European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 12, pp 4315–4319 | Cite as

The effect of the presence of the accessory maxillary ostium on the maxillary sinus

  • Alper YenigunEmail author
  • Zeliha Fazliogullari
  • Cihat Gun
  • Ismihan Ilknur Uysal
  • Alaaddin Nayman
  • Ahmet Kagan Karabulut


This study was conducted to investigate the presence of the accessory maxillary ostium and its effects on the maxillary sinus, and the concurrent occurrence of morphological variations of neighboring anatomical structures. This study was performed in a tertiary referral center. This is a cross-sectional retrospective study that evaluated coronal CTs of patients to determine the frequency of the accessory maxillary ostium and investigated any simultaneous morphological variations in neighboring anatomical structures. The presence of the accessory maxillary ostium (AMO) plus any concurrent morphological variations of neighboring structures were investigated in 377 patients, with 754 sides. AMO was found to be present in 19.1 % (72/377) of the patients. A concurrent mucus retention cyst was found to be statistically significant on both sides (right side: p = 0.00, left side: p = 0.00), as well as mucosal thickening (right side: p = 0.00, left side: p = 0.00), and maxillary sinusitis (right side: p = 0.04, left side: p = 0.03). No other concurrent variations of statistical significance were detected in the neighboring structures. Our study demonstrated that with the presence of AMO, the likelihood of encountering a mucus retention cyst (48.6 %) had an approximately threefold increase, and that of encountering mucosal thickening (43.0 %) and maxillary sinusitis (29.1 %) had a twofold increase.


Paranasal sinuses Accessory maxillary ostia Mucus retention cyst Sinusitis Computer tomography 



Accessory maxillary ostium


Agger nasi cells


Computed tomography


Haller cells


Hypertrophy of inferior concha


Mucus retention cyst


Maxillary sinusitis


Mucosal thickening


Pneumatization of middle concha


Septal deviation


Compliance with ethical standards

Funding source, financial disclosures


Conflict of interest



  1. 1.
    Stammberger H (1990) Functional endoscopic sinus surgery. The Messerklinger technique, vol 247. B.C. Decker, Philadelphia, pp 63–76Google Scholar
  2. 2.
    Genc S, Ozcan M, Titiz A, Unal A (2008) Development of maxillary accessory ostium following sinusitis in rabbits. Rhinology 46:121–124PubMedGoogle Scholar
  3. 3.
    Joe JK, Ho SY, Yanagisawa E (2000) Documentation of variations in sinonasal anatomy by intraoperative nasal endoscopy. Laryngoscope 110:229–235CrossRefPubMedGoogle Scholar
  4. 4.
    Jones NS (2002) CT of the paranasal sinuses: a review of the correlation with clinical, surgical and histopathological findings. Clin Otolaryngol Allied Sci 27:11–17CrossRefPubMedGoogle Scholar
  5. 5.
    Kane KJ (1997) Recirculation of mucus as a cause of persistent sinusitis. Am J Rhinol 11:361–369CrossRefPubMedGoogle Scholar
  6. 6.
    Kuma RH, Kaka RS (2001) Accessory maxillary ostia: topography and clinical application. J Anat Soc India 50:3–5Google Scholar
  7. 7.
    Jog M, McGarry GW (2003) How frequent are accessory sinus ostia? J Laryngol Otol 117:270–272PubMedGoogle Scholar
  8. 8.
    Youngs R, Evans K, Watson M (2005) The paranasal sinuses. A handbook of applied surgical anatomy. Taylor & Francis, LondonGoogle Scholar
  9. 9.
    Balasubramanian T (2012) Advanced anatomy of lateral nasal wall: for the endoscopic sinus surgeon. Otolaryngol Online J Rhinol 2:4–9CrossRefGoogle Scholar
  10. 10.
    Zinreich SJ (1998) Functional anatomy and computed tomography imaging of the paranasal sinuses. Am J Med Sci 316:2–12PubMedGoogle Scholar
  11. 11.
    Matthews BL, Burke AJ (1997) Recirculation of mucus via accessory ostia causing chronic maxillary sinus disease. Otolaryngol Head Neck Surg 117:422–423CrossRefPubMedGoogle Scholar
  12. 12.
    Albu S (2010) Symptomatic maxillary sinus retention cysts: should they be removed? Laryngoscope 120:1904–1909CrossRefPubMedGoogle Scholar
  13. 13.
    Hadar T, Shvero J, Nageris BI et al (2000) Mucus retention cyst of the maxillary sinus: the endoscopic approach. Br J Oral Maxillofac Surg 38:227–229CrossRefPubMedGoogle Scholar
  14. 14.
    Wang JH, Yong JJ, Lee BJ (2007) Natural course of retention cysts of the maxillary sinus: long-term follow-up results. Laryngoscope 117:341–344CrossRefPubMedGoogle Scholar
  15. 15.
    Busaba NY, Kieff D (2002) Endoscopic sinus surgery for inflammatory maxillary sinus disease. Laryngoscope 112:1378–1384CrossRefPubMedGoogle Scholar
  16. 16.
    Harar RP, Chadha NK, Rogers G (2007) Are maxillary mucosal cysts a manifestation of inflammatory sinus disease? J Laryngol Otol 121:751–754CrossRefPubMedGoogle Scholar
  17. 17.
    Kanagalingam J, Bhatia K, Georgalas C et al (2009) Maxillary mucosal cyst is not a manifestation of rhinosinusitis: results of a prospective three-dimensional CT study of ophthalmic patients. Laryngoscope 119:8–13CrossRefPubMedGoogle Scholar
  18. 18.
    Bhattacharyya N (2000) Do maxillary sinus retention cysts reflect obstructive sinus phenomena? Arch Otolaryngol Head Neck Surg 126:1369–1371CrossRefPubMedGoogle Scholar
  19. 19.
    Hong SL, Cho KS, Roh HJ (2014) Maxillary sinus retention cysts protruding into the inferior meatus. Clin Exp Otorhinolaryngol 7:226–228CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Behrbohm H, Sydow K (1991) Nuclear medicine studies of the regenerative behavior of paranasal sinus mucosa after functional endoscopic ethmoid bone surgery [in German]. HNO 39:173–176PubMedGoogle Scholar
  21. 21.
    Stallman JS, Lobo JN, Som PM (2004) The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol 25:1613–1618PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Alper Yenigun
    • 1
    Email author
  • Zeliha Fazliogullari
    • 2
  • Cihat Gun
    • 2
  • Ismihan Ilknur Uysal
    • 2
  • Alaaddin Nayman
    • 3
  • Ahmet Kagan Karabulut
    • 2
  1. 1.Department of Otorhinolaryngology, Faculty of MedicineBezmialem Vakif UniversityFatihTurkey
  2. 2.Department of Anatomy, Selcuklu Faculty of MedicineSelcuk UniversityKonyaTurkey
  3. 3.Department of Radiology, Selcuklu Faculty of MedicineSelcuk UniversityKonyaTurkey

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