Skip to main content
SpringerLink
Log in

The imaging anatomy of ethmomaxillary sinus and its impact on chronic rhinosinusitis

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study was to investigate the pneumatization degree of ethmomaxillary sinus (EMS) and adjacent structures, and its impact on chronic rhinosinusitis (CRS).

Methods

A retrospective analysis of paranasal sinus CT scans of 996 patients was conducted. The maximum vertical diameter of EMS in the coronal plane was measured, allowing EMS to be classified, and its impact on ipsilateral CRS were examined.

Results

The prevalence of EMS was 11.9%. The maximum vertical diameter of EMS in the coronal plane ranged from 3.68 to 28.76 mm with a mean (± SD) of 11.32 ± 5.12 mm. The prevalence rates of EMS in CRS sides and non-CRS sides were 12.5% and 9.3%, respectively, which was significantly different (χ2 = 4.495; p < 0.05). The difference in prevalence between the three types of EMS in ipsilateral CRS was statistically significant (χ2 = 6.733; p < 0.05). The difference in Lund–Mackay (LM) score of ipsilateral CRS between the three types showed no statistically significant difference (H = 4.033; p > 0.05).

Conclusion

EMS is a common anatomical variation with marked individual differences in shape and pneumatization degree. A higher degree of EMS pneumatization may contribute to the occurrence of CRS; this should be investigated before surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Levine CG, Casiano RR (2017) Revision functional endoscopic sinus surgery. Otolaryngol Clin North Am 50(1):143–164

    Article  Google Scholar 

  2. Sirikci A, Bayazit YA, Bayram M (2004) Ethmomaxillary sinus: a particular anatomic variation of the paranasal sinuses. Eur Radiol 14(2):281–285

    Article  Google Scholar 

  3. Liu JY, Liu QT, Yan ZF (2017) The measurement of pneumatization of maxillary sinus extended into alveolar process basing on the CT and its clinical significance. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 31(15):1161–1164

    CAS  PubMed  Google Scholar 

  4. Kuan EC, Mallen-St Clair J, Frederick JW (2016) Significance of undissected retromaxillary air cells as a risk factor for revision endoscopic sinus surgery. Am J Rhinol Allergy 30(6):448–452

    Article  Google Scholar 

  5. Baban M, Mirza B, Castelnuovo P (2020) Radiological and endoscopic findings in patients undergoing revision endoscopic sinus surgery. Surg Radiol Anat 42(9):1003–1013

    Article  Google Scholar 

  6. Azila A, Irfan M, Rohaizan Y, Shamim AK (2011) The prevalence of anatomical variations in osteomeatal unit in patients with chronic rhinosinusitis. Med J Malays 66(3):191–194

    CAS  Google Scholar 

  7. Johari HH, Mohamad I, Sachlin IS, Aziz ME, Mey TY, Ramli RR (2018) A computed tomographic analysis of frontal recess cells in association with the development of frontal sinusitis. Auris Nasus Larynx 45(6):1183–1190

    Article  Google Scholar 

  8. Caversaccio M, Boschung U, Mudry A (2011) Historical review of Haller's cells. Ann Anat 193(3):185–190

    Article  Google Scholar 

  9. Jinfeng L, Jinsheng D, Xiaohui W, Yanjun W, Ningyu W (2017) The pneumatization and adjacent structure of the posterior superior maxillary sinus and its effect on nasal cavity morphology. Med Sci Monit 23:4166–4174

    Article  Google Scholar 

  10. Khanobthamchai K, Shankar L, Hawke M (1991) Ethmomaxillary sinus and hypoplasia of maxillary sinus. J Otolaryngol 20(6):425–427

    CAS  PubMed  Google Scholar 

  11. Liu X, Han D, Zhou B (1998) Relationship between anatomic variations of nasal sinus and chronic sinusitis. Zhonghua Er Bi Yan Hou Ke Za Zhi 33(3):149–152

