RADIOLOGICAL ANATOMY ANALYSIS OF UNCINATE PROCESS, CONCHA BULLOSA, AND DEVIATED SEPTUM IN CHRONIC RHINOSINUSITIS
ABSTRACT: Risk factors of
chronic rhinosinusitis include epithelial disease related to disturbanceof
mucociliary transport system, anatomical variations obstructing the ostiomeatal
complex anddysfunction of neural regulation.
Purpose: To find the prevalence of deviated septum, concha bullosa
andlateral deflection of the uncinate process in ipsilateral chronic
rhinosinusitis.
Methods: A retrospectivestudy of computed tomographic (CT) scans of
chronic rhinosinusitis patients who were not cured by6 weeks of maximal medical
treatment of rhinosinusitis. Pneumatization of the middle turbinate
anddeviation of the septum were evaluated on coronal slices, while lateral
deflection of the uncinate processwas also assessed by calculating the angle
using Osirix software (Pixmeo, Geneva, Switzerland).
Results:One hundred ninety-three CT scans comprising 386 nasal sides were
analyzed. The prevalence of thecombination of deviated septum, concha bullosa
and lateral deflection of the uncinate process occurringconcurrently with
ipsilateral maxillary sinusitis was found to be 32,9% (p=0.01, OR=9.1, 95%
CI=1.2-69.7). The prevalence of deviated septum with concha bullosa was found
in 40.9% with ipsilateral maxillarysinusitis (p=0.03, OR=3.8, 95% CI=1.1-13.3).
One single anatomical variation of lateral deflection ofthe uncinate process
had a proportion of 71.5% in ipsilateral maxillary sinusitis (p=0.03, OR=2.7
95%CI=1.1-6.9).
Conclusion: Deviated septum, concha bullosa and lateral deflection of the
uncinate processwere frequently present in the existence of ipsilateral chronic
maxillary rhinosinusitis. It suggested greaterassociation compared to one or a
combination of two anatomical variation in the role of local
factorscontributing to sinonasal epithelial dysfunction.
Keywords: chronic
rhinosinusitis, deviated septum, concha bullosa, lateral deflection of uncinate
process
Penulis: Retno Sulistyo
Wardani, Arroyan Wardhana, Endang Mangunkusumo, Vally Wulani, Brent Anthony
Senior
Kode Jurnal: jpkedokterandd170581
