Osteomeatal Complex: A Study of Its Anatomical Variation Among Patients Attending North Bengal Medical College and Hospital

Abstract

Lateral nasal wall of each nasal cavity provides the final common pathway of drainage of the mucociliary clearance of frontal, maxillary and anterior ethmoidal air cells. Anatomical variants like concha bullosa, Haller cells, agger nasi cells, enlarged bulla ethmoidalis may obstruct the mucociliary clearance through osteomeatal complex and cause rhino sinusitis. The objectives were to find out the anatomical variation of osteomeatal complex and its dimensions when present. The present study was a descriptive, hospital based cross sectional study carried out in the outpatient departments of North Bengal Medical College and Hospital, West Bengal, India, among patients aged 15 years and above. Coronal CT scan of paranasal sinus and orbit region was done. Data was collected with the help of semi structured predesigned and pretested questionnaire. Of the 44 study patients, 15.9 % had concha bullosa, 11.36 % had paradoxical middle concha, 27.3 % had Haller cell, 18.2 % had agger nasi cell. Lateral attachment and medial free margin of uncinate process were also measured in respect to medial body line. 77.3, 59.1 and 47.7 % had sneezing, rhinorrhoea and headache respectively. The harmony of mucociliary clearance and obstruction free osteomeatal complex is the key factor for ventilation and drainage of maxillary, frontal and anterior ethmoidal air cells.

Agger Nasi Cells Versus Lacrimal Cells and Uncinate Bullae in Cone-Beam Computed Tomography

“…During fetal development, in the lateral nasal wall, ridges or folds called ethmoturbinals form, and these have ascending anterior and descending posteroinferior portions. 7 The ascending portion of the first ethmoturbinal remains as the agger nasi. 7 Bone pneumatization at the agger nasi ridge is an ANC.…”

“…7 The ascending portion of the first ethmoturbinal remains as the agger nasi. 7 Bone pneumatization at the agger nasi ridge is an ANC.…”

“…2 We used these landmarks in our study, and we found that true ANCs were absent, but they could be imitated by LCs (types I and III), in 53% of cases. When anatomical diagnoses are performed on CT slices, it should not simply be assumed that ''the most anterior air cell in the lateral nasal wall is the ANC'' 7,8 ; rather, the middle turbinate and lacrimal and maxillary bones should be observed to determine whether the air space is an ANC or just an LC. An air cell above the anterior end of the middle turbinate on coronal CT is not an ANC, as some authors have indicated, 8 but an LC.…”

“…17 A frequency of 18.2% for ANCs was reported in one study, but these were identified as ''the most anterior ethmoidal cell, situated below the frontal sinus, next to the frontal recess, representing the lacrimal bone pneumatization due to ethmoidal extension.'' 7 This definition undoubtedly indicates LCs and not ANCs.…”

Clinicoradiological Comparative Study of Obstructive Osteomeatal Complexin Cases of Rhinosinusitis

“…However, this difference was statistically not signi icant as per Student ttest(p>0.05)Sachdeva P et al (Aramani, 2014)study assessing the event of anatomical varieties of osteomeatal complex (OMC) and evaluating its connection in the causation of constant rhino sinusitis discovered more signi icant part of patients were found in 18-24 years old gathering (29%) with guys commanding the investigation (M: F = 1.7:1). Aramani An et al (Bandyopadhyay et al, 2015) spellbinding cross-sectional examination coniguration surveying the anatomical varieties of osteomeatal complex in incessant sinusitis patients discovered range 13 to 70 y. 73% of the patients were generally more youthful as they were either equivalent to or under a multi-year old enough with the equivalent extent of the patients in the age gatherings of 21-30 y and 31-40 y.…”