Novosti
Khirurgii
This journal is
indexed in Scopus



Year 2019 Vol. 27 No 2

MAXILLOFACIAL SUGERY

DOI: https://dx.doi.org/10.18484/2305-0047.2019.2.168   |  

V. ALEKSEEVA, A. LUPYR, N. UREVICH, R. NAZARYAN, V. GARGIN

SIGNIFICANCE OF ANATOMICAL VARIATIONS OF MAXILLARY SINUS AND OSTIOMEATAL COMPONENTS COMPLEX IN SURGICAL TREATMENT OF SINUSITIS

Kharkiv National Medical University, Kharkiv,
Ukraine

Objective. Determining the anatomical variability of the upper maxillary sinus and ostiomeatal complex components as well as on the basis of the obtained data the selection of the optimal access to the zones of the maxillary sinus to choose sinusitis treatment method, which allows minimizing intra- and postoperative complications.
Methods. The results of studies of the paranasal sinuses of 30 patients conducted on the spiral computed tomography were studied: 10 with the subtotal reduction of pneumatization of the maxillary sinus and 10 patients with hyperplasia of the mucous membrane. The control group included 10 SCTs of healthy individuals. The average volume, bone density of the maxillary sinus, the average size of the inferior nasal turbinate, the size, density of processus uncinatus under physiological and pathological conditions, the correlation between these parameters were determined.
Results. A significant correlation (r=0.96, 0.96, 0.95, and 0.9 in the physiological state and r=0.95, 0.94, 0.97, and 0.91 in sinusitis) was noted between the volume, thickness and the density of the walls of the maxillary sinus. A moderate correlation was between the volume of the sinus, the thickness and density of the processus uncinatus, the volume of the sinus and the longitudinal size of the inferior turbinate in the unchanged sinus (r=0.65, 0.68 and 0.66). A very strong correlation was between the thickness of the upper wall and the volume of the sinus (r=0.96). A strong positive linear relationship (r=0.72) is noted between the volume and thickness of the medial wall (p<0.05). The reliable (p<0.01) strong (r=0.75) interconnection was between the thickness of the processus uncinatus and the average sinus volume. Very strong linear correlation was between the density of the middle and upper walls of the maxillary sinus in physiological and pathological conditions (r=0.9 and 0.84)
Conclusions. Spiral computed tomography is a diagnostically significant method for the study of the maxillary sinuses. Parameters of the paranasal sinuses necessary for successful endoscopic rhinosurgery were determined. The obtained data helps to choose access during endoscopic operations, to prevent intra-, postoperative complications, to predict the likelihood of intracranial or intraocular spread of the pathological process.