    CAS  PubMed  Google Scholar 

  12. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F et al (2012) EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists. Rhinology 50(1):1–12

    Article  Google Scholar 

  13. Liu J, Dai J, Wen X, Wang Y, Zhang Y, Wang N (2018) Imaging and anatomical features of ethmomaxillary sinus and its differentiation from surrounding air cells. Surg Radiol Anat 40(2):207–215

    Article  Google Scholar 

  14. Herzallah IR, Saati FA, Marglani OA, Simsim RF (2016) Retromaxillary pneumatization of posterior ethmoid air cells: novel description and surgical implications. Otolaryngol Head Neck Surg 155(2):340–346

    Article  Google Scholar 

  15. Liu JF, Liu QT, Liu JY, Wang NY (2018) CT observation of retromaxillary posterior ethmoid. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 32(2):121–124

    PubMed  Google Scholar 

  16. Ulm CW, Solar P, Krennmair G, Matejka M, Watzek G (1995) Incidence and suggested surgical management of septa in sinus-lift procedures. Int J Oral Maxillofac Implants 10(4):462–465

    CAS  PubMed  Google Scholar 

  17. Lund VJ, Kennedy DW (1997) Staging for rhinosinusitis. Otolaryngol Head Neck Surg 117(3 Pt 2):S35–40

    Article  CAS  Google Scholar 

  18. Ozcan KM, Selcuk A, Oruk V, Sarikaya Y, Dere H (2008) Ethmomaxillary sinus. Eur Arch Otorhinolaryngol 265(2):185–188

    Article  Google Scholar 

  19. Zhang L, Han D, Ge W, Tao J, Wang X, Li Y, Zhou B (2007) Computed tomographic and endoscopic analysis of supraorbital ethmoid cells. Otolaryngol Head Neck Surg 137(4):562–568

    Article  Google Scholar 

  20. Cho JH, Citardi MJ, Lee WT, Sautter NB, Lee HM, Yoon JH et al (2006) Comparison of frontal pneumatization patterns between Koreans and Caucasians. Otolaryngol Head Neck Surg 135(5):780–786

    Article  Google Scholar 

  21. Sanchez Fernandez JM, Anta Escuredo JA, Sanchez DA (2000) Morphometric study of the paranasal sinuses in normal and pathological conditions. Acta Otolaryngol 120(2):273–278

    Article  CAS  Google Scholar 

  22. Shi MH, Wang M, Li H, Wu YX (2019) The CT image features of ethmomaxillary sinus and their significance in endoscopic surgery. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 54(11):813–818

    CAS  PubMed  Google Scholar 

  23. Okushi T, Mori E, Nakayama T, Asaka D, Matsuwaki Y, Ota K et al (2012) Impact of residual ethmoid cells on postoperative course after endoscopic sinus surgery for chronic rhinosinusitis. Auris Nasus Larynx 39(5):484–489

    Article  Google Scholar 

  24. Mathew R, Omami G, Hand A, Fellows D, Lurie A (2013) Cone beam CT analysis of Haller cells: prevalence and clinical significance. Dento Maxillofac Radiol 42(9):20130055

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, China

    Fangwei Zhou, Cheng Cao, Wenjun Fan, Lu Tan, Peiqiang Liu, Hao Lv & Yu Xu

  2. Research Institute of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, 238 Jiefang Rd, Wuhan, 430060, China

    Yu Xu

Authors
  1. Fangwei Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cheng Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Wenjun Fan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lu Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Peiqiang Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hao Lv
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yu Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yu Xu.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

A formal informed consent procedure was waived due to the retrospective nature of this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhou, F., Cao, C., Fan, W. et al. The imaging anatomy of ethmomaxillary sinus and its impact on chronic rhinosinusitis. Eur Arch Otorhinolaryngol 278, 719–726 (2021). https://doi.org/10.1007/s00405-020-06322-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-020-06322-y

Keywords

Search

Navigation