DOI QR코드

DOI QR Code

Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance

  • Ali, Ibrahim K. (Department of Oral Medicine and Radiology, Nair Hospital Dental College) ;
  • Sansare, Kaustubh (Department of Oral Medicine and Radiology, Nair Hospital Dental College) ;
  • Karjodkar, Freny R. (Department of Oral Medicine and Radiology, Nair Hospital Dental College) ;
  • Vanga, Kavita (Department of Oral Medicine and Radiology, Nair Hospital Dental College) ;
  • Salve, Prashant (Department of Oral Medicine and Radiology, Nair Hospital Dental College) ;
  • Pawar, Ajinkya M. (Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College)
  • Received : 2016.11.19
  • Accepted : 2017.01.27
  • Published : 2017.03.31

Abstract

Purpose: This study aimed to evaluate the prevalence of Haller cells and accessory maxillary ostium (AMO) in cone-beam computed tomography (CBCT) images, and to analyze the relationships among Haller cells, AMO, and maxillary sinusitis. Materials and Methods: Volumetric CBCT scans from 201 patients were retrieved from our institution's Digital Imaging and Communications in Medicine archive folder. Two observers evaluated the presence of Haller cells, AMO, and maxillary sinusitis in the CBCT scans. Results: AMO was observed in 114 patients, of whom 27 (23.7%) had AMO exclusively on the right side, 26 (22.8%) only on the left side, and 61 (53.5%) bilaterally. Haller cells were identified in 73 (36.3%) patients. In 24 (32.9%) they were present exclusively on the right side, in 17 (23.3%) they were only present on the left side, and in 32 (43.8%) they were located bilaterally. Of the 73 (36.3%) patients with Haller cells, maxillary sinusitis was also present in 50 (68.5%). On using chi-square test, a significant association was observed between AMO and maxillary sinusitis in the presence of Haller cells. Conclusion: Our results showed AMO and Haller cells to be associated with maxillary sinusitis. This study provides evidence for the usefulness of CBCT in imaging the bony anatomy of the sinonasal complex with significantly higher precision and a smaller radiation dose.

Keywords

References

  1. Som PM. CT of the paranasal sinuses. Neuroradiology 1985; 27: 189-201. https://doi.org/10.1007/BF00344487
  2. Lloyd GA. CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. J Laryngol Otol 1990; 104: 477-81. https://doi.org/10.1017/S0022215100112927
  3. Yenigun A, Fazliogullari Z, Gun C, Uysal II, Nayman A, Karabulut AK. The effect of the presence of the accessory maxillary ostium on the maxillary sinus. Eur Arch Otorhinolaryngol 2016; 273: 4315-9. https://doi.org/10.1007/s00405-016-4129-8
  4. Genc S, Ozcan M, Titiz A, Unal A. Development of maxillary accessory ostium following sinusitis in rabbits. Rhinology 2008; 46: 121-4.
  5. Mladina R, Vukovic K, Poje G. The two holes syndrome. Am J Rhinol Allergy 2009; 23: 602-4. https://doi.org/10.2500/ajra.2009.23.3375
  6. Kane KJ. Recirculation of mucus as a cause of persistent sinusitis. Am J Rhinol 1997; 11: 361-9. https://doi.org/10.2500/105065897781286034
  7. Gutman M, Houser S. Iatrogenic maxillary sinus recirculation and beyond. Ear Nose Throat J 2003; 82 :61-3.
  8. Mathew R, Omami G, Hand A, Fellows D, Lurie A. Cone beam CT analysis of Haller cells: prevalence and clinical significance. Dentomaxillofac Radiol 2013; 42: 20130055. https://doi.org/10.1259/dmfr.20130055
  9. Stammberger H, Wolf G. Headaches and sinus disease: the endoscopic approach. Ann Otol Rhinol Laryngol Suppl 1988; 97: 3-23.
  10. Stackpole SA, Edelstein DR. The anatomic relevance of the Haller cell in sinusitis. Am J Rhinol 1997; 11: 219-23. https://doi.org/10.2500/105065897781751910
  11. 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. https://doi.org/10.1016/j.ejrad.2003.08.012
  12. Rafferty MA, Siewerdsen JH, Chan Y, Moseley DJ, Daly MJ, Jaffray DA, et al. Investigation of C-arm cone-beam CT-guided surgery of the frontal recess. Laryngoscope 2005; 115: 2138-43. https://doi.org/10.1097/01.mlg.0000180759.52082.45
  13. Jackman AH, Palmer JN, Chiu AG, Kennedy DW. Use of intraoperative CT scanning in endoscopic sinus surgery: a preliminary report. Am J Rhinol 2008; 22: 170-4. https://doi.org/10.2500/ajr.2008.22.3153
  14. Batra PS, Kanowitz SJ, Citardi MJ. Clinical utility of intraoperative volume computed tomography scanner for endoscopic sinonasal and skull base procedures. Am J Rhinol 2008; 22: 511-5. https://doi.org/10.2500/ajr.2008.22.3216
  15. Kumar H, Choudhry R, Kakar S. Accessory maxillary ostia: topography and clinical application. J Anat Soc India 2001; 50: 3-5.
  16. Jog M, McGarry GW. How frequent are accessory sinus ostia? J Laryngol Otol 2003; 117: 270-2.
  17. Earwaker J. Anatomic variants in sinonasal CT. Radiographics 1993; 13: 381-415. https://doi.org/10.1148/radiographics.13.2.8460226
  18. May M, Sobol SM, Korzec K. The location of the maxillary os and its importance to the endoscopic sinus surgeon. Laryngoscope 1990; 100: 1037-42. https://doi.org/10.1288/00005537-199010000-00002
  19. Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 1991; 101: 56-64.
  20. Perez-Pinas I, Sabate J, Carmona A, Catalina-Herrera CJ, Jimenez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat 2000; 197: 221-7. https://doi.org/10.1017/S0021878299006500
  21. Rysz M, Bakon L. Maxillary sinus anatomy variation and nasal cavity width: structural computed tomography imaging. Folia Morphol (Warsz) 2009; 68: 260-4.

Cited by

  1. Accessory maxillary ostium repair using middle turbinate flap: a case series of 116 patients with chronic rhinosinusitis : Accessory ostium repair in CRS vol.8, pp.10, 2017, https://doi.org/10.1002/alr.22159
  2. Clinical Significance of Haller Cells: A Cone Beam Computed Tomography Study vol.9, pp.3, 2017, https://doi.org/10.5005/jp-journals-10015-1538
  3. Cone Beam Computed Tomography Evaluation of Maxillary Sinus Before and After Sinus Floor Elevation vol.73, pp.4, 2019, https://doi.org/10.2478/prolas-2019-0060
  4. Visibility, location, and morphology of the primary maxillary sinus ostium and presence of accessory ostia: a retrospective analysis using cone beam computed tomography (CBCT) vol.23, pp.11, 2017, https://doi.org/10.1007/s00784-019-02829-9
  5. CBCT analysis of haller cells: relationship with accessory maxillary ostium and maxillary sinus pathologies vol.37, pp.3, 2017, https://doi.org/10.1007/s11282-020-00487-2
  6. Investigation of the accessory maxillary ostium: a congenital variation or acquired defect? vol.50, pp.6, 2017, https://doi.org/10.1259/dmfr.20200575