Serin Peter1, Vijayamma Kunnath Narayanan2, Suresh Jacob3
Ostiomeatal complex is the final common pathway for the drainage of secretions from maxillary, frontal, anterior and middle ethmoidal air sinuses. Any obstruction at the ostiomeatal complex region can result in impedance to the free flow of secretions or even blockage of secretions in these anteriorly draining sinuses. Obstructions can be due to distortion of normal anatomy or some pathological processes. In case of a distorted anatomy, there is a high chance for the chronicity of sinus infections. Ostiomeatal complex is formed within the ethmoid bone. Ethmoid sinuses and air cells, due to their bizarre embryological development are notorious for anatomical variations at the level of ostiomeatal complex. Some of these variations are thought to be very significant in the persistence of sinus infections, especially when the size and degree of variation is more. A thorough knowledge of the anatomy of the lateral nasal wall and its variations would be of immense help for the endoscopic sinus surgeons to tackle the confusing situations that arise at the level of variation during surgery.
MATERIALS AND METHODS The present study was done to evaluate the different anatomical variations of the ostiomeatal complex by cadaveric dissection. Fifty cadaveric specimens of the lateral nasal wall were taken and meticulous dissection was done to find out the anatomical variations of the ostiomeatal complex. The study was done over a period of two years from January 2015 to December 2016 in the Department of Anatomy, Government Medical College, Kottayam.
The result of the study was very much rewarding as majority of the specimens had variations of the ostiomeatal complex. It was also noted that an increase in the number of anatomical variations was associated with chronic sinusitis (as indirectly depicted by the presence of accessory maxillary ostia that arise following persistent blockage of the normal maxillary ostium).
The study showed a very close correlation between the number and size of the variations of the ostiomeatal complex and chronic sinusitis (as indicated by the presence of accessory maxillary ostia in the cadavers). Thus, an early surgical correction of these variations would help to prevent progression and complications of chronic sinusitis.