Keywords: paranasal sinuses, maxillary sinus, density, processus uncinatus, inferior turbinate
p. 168-176 of the original issue
References
  1. Shcherbakov DA, Kryukov AI, Krasnozhen VN, Hukumatshoev AI, Karimova AI. Certain morphometric characteristics of the normal maxillary sinus. [Article in Russian]; Abstract available in Russian from the publisher Vestn Otorinolaringol. 2017;82(4):44-47. doi: 10.17116/otorino201782444-47
  2. Denga O, Pyndus T, Gargin V, Schneider S. Influence of metabolic syndrome on condition of microcirculatory bed of oral cavity. Georgian Med News. 2017 Dec;(273):99-104. http://www.geomednews.org/
  3. Tahmasbi-Arashlow M, Barghan S, Bennett J, Katkar RA, Nair MK. Arrested pneumatization of the sphenoid sinus on large field-of-view cone beam computed tomography studies. Dent J (Basel). 2015 May 11;3(2):67-76. doi: 10.3390/dj3020067
  4. Fokkens WJ, Bachert C, Bernal-Sprekelsen M, Bousquet J, Djandji M, Dorenbaum A, Hakimi-Mehr D, Hendry S, Hopkins C, Leunig A, Mannent L, Mucha D, Onerci M, Pugin B, Toppila-Salmi S, Rowe P, Seys SF, Stimson S, Strzembosz A, Hellings PW. Rhinology Future Debates, an EUFOREA Report. Rhinology. 2017 Dec 1;55(4):298-304. doi: 10.4193/Rhin17.221
  5. Kovach I, Buniatian K, Makarevych A, Verbyts’ka A, Gargin V. Influence of tricalcium silicate on course of traumatic pulpitis. Georgian Med News. 2018 Mar;(276):130-34. http://www.geomednews.org/
  6. Drumond JP, Allegro BB, Novo NF, de Miranda SL, Sendyk WR. Evaluation of the prevalence of maxillary sinuses abnormalities through spiral computed tomography (CT). Int Arch Otorhinolaryngol. 2017 Apr;21(2):126-33. doi: 10.1055/s-0036-1593834
  7. Farneti P, Sciarretta V, Macrì G, Piccin O, Pasquini E. Silent sinus syndrome and maxillary sinus atelectasis in children. Int J Pediatr Otorhinolaryngol. 2017 Jul;98:150-57. doi: 10.1016/j.ijporl.2017.05.005
  8. Bhushan B, Rychlik K, Schroeder JW Jr. Development of the maxillary sinus in infants and children. Int J Pediatr Otorhinolaryngol. 2016 Dec;91:146-51. doi: 10.1016/j.ijporl.2016.10.022
  9. Piskunov SZ, Piskunov IS, Piskunov VS. The anatomic features and functional and clinical value of the hamulus. Ros Rinologiia. 2014;22(3):26-32. https://www.mediasphera.ru/issues/rossijskaya-rinologiya/2014/3/030869-5474201436 (in Russ.)
  10. Mendiratta V, Baisakhiya N, Singh D, Datta G, Mittal A, Mendiratta P. Sinonasal anatomical variants: CT and endoscopy study and its correlation with extent of disease. Indian J Otolaryngol Head Neck Surg. 2016 Sep;68(3):352-58. doi: 10.1007/s12070-015-0920-x
  11. Socher JA, Mello J, Baltha BB. Tomographical findings in adult patients undergoing endoscopic sinus surgery revision. Int Arch Otorhinolaryngol. 2018 Jan;22(1):73-80. doi: 10.1055/s-0037-1601417
  12. Liu J, Dai J, Wen X, Wang Y, Zhang Y, Wang N. Imaging and anatomical features of ethmomaxillary sinus and its differentiation from surrounding air cells. Surg Radiol Anat. 2018 Feb;40(2):207-15. doi: 10.1007/s00276-018-1974-8
  13. Magill D, Beckmann N, Felice MA, Yoo T, Luo M, Mupparapu M. Investigation of dental cone-beam CT pixel data and a modified method for conversion to Hounsfield unit (HU). Dentomaxillofac Radiol. 2018 Feb;47(2):20170321. doi: 10.1259/dmfr.20170321
  14. Baimenov AZ. The early prophylaxis of postoperative stenosis by means of modified endonasal functional dacryocystorhinostomy. Vestn Otorinolaringol. 2015;80(2):60-62. doi: 10.17116/otorino201580260-62
  15. Kaya M, Çankal F, Gumusok M, Apaydin N, Tekdemir I. Role of anatomic variations of paranasal sinuses on the prevalence of sinusitis: Computed tomography findings of 350 patients. Niger J Clin Pract. 2017 Nov;20(11):1481-88. doi: 10.4103/njcp.njcp_199_16
Address for correspondence:
61022, Ukraine,
Kharkiv, Nauki Ave., 4,
Kharkiv National Medical University,
Department of Histology,
Cytology and Embryology.
Tel. +380982589078,
e-mail: vik13052130@i.ua,
Victoriia V. Alekseeva
Information about the authors:
Lupyr Andrii V., MD, Associate Professor of Otolaryngology Department, Kharkiv National Medical University, Kharkiv, Ukraine.
https://orcid.org/0000-0002-9896-163X
Alekseeva Victoriia V., Assistant of the Department of Histology, Cytology and Embryology, Kharkiv National Medical University, Kharkiv, Ukraine.
https://orcid.org/0000-0001-5272-8704
Urevich Nadejda A., PhD, Associate Professor of Otolaryngology Department, Kharkiv National Medical University, Kharkiv, Ukraine.
http://orcid.org/0000-0001-7340-2850
Nazaryan, Rosana S., MD, Professor, Head of the Department of Pediatric Dentistry, Pediatric Maxillofacial Surgery and Implantology, Kharkiv National Medical University, Kharkiv, Ukraine.
http://orcid.org/0000-0002-0005-8777
Gargin Vitaliy V, MD, Professor of the Pathologic Anatomy Department, Kharkiv National Medical University, Kharkiv, Ukraine.
http://orcid.org/0000-0001-8194-4019
Contacts | ©Vitebsk State Medical University, 2007