Anatomical variations of the ethmoid sinuses and their association with health or pathology of the ethmoid and maxillary sinuses in a Southern Chinese population: An analysis using cone-beam computed tomography

Abstract

Purpose The aim of this study was to evaluate the prevalence of clinically relevant anatomical variations of the ethmoid sinuses and their potential association with ethmoid and maxillary sinus pathologies on cone-beam computed tomography (CBCT) scans. Additionally, potential associations with different sides and demographic factors, including age and sex, were evaluated. Materials and Methods In total, 273 CBCT scans with complete ethmoid and maxillary sinuses were analyzed to determine the prevalence of Agger nasi cell, supraorbital ethmoid cell, Haller cell, Onodi cell, and ethmomaxillary sinus. In addition, the health or pathology of the ethmoid and maxillary sinuses was also recorded to assess correlations with the aforementioned variations. Results The prevalence of Agger nasi cell was found to be the highest (95.6%) in this study, followed by Onodi cell (60.4%), Haller cell (29.3%), and supraorbital ethmoid cell (19.4%). Ethmomaxillary sinus was the least common finding (16.5%). Males and persons above 61 years of age had a significantly higher frequency of supraorbital ethmoid cell and Onodi cell, respectively. However, no significant relationships were noted between anatomical variations of the ethmoid sinus and pathologies of the ethmoid or maxillary sinus. Conclusion There was a high prevalence of ethmoid sinus variations in this Southern Chinese population. The prevalence of Agger nasi cell and Onodi cell was higher than that of other anatomical variations of the ethmoid sinuses. Anatomical variations of the ethmoid sinuses were not associated with ethmoid or maxillary sinus pathologies in this patient cohort.

Cone Beam CT Analysis of Haller Cells: Prevalence and Relationship with Orbital Floor Dehiscence

“…This study estimated the prevalence of Haller cells in CBCT images almost high and about 56.7%. In some studies, an extremely variable range (2%–70.3%) has been reported for the prevalence of Haller cells [ 8 , 11 – 25 ]. Mathew et al [ 6 ] reported a 60% prevalence for Haller cells and Khojastepour et al [ 26 ] reported 68%, which are close to our study.…”

“…The prevalence of Haller cells in CT examinations has a wide range [ 1 , 3 , 7 ]. Hui et al indicated that the prevalence of Haller cell is 29.5% and there was no significant relation between the presence of Haller cell and maxillary sinus pathologies [ 8 ]. Some studies showed a significant relationship between Haller cell size (>3 mm) and orbital floor dehiscence; nevertheless, there is no definite information on this matter [ 2 , 6 ].…”

The Ethmomaxillary Sinus—A False Duplicate Maxillary Sinus

“…This was not documented in previous reports of EMSs. 8,26 THE MAXILLARY BULLA Both Ozcan et al (2008) 7 and Sirikci et al (2004) 9 found ethmomaxillary septa convex towards the MS. These were bona fide cases with maxillary bullae produced by the EMS.…”

“…Interestingly, different studies on the EMS reported it posterosuperior to the MS, [7][8][9]13,26,27 therefore, with a horizontal or oblique position of the ethmomaxillary septum separating the MS and the EMS. This septum was indicated by Liu et al (2018) 8 as "ethmomaxillary plate."…”

“…That SMS appeared on coronal slices as an ethmoidal bulla expanded in the orbit floor above the MS. 13 A supra maxillary cell drains in the middle nasal meatus, but an EMS superior to the MS drains into the SNM. [7][8][9]13,26 Figure 1A and B present an EMS located posteriorly to the MS, thus interposed between the MS and the pterygopalatine fossa. It drains into the SNM.…”