The imaging anatomy of ethmomaxillary sinus and its impact on chronic rhinosinusitis
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RHINOLOGY
The imaging anatomy of ethmomaxillary sinus and its impact on chronic rhinosinusitis Fangwei Zhou1 · Cheng Cao1 · Wenjun Fan1 · Lu Tan1 · Peiqiang Liu1 · Hao Lv1 · Yu Xu1,2 Received: 10 June 2020 / Accepted: 24 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of this study was to investigate the pneumatization degree of ethmomaxillary sinus (EMS) and adjacent structures, and its impact on chronic rhinosinusitis (CRS). Methods A retrospective analysis of paranasal sinus CT scans of 996 patients was conducted. The maximum vertical diameter of EMS in the coronal plane was measured, allowing EMS to be classified, and its impact on ipsilateral CRS were examined. Results The prevalence of EMS was 11.9%. The maximum vertical diameter of EMS in the coronal plane ranged from 3.68 to 28.76 mm with a mean (± SD) of 11.32 ± 5.12 mm. The prevalence rates of EMS in CRS sides and non-CRS sides were 12.5% and 9.3%, respectively, which was significantly different (χ2 = 4.495; p 0.05, Table 1) between CRS and non-CRS patients. The medical history review showed that patients underwent paranasal sinus CT scans for different purposes, such as nasal symptoms, headache, maxillofacial discomfort, ocular discomfort, and preoperative evaluation for endoscopic dacryocystorhinostomy. In all of these cases, the bony structures of the ethmoid cells were clearly visible on paranasal sinus imaging. The exclusion criteria were: (1) age less than 18 years; (2) a history of head and sinus trauma; (3) a
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Table 1 Distribution of CRS with respect to gender and age of patients χ2
CRS
Gender Male Female Age (years) 18 ~ < 40 40 ~ < 60 ≥ 60
p value
Present (n = 284) n (%)
Absent (n = 712) n (%)
152 (29.7) 132 (27.3)
360 (70.3) 352 (72.7)
0.712 0.399
117 (29.9) 108 (28.3) 59 (26.3)
274 (70.1) 273 (71.7) 165 (73.7)
0.906 0.636
CRS chronic rhinosinusitis
history of nasal sinus surgery; (4) a history of sinus tumors; (5) a history of craniofacial abnormalities. In this study, the diagnosis of rhinosinusitis was based on the European position paper on rhinosinusitis and nasal polyps (EPOS) [12] and paranasal sinus CT scans, which were performed by two ENT surgeons and a radiologist. This study complied with the Declaration of Helsinki and was approved by the Ethical Committee in our hospital.
CT scan, reconstruction, and observation The CT scanning range was from the superior margin of the frontal sinuses to the inferior margin of the maxillary alveolar process, using a Light Speed GE 64-slice spiral CT (General Electric Medical Systems, Milwaukee, USA) with a bone-imaging algorithm. CT scans were obtained at 0.625 mm section thickness, 0.5 mm intervals, at 120–320 mA and 120 kV. The CT scan images were transmitted to an Advantage Windows back-end workstation. Intermediate window and level settings were 2000 HU and 350 HU. A GE Centricity Enterprise Web 3.0 imaging system was used for viewing and measuring. The characteristics
European Archives of Oto-Rhino-Laryngolog
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