The uncinate process

The uncinate process, for the anatomist, is the first grand lamella. For the surgeon, it is the first structure encountered upon entering the middle meatus and the first critical anatomical landmark. The uncinate serves as the medial boundary of the infun

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The uncinate process, for the anatomist, is the first grand lamella. For the surgeon, it is the first structure encountered upon entering the middle meatus and the first critical anatomical landmark. The uncinate serves as the medial boundary of the infundibul Lim that collects drainage from the maxillary sinus, certain anterior ethmoid cells, and, in some instances, the frontal sinus. It is continuous superiorly with either the middle turbinate, base of skull, or lamina papyracea. Anteriorly it is continuous with the lamina papyracea, marking the anterior limit of the infundibulum. The most posterior and inferior portion of the uncinate process disappears into the membranous portion of the lateral nasal wall, near the posterior fontanelle. The uncinate process is, in most instances, a relatively mobile structure which may be manipulated from either the infundibular or middle meatal side.

Fig. 4.1. Left side, zero degree lens, typical appearance of uncinate at endoscopy.

--------------------------~(Jr--------------------------P. S. Hechl et al., Endoscopic Anatomy of the Paranasal Sinuses © Springer-Verlag Wien 1997

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4.The uncinate process

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Fig. 4.2. Left side, zero degree lens, anterior displacement of uncinate process.

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Fig. 4.3. Left side, zero degree lens, anterior displacement and distortion of uncinate process with a "rolled" edge.

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4.The uncinate process

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Fig. 4.4. CT showing "rolled" uncinate.

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~NW Fig. 4.5. Right side, zero degree lens, another "rolled" uncinate with unusual middle turbinate configuration.

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4.The uncinate process

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Fig. 4.6. Right side, zero degree lens, accessory entrance to infundibulum through the uncinate process; uncinate process itself completely covers the ethmoidal bulla.

Fig. 4.7. CT showing "rolled" uncinate process on left side.

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Fig. 4.8. Left side, zero degree lens, corresponding endoscopic finding from previous CT. Uncinate process well anterior to middle turbinate.

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Fig. 4.9. Left side, zero degree lens, anteriorly displaced uncinate process partially covering middle turbinate.

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4. The uncinate process

Fig. 4.10. Left side, zero degree lens, large middle meatus, small uncinate process.

Fig. 4.11. Right side, zero degree lens, uncinate process and ethmoidal bulla with polypoid change.

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Fig. 4.12. Right side, zero degree lens, same patient showing exit of infundibulum, exposed posterior fontanelle and relationship of uncinate process to ethmoidal bulla.

Fig. 4.13. Right side, 30 degree lens, tail of uncinate being removed.

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