Varianti anatomiche del complesso ostio-meatale. Studio TC e correlato clinico.

Although anatomic variations of the nose and paranasal sinuses do not themselves represent a disease state, in many cases they are responsible for headache which may or may not be associated with sinusitis. For several reasons computed tomography (CT) is considered the examination of choice for evaluation of the ostiomeatal complex (COM) and of inflammatory diseases of the sinuses. In order to determine the incidence of anatomical variants of ostiomeatal complex in patients with non traumatic and non neoplastic sinus headache, we carried out a retrospective study of 316 CT scans of the paranasal sinuses, performed over a 1-year period. The scans were assessed for the presence of anatomical variants in the middle meatus and for signs of asymptomatic infection revealed by the presence of clouding or mucosal thickening in the sinuses. Overall, patients with sinus disease did not have significantly more frequent variants in the ostiomeatal complex. Nevertheless, some of them, i.e. the pneumatized vertical lamella, paradoxical curvature of the middle turbinate, Haller cells and pneumatization of the uncinate process, were more common in patients with sinus disease. Our findings suggest that ostiomeatal complex dysfunction can be considered a favouring factor in the pathogenesis of sinus disease.