ABSTRACT
Twenty cadaveric head regions were sagitally sectioned and examined for the anatomy of the middle meatus region. Serial coronal CT section [1-3 mm] of fifty persons were done. Twenty five of tehm belong to patients suffering from chronic sinusitis, and the other twenty five of sinusitis-free persons. Selected measures were applied on both cadaveric speciments and coronal CT scans. The results of the present study showed a wide range of anatomical cariations in this region, even in the sinusitis-free. Certain anatomical structures showed marked discrepancy in frequency of variations or its dimensions in patient suffering from chronic sinusitis in relation to sinusitis-free persons. The most important variation in the middle turbinate was the concha bullosa which was present in 28% of sinusitis-free bit it was found in 52% of sinusitis patients. Also, the curvature of the middle turbinate was abnormal in 20% sinusitis patient while no cases of abnormal curvature were recorded in sinusitis-free persons. The distance between the middle turbinate and the bulla ethmoidalis was wider in sinusitis-free persons as it was of mean value 1.9 mm than in sinusitis patients which was of mean value 1.7 mm. As regards the uncinate process, it showed abnormal deflections in 28% of sinusitis-free persons and in 60% of sinusitis patients. Concerning the hiatus semilunaris and the infundibulum, it was found that in sinusitis-free persons the hiatus semilunaris was more wide as it was of mean value 2.7 mm while in sinusitis patients the mean width was 1.4 mm. The infundibulum depth was more shallow in sinusitis-free persons as its mean depth was 5.6 mm, while in sinusitis patients, the mean depth was 6.6 mm. Concerning the bulla ethmoidalis size, it was larger in sinusitis patients as it was of mean value 17 x 7 mm while in sinusitis-free persons, it was of mean value 14 x 6 mm. Haller's cells were detected in 28% of sinusitis-free persons and in 60% of sinusitis patients. As regards the maxillary sinus ostium, it was found that its transverse diameter was of mean value 6 mm in sinusitis-free persons while it was 3.5 mm in patients of sinusitis. Scanning of the anatomical variations and measures in cadavers and sinusitis-free persons could act as an accurate Egyptian guide serving surgical procedures. The higher incidence of variations in certain parts and discrepancy in dimensions of other parts between the sinusitis and non-sinusitis cases may support the theory that emphasizes the role of anatomical variations in the aetiology of chronic sinusitis and consequently may help to settle the controversy around this point