Incidence of accessory ostia in patients with chronic maxillary sinusitis

Abstract

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Chronic maxillary sinusitisis is one of the most frequent diseases presenting in ENT out patient department seeking medical attention<sup>.</sup><strong> </strong>Defects in the fontanelle region of the lateral nasal wall have been described as accessory ostia. The presence of AMO in both pre and post operated cases of chronic maxillary sinusitis can cause recirculation of mucus leading to recurrences. In the present study we will investigate the incidence of accessory ostia in patients with clinical and radiological signs of chronic maxillary sinusitis. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The study included 100 patients visiting the out patient department of Shri Sathya Sai Medical College and Research Institute selected according to inclusion criteria with a clinical diagnosis of chronic rhino sinusitis which was confirmed by high resolution CT scan and those patients were subjected to diagnostic nasal endoscopy under local anesthesia. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study group consisted of total 100 patients among whom 56 were male patients and 44 were female patients. Accessory maxillary ostia were detected in 23% of the cases and in rest of the 77% cases it was absent. Among the 23 cases in 35% cases accessory ostia were found to be bilateral and in 65% cases it was found to be unilateral. Among the cases where accessory ostia were seen, in 39% cases only accessory ostia were found. Where as in 17.39% cases it was associated with concha bullosa, in 65.2% cases there was deviated nasal septum and in 8.7% cases paradoxical middle turbinate were found to be present. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">To conclude, the present study revealed close association of accessory ostia with chronic maxillary rhino sinusitis. It was also found that majority of the cases accessory ostia were found to be unilateral and were frequently found in the posterior fontanelle region.</span></p>

A Study on the Association Between Accessory Maxillary Ostium and Maxillary Sinus Mucosal Thickening Using Cone Beam Computed Tomography

“…[6] In our study there was no statistically signi cant difference in the occurrence of AMOs between male and female subjects, although the occurrence was numerically higher in male subjects. Similar observations were found in the studies by Bani-Ata et al and Ghosh et al [1,7] However, Hung K et al found AMOs to be more commonly present in, CBCT scans of female subjects. 9 It is important to note that there was no statistical difference in terms of gender in any of the studies reiterating the fact that, gender had no signi cant in uence on the occurrence of AMO.…”

“…[6,20,21] In another CT and endoscopy-based research on the Indian population conducted in 2018, AMOs were found in 23 percent of the cohort. [1] Similar percentages were reported by purely endoscopic studies in the Indian population. [19] AMOs were reported in 13.8-26% of the cadavers as per few recently study published anatomical studies.…”

“…[30,31] In most studies, the frequency of AMOs has not been signi cantly dependent on the age group. [1,6,7,18] However, there was a higher prevalence of AMOs in older age groups in one study by Dedeoğlu N and Altun O. The authors attributed the greater incidence of AMOs in the elderly to be due to the age-related phenomenon and the resorption phenomenon that accompanied age-related edentulism.…”

<p>Accessory Maxillary Ostia: Prevalence of an Anatomical Variant and Association with Chronic Sinusitis</p>

“…1 Another study also showed this association and recommended including the posterior or anterior fontanelle when performing middle meatal antrostomy to reduce mucus recirculation. 2 In addition, Capelli et al found that maxillary mucosa thickness ≥2 mm and closure of the natural maxillary ostium were significantly associated with chronic rhinosinusitis; common anatomical variants, including concha bullosa, Haller cells, and accessory maxillary ostia, were not. 13 Yenigun et al reported that the presence of accessory maxillary ostium was associated with an approximately threefold increase in the incidence of mucus retention cysts and a two-fold increase in the incidence of mucosal thickening and maxillary sinusitis.…”

“…The accessory ostium of the maxillary air sinus is an anatomical variation that may play a role in the development of chronic sinusitis. 1,2 Accessory maxillary ostia are most commonly located in the posterior nasal fontanelle of the middle meatus and may occur unilaterally or bilaterally. 3,4 Accessory maxillary ostium is usually located on the lateral nasal wall, and should not be confused with the maxillary hiatus.…”