Morpho-functional evaluation of osteomeatal complex in chronic sinusitis by coronal CT

Abstract.

The objective was to determine whether or not there exists a clinical–radiological correlation in chronic sinusitis of anterior paranasal sinus and to quantitatively evaluate the importance of osteomeatal complex structures and anatomic variants in chronic sinusitis etiopathology. We analyzed 208 nasal fossae with high-resolution and low-irradiation coronal computed tomography. The following inclusion criteria we established: one case control and one control group. We considered any chronic thickness of sinusal mucosal as a radiological indicator of chronic sinusitis. We evaluated the mucosal thickness of internal, external, superior and inferior maxillary walls, the addition of four maxillary walls and the maximal mucosal thickness in frontal sinus and anterior ethmoidal cells. We also obtained 15 parameters of osteomeatal complex structures and anatomical variants in each nasal fossa, and we correlated them statistically with chronic sinusitis radiological indicators. Uncinate process length is the only anatomic element from which we have been able to obtain a statistically significant cut point between case and control groups, but only with a sensitivity of 51.6%, specificity of 71.2%, positive predictive value of 74.2%, and negative predictive value of 47.9%. No association of radiological parameters exists that can explain chronic sinusitis.