THE ROLE OF THE OSTIOMEATAL UNIT ANATOMIC VARIATIONS IN INFLAMMATORY DISEASE OF THE MAXILLARY SINUSES

Objective: The purpose of the study was to determine the correlation b etween bony anatomic variations of the ostiomeatal unit (OMU) and chro nic maxillary sinusitis. The study was based on the hypothesis that th e mucosal contact caused by the variations represents the critical fac tor in increasing the risk of maxillary sinusitis. Materials and Metho ds: Thin section high resolution computerised tomography (CT) examinat ions of the paranasal sinuses in 73 consecutive patients with 113 anat omic variations of the OMU were retrospectively reviewed. The followin g CT features were assessed: (1) Type of anatomic variations, (2) pres ence of a mucosal contact in the OMU and (3) presence of maxillary dis ease. Statistical evaluation was carried out using chi(2)-test. Result s: The following bony anatomic variations were found: Concha bullosa ( 67 cases), abnormalities of the uncinate process (18 cases), Haller's cells (24 cases) and large ethmoidal bulla (four cases). Only 52 of th e 113 anatomic variations were associated with ipsilateral maxillary d isease (mucosal thickening, mucous retention cysts, polyps, retained s ecretions). Of 113 variations, 44 caused a mucosal contact, 35 of thes e were associated with maxillary abnormalities, while in nine cases th ere were no pathologic changes. Of 69 variations, 17 did not cause muc osal contact (P < 0.05). Conclusion: Our data shows that, in the prese nce of anatomic bony variations. a contact between the mucosal surface of the OMU is valuable in predicting the likelihood of a maxillary in flammatory disease. (C) 1997 Elsevier Science Ireland Ltd.