Yüksek Rezolüsyonlu BT ile Erişkin Yaş Grubunda Ünsinat Proçes Anatomik Varyasyonlarının ve Maksiller Sinüs Hastalıkları ile İlişkisinin Değerlendirilmesi

Ünsinat proçes (UP) osteomeatal kompleksin ve nazal lateral duvarın ana parçalarından biridir ve UP varyasyonları inflamatuar paranazal sinüs hastalıklarına zemin hazırlamaktadır. En yaygın UP varyasyonları laterale ve mediale deviasyon, büllöz varyasyon ve çatı varyasyonlarıdır. Bu çalışmanın amacı, Paranazal BT çekimi gerçekleştirilen hastalarda UP varyasyonlarını ve diğer popülasyondan farklarını tanımlamak ve maksiller sinüs hastalıkları ile ilişkisini bildirmektir. Çalışma Ocak 2018-Mart 2018 tarihleri arasında çekilen 176 adet paranazal sinüs BT üzerinden gerçekleştirilen retrospektif bir çalışmadır. Tip I, II, III, IV olmak üzere çatı insersiyonları, maksiller sinüzit (MS) ve maksiller sinüs hipoplazisi (MH) ile ilişkileri, tokmak ve çengel UP varyasyonları bilateral olarak kemik ve yumuşak doku pencerelerinde değerlendirdi. Çatı varyasyonları: Sağ %67.05 Tip II, %18.2 Tip III, %13.6 ile Tip I, %1.15 Tip IV; Sol %71 Tip II, %15.9 Tip III, %12.5 Tip I, %0,6 Tip IV Deviasyon anomalileri: Sağda %86.9 nötr, %7.4 medialize, %5.7 lateralize; Solda %92 nötr, %5.9 medialize, %2.1 lateralize. Büllöz varyant: %7.7 MS-deviasyon, MH- deviasyon ilişkileri p< 0.05 çengel ve tokmak UP, çift orta konka: %0.6. Çatı varyasyonları bölgesel olarak belirgin farklılıklar göstermektedir. Araştırmanın yapıldığı popülasyonda Tip II varyant çoğunluktaydı. Deviasyon anomalileri literatürle benzer orandaydı. Büllöz varyant Türkiye’de yapılan araştırmalar ile benzer olarak diğer ülkelere göre daha yüksek orandaydı. MS ve MH ile deviasyon anomalileri arasında ilişki mevcuttu. Çatı varyasyonları ile MS ve MH ilişkisi izlenmedi.

Anahtar Kelimeler:

Anatomik Varyasyonlar, Maksiller, Paranazal Sinüs BT, Ünsinat Proçes

Evaluation of Uncinate Process’ Anatomical Variations in Adult Age Group with High Resolution CT and Their Relationship with Maxillary Sinus Pathologies

Uncinate process (UP) is one of the key parts of the osteomeatal complex and the nasal lateral wall. UP variations can lead to inflammatory paranasal sinus diseases. The most common UP variations are lateral and medial deviations, bullous variation, and superior tip insertions. The purpose of this study is to describe the different variations of UP in patients undergoing CT scan and to report their association with maxillary sinus diseases. We conducted a retrospective study of 176 paranasal sinus CT performed between January 2018 and March 2018. Root insertions such as Type I, II, III and IV; bilateral hammer and hook UP variations were evaluated in bone and soft tissue windows and correlated to maxillary sinusitis (MS) as well as maxillary sinus hypoplasia (MH). Roof Variations: in the right side 67.05% were Type II, 18.2% Type III, 13.6% Type I and 1.15% Type IV; in the left side 71% were Type II, 15.9 Type III, 12.5% Type I and 0.6% Type IV. Deviation Anomalies; in the right side 86.9% were neutral, 7.4% medialized and 5.7% lateralized; in the left side 92% were neutral, 5.9% medialized and 2.1% lateralized. Bullous variation were found in 7.7% of the patients. Hook and hammer UP, double middle concha were found in 0.6% of the patients. Roof variations showed significant regional differences. In our study, Type II variation was dominant. Rates of UP deviation anomalies were similar to the literature. Bullous variant had higher rates than observed in other countries and similar to researches done in Turkey. A significant correlation (p <0.05) were found between MS and UP deviations’ type as well as between MH and UP deviations’ type. Relationship between roof variations and MS, MH as well as UP deviations were not found.

Keywords:

Anatomical Variations, Maxillary, Paranasal Sinus CT, Uncinate Process,

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