Significance of Uncinate Process and Paranasal Sinus Computed Tomography in Endoscopic Frontal Recess Approach / 대한이비인후과학회지

ABSTRACT

OBJECTIVES: To determine the value of uncinate process variations in paranasal sinus(PNS) coronal computed tomography(CT) scan, and to recommend the accurate frontal recess approach technique by uncinate process variations. METHOD: We initiated a prospective, randomized study in fifty patients(100 cases) of frontal sinusitis. Cases were classified as three groups depending on the PNS CT scan findings according to the Stammberger's classification. And then, we could identify the ostium of the frontal sinus by manipulating the terminal recess in group A. It was also shown at the lateral side of uncinate process by approaching anterosuperiorly from below the uncinate process with a bent spoon in group B. Finally, we could find the ostium of the frontal sinus by fracturing the bony septa with a bent spoon in group C. RESULTS: In the evaluation of the uncinate process variations by PNS CT scan, 45(98%) of 46 cases(Group A), 24(100%) of 24cases(Group B), 18(86%) of 21cases(Group C) were in accord with operative finding, and 9cases could not be determined by PNS CT scan. We could identify easily the frontal sinus opening with this technique, and there were no serious post-operative complications. CONCLUSIONS: PNS coronal CT scan is useful in the evaluation of the uncinate process variations, and this frontal recess approach technique is safe and easy to identify the frontal sinus opening.