Evaluation Of Relationship Between The Anatomical Variations Of Ostiomeatal Complex And Chronic Sinusitis By Multi-slice Spiral CT

Ostiomeatal complex (OMC) proposed firstly by Naumann is the new concept of the anatomy,and it refers to ethmoidal infundibulum for the nearby region,including ethmoidal infundibulum,months split,uncinate,ethmoid bulla,middle turbinate,opening of the front sinuses and so on.Anatomical structure of OMC is more complex and diverse.Many variations are closely related with the incidence and treatment of sinusitis and surgical complications.In recent years,relationship between anatomic variations of OMC and chronic sinusitis has been studied largely.That is,anatomic variations of OMC can lead to the stenosis and obstruction of opening of sinuses,which is one of the reasons of sinusitis.This has been recognized by the vast number of scholars.relationship between anatomic variations of OMC and postoperative complications has been paid close attention to with the increasingly significant postoperative complications,that is,any one of variations may lead to obstruction of middle nasal meatus and affect the operation,which must be removed or corrected by choosing appropriate approach in the operative treatment.Certain mutation may lead to unilateral treatment,surgical injury,even serious complications. So,anatomic variations of OMC should be analysed with emphasis and bony anatomitic variation of pathological sides should be recognized again before surgery.Presently imaging examination is major method for evaluating variation of OMC and classifying the location and extent of disease.But X-ray films and MRI in the diagnosis of OMC have their own limitations.In conventional CT scanning technology,coronal high-resolution CT scan is the best available technology for displaying the structure of OMC.But elderly patients or patients whose neck is not over backwards is too painful when using this coronalscanning technique,and this requirement is difficult to meet the scanning technology.Multipliate Plane Reconstruction is the optimal scanning place for displaying the anatomical structure and variation of OMC,views of coronal reconstruction are nearly the same with,even better than the primitive coronal images and can show clearly the location(such as ethmoidal,sinus sphenoidalis)which can, t be displayed before endoscopic sinus surgery.The main purpose of this study is to deepen our understanding of relationship between anatomic variations of OMC and chronic sinusitis,and to improve the curative effects of endoscopic operation on sinusitis and reduce operative complication.Materials and Methods:In this paper,200 cases of sinuses were scanned by SIEMENS 16 slices spiral CT in the supine position ,and OML is a baseline scan.100 cases of clinically confirmed patients with sinusitis were examined,100 healthy volunteers were in the normal control group.After scanning the data was inserted between 1mm.Then the processed data would be transmitted CT workstation and reconstructed multiple views,and coronal reconstruction was the main.The best visual images were adjusted to show the best standards on the basis of cross-sectional images When images were analyzed,and to investigate the relationship between the structure of OMC and the surrounding structure from all directions.It was emphatically observed that the shape and position and variation of uncinate process,middle turbinate,nasal septum and ethmoid bulla.In addition,the close relationship between chronic sinusitis and them was observed cautiously too.Nasal and sinus were analysed according to the"side"in the article,because of their pair distribution and function independently.Statistical methods were used to evaluate the relationship with anatomic variations of OMC and chronic sinusitis.Results:(1) OMC refers to ethmoidal infundibulum for the nearby region,including ethmoidal infundibulum,months split,uncinate,ethmoidbulla,middle turbinate,opening of the front sinuses and so on.The main anatomical landmark of OMC is ethmoidal infundibulum,months split,uncinate,ethmoid bulla.Multislice CT multiplanar reconstruction (MPR) images can observe anatomical structure of OMC and relationship between these structures and surrounding structures from various angles and aspects.Therefore,MPR can clearly show the anatomical structure of OMC.(2) The anatomical variations of OMC can be clearly displayed by MPR according to the standard of domestic reports of Liu Xian.The ratios of the side of Concha bullosa and paradoxical middle turbinate,uncinate process gasificatio,deviation and hyperplasia,large ethmoid bulla,nasi cells,Haller cells in the pathological group (200 sides)and the normal group (200 sides) were respectively 79:33 and 32:21,21:11,57:31 and 40:15,35:21,32:19,39:14.We can clearly see the occurrence rates of the OMC,s anatomic variations in the pathological group were higher than the normal group,and the occurrence rates of Concha bullosa were tallest (39.5%), uncinate gasification were lowest(10.5%).(3) In 100 cases of chronic sinusitis patients in this paper,chronic genyantritis,frontal sinusitis and ethmoiditis patients accounted for 28 cases,chronic genyantritis and ethmoiditis patients accounted for 38 cases,chronic genyantritis patients accounted for 27cases,chronic frontal sinusitis patients accounted for 37cases.patients with polyp of nasal cavity accounted for 24 cases.Conclusions:(1) Multipliate Plane Reconstruction is the optimal scanning place for displaying view of coronal reconstruction and variation of OMC.(2) The relativity between variation of OMC and chronic sinusitis is definite,pay attention to the variation of pathological sides of OMC before FESS,and the serious complications can be validly avoided and the functional endoscopic sinus surgery can be guided Significantly.In a word, the structure and Open position of OMC is closely related to disease of nasal sinus,and there is important reference value for enacting clinical operations and eradicating the disease.So,there is important clinical physiological significance for displaying clearly the structure and variation of OMC.Multipliate Plane Reconstruction (MPR) images could clearly demonstrate anatomical variation of OMC,the location and degree of chronic sinusitis and correlation between the two,and it can be used to guide Significantly the functional endoscopic sinus surgery.