pnömatize UP, infundibulum daralmasına ve bozulmuş sinüs drenajına neden olabilir. Bu tür fonksiyonel blokaj tekrarlayan maksiller sinüzit, burun tıkanıklığı ve koku alma duyusunun azalmasına yol açabilir

Anahtar Kelimeler

Bilgisayarlı tomografi, paranazal sinüs, pnömatize, sinüzit, unsinat proses

Kaynakça

• Prescher A. Paranasal sinuses. In: Stucker FJ, de Souza C, Kenyon GS, Lian TS, Draf W, Schick B, editors. Rhinology and Facial Plastic Surgery. Berlin: Springer- Verlag; 2009. p. 498-503.
• Neskey D, Eloy JA, Casiano RR. Nasal, septal, and turbinate anatomy and embryology. Otolaryngol Clin North Am 2009;42:193-205.
• Burrows SA. Mucocele of a pneumatised uncinate process: first reported case. J Laryngol Otol 2011;125:635-7.
• Beale TJ, Madani G, Morley SJ. Imaging of the paranasal sinuses and nasal cavity: normal anatomy and clinically relevant anatomical variants. Semin Ultrasound CT MR 2009;30:2-16.
• Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol 2004;50:296-302.
• Zinreich SJ. Progress in sinonasal imaging. Ann Otol Rhinol Laryngol Suppl 2006;196:61-5.
• Hauman CH, Chandler NP, Tong DC. Endodontic implications of the maxillary sinus: a review. Int Endod J 2002;35:127-41.
• Cunnane ME, Platt M, Caruso PA, Metson R, Curtin HD. Medialization of the lamina papyracea after endoscopic ethmoidectomy: comparison of preprocedure and postprocedure computed tomographic scans. J Comput Assist Tomogr 2009;33:79-81.
• Stammberger H. The evolution of functional endoscopic sinus surgery. Ear Nose Throat J 1994;73:451, 454-5.
• Joe Jacob K, George S, Preethi S, Arunraj VS. A comparative study between endoscopic middle meatal antrostomy and caldwell-luc surgery in the treatment of chronic maxillary sinusitis. Indian J Otolaryngol Head Neck Surg 2011;63:214-9.
• Donmez BO, Agirdir BV, Sindel MM. Important anatomical landmarks in the lateral nasal wall. Saudi Med J 2005;26:1403-8.
• Scribano E, Ascenti G, Loria G, Cascio F, Gaeta M. The role of the ostiomeatal unit anatomic variations in inflammatory disease of the maxillary sinuses. Eur J Radiol 1997;24:172-4.
• Kennedy DW, Zinreich SJ. The functional endoscopic approach to inflammatory sinus disease: current perspectives and technique modification. Am J Rhino 1988;2:89-96.
• Bolger WE, Woodruff W, Parsons DS. CT demonstration of pneumatization of the uncinate process. AJNR Am J Neuroradiol 1990;11:552.
• Cumberworth VL, Russella J, Colquhouna I, Mackaya IS. Radiology in focus pneumatization of the uncinate process. The Journal of Laryngology and Otology 1993;107:361-2.
• Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol 2004;50:296-302.
• Christmas DA, Mirante JP, Yanagisawa E. A pneumatized uncinate process causing obstruction. Ear Nose Throat J 2005;84:754.
• Lee JH, Kim CJ. Endoscopic view of an uncinate process pyocele. Ear Nose Throat J 2011;90:E28.