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Morphometry of Paranasal Sinus Anatomy in Chronic Rhinosinusitis
A Pilot Study
Nicholas C. Saunders, FRCS;
Martin A. Birchall, MD, FRCS;
Susan J. Armstrong, FRCR;
Norman Killingback, BDS;
G. David Singh, PhD
Arch Otolaryngol Head Neck Surg. 1998;124:656-658.
Objectives To test the null hypothesis that there is no relationship between anatomical variations around the ostiomeatal complex and a predisposition to chronic rhinosinusitis and to define such variations with increased precision.
Design Case-control study of anatomical variations in diseased and normal sinuses. Eight homologous landmarks defining the ostiomeatal complex were located on coronal computed tomographic scans, and their x and y coordinates were digitized using image analysis.
Subjects Ten patients with unilateral sinus disease and 10 subjects without sinus disease (scanned for facial pain) who were selected retrospectively by case-note analysis.
Results Logistic regression showed that the only significant spatial change predictive of a person with rhinosinusitis was the vertical position of the middle turbinate (P=.04), although this was not confirmed by Wilcoxon testing (P>.10). When examined by sinus, however, the horizontal position of the uncinate process was more laterally placed in persons with rhinosinusitis (P=.01), confirmed on Wilcoxon testing (P=.04), but there was no significant difference when compared with sinuses in persons without rhinosinusitis.
Conclusions Our findings suggest that there are no anatomical differences within the ostiomeatal complex between patients with and without rhinosinusitis. Patients with rhinosinusitis, however, are more likely to develop it in the side with a more laterally positioned uncinate process. Further studies, with more patients and more advanced techniques, including thin-plate spline analysis, are indicated.
From the Departments of Otolaryngology–Head and Neck Surgery (Dr Saunders and Birchall) and Radiology (Dr Armstrong), Southmead Hospital, Bristol, England; the Department of Child Dental Health, University of Bristol Dental School (Dr Killingback); and the Department of Dental Surgery, University of Dundee, Dundee, Scotland (Dr Singh).
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