An endoscopic study on the prevalence of the accessory maxillary ostium in chronic sinusitis patients
Keywords:AMO, Chronic sinusitis, Nasal endoscopy
Background: Chronic maxillary sinusitis is one of the common ENT problems. Accessory maxillary ostium (AMO) has been postulated in many publications to play a role in the development of chronic maxillary sinusitis. AMO is found in the medial wall of maxillary sinus and located in the lateral wall of the nose. It’s been frequently identified in the routine nasal endoscopy. The variations in the location of AMO have been evaluated by nasal endoscopy in live subjects or through cadaver dissections by many authors. This live study is conducted to identify the prevalence of AMO during nasal endoscopic evaluation of chronic sinusitis patients.
Methods: 52 adult patients with symptoms of chronic sinusitis attending the ENT outpatient department were selected and subjected to X-ray of the paranasal sinuses and laboratory tests. Nasal endoscopy was done in all patients to identify the presence and location of the AMO and the results presented.
Results: In the 52 patients studied the X-ray of the paranasal sinuses showed positive signs of sinusitis in 32 patients (61.5%). During nasal endoscopy in those 32 patients AMO was identified in 20 patients (62.5%).
Conclusions: In patients presenting with symptoms of chronic sinusitis, apart from routine X-ray of the para nasal sinus, identification of the AMO during nasal endoscopy provides an additional evidence of obstruction of the natural ostia of the maxillary sinus. This will be valuable information to the surgeon who is contemplating on a surgical treatment to manage the chronic sinusitis.
Bajaj V, Singh B. Prevalence of anatomical variations of lateral wall of nose in chronic sinusitis patients. J Evol Med Dent Sci. 2015;4(32):5492-505.
Levine HL, Mark M, Rontal M, Rontal E. Complex anatomy of lateral nasal wall simplified for endoscopic sinus surgery. New York: Thieme Medical Publishers; 1993: 1-28.
Lund VJ. Anatomy of nose and paranasal sinuses. In: Kerr AG, Gleeson M, eds. Scott-Brown’s Otolaryngology. 6th ed. Great Britain: Butterworth-Heinemann; 1997: 1.
Daan G Uitenbroek.- SISA-Binomial, 1997. Available at: https://www.quantitativeskills.com/ sisa/distributions/binomial.htm. Accessed on 10 October 2019.
Sindel A, Turhan M, Ogut E, Akdag M, Bostanci A, Sindel M. An endoscopic cadaveric study: accessory maxillary ostia. Dicle Med J. 2014;41(2):262-7.
Yenigun A, Fazliogullari Z, Gun C, Uysal II, Nayman A, Karabulut AK. The effect of the presence of the accessory maxillary ostium on maxillary sinus. Eur arch Otorhinolaryngol. 2016;273:4315.
Singhal M, Singhal D. Maxillary sinus ostium-morphology and its clinical relevance. Cibtech J Surg. 2013;2(3):26-9.
Genc S, Ozcan M, Titiz A, Unal A. Development of maxillary accessory ostium following sinusitis in rabbits. Rhinol. 2008;46:121-4.
Zhu JH, Lee HP, Lim KM, Gordon BR, Wang DY. Effect of accessory ostia on maxillary sinus ventilation: A computational fluid dynamics (CFD) study. Respirator Physiol Neurobiol. 2012;183(2):91-9.
Sahin C, Ozcan M, Unal A. Relationship between development of accessory maxillary sinus and chronic sinusitis. Med J DY Patil Univ. 2015;8:606-8.
Mahajan A, Gupta K, Verma P, Lalit M. Anatomical variations of accessory maxillary sinus ostium: an endoscopic study. Int J Anat Res. 2017;5(1):3485-490.
Kane KJ. Recirculation of mucus as a cause of persistent sinusitis. Am J Rhinol. 1997;11(5):361-70.
Ozel HE, Ozdogan F, Esen E, Genc MG, Genc S, Selcuk A. The association between septal deviation and the presence of a maxillary accessory ostium. Int Forum Allergy Rhinol. 2015;5:1177‐80.
Gujrathi A, Wakode PT. Haziness in X-ray paranasal sinus Water's view in sinusitis: a fact or fiction. Indian J Otolaryngol Head Neck Surg. 2013;65(2):242-6.
Coleman JR, Duncavage JA. Extended middle meatal antrostomy: the treatment of circular flow. Laryngoscope. 1996;106:1214-7.