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      Bilateral Maxillary Sinus Hypoplasia

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          Abstract

          Maxillary sinus hypoplasia (MSH) is an uncommon abnormality of paranasal sinuses noted in clinical practice. Computed tomography (CT) scan helps in diagnosing the anomaly along with any anatomical variation that may be associated with it. MSH is usually associated with other anomalies like uncinate process hypoplasia. Three types of MSH have been described. Type 1 MSH shows mild maxillary sinus hypoplasia, type 2 shows significant sinus hypoplasia with narrowed infundibular passage and hypoplastic or absent uncinate process, and type 3 is cleft like maxillary sinus hypoplasia with absent uncinate process. CT and endoscopic examination usually complement each other in diagnosing MSH.

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          Most cited references 7

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          Maxillary sinus hypoplasia: classification and description of associated uncinate process hypoplasia.

          Maxillary sinus hypoplasia is an anomaly of the paranasal sinuses occasionally encountered by otolaryngologists. Although this entity has been previously reported, an association between maxillary sinus hypoplasia and anomalies of other paranasal sinus structures, such as the uncinate process, has not yet been described. Additionally, the literature lacks a system by which the various types of maxillary sinus hypoplasia can be classified using computerized tomographic (CT) imaging. Two hundred and two consecutive coronal sinus computerized tomographic scans from patients undergoing evaluation at our institution were analyzed to determine the prevalence of MSH and associated paranasal sinus anomalies. The overall prevalence of maxillary sinus hypoplasia was 10.4%. Three distinct patterns of hypoplasia were evident. Type I, characterized by a normal uncinate process, a well-defined infundibular passage, and mild sinus hypoplasia, occurred in 14 patients (6.9%). Type II, characterized by absence or hypoplasia of the uncinate process, an ill-defined infundibular passage, and soft-tissue density opacification of a significantly hypoplastic sinus occurred in 6 patients (3.0%). Type III, characterized by absence of the uncinate process and a profoundly hypoplastic, cleft-like sinus, occurred in 1 patient (0.5%). Recognition of associated anomalies of the uncinate process in patients with maxillary sinus hypoplasia undergoing sinus surgery is of utmost clinical significance because the uncinate process serves as a key landmark during functional endoscopic sinus surgery. Failure to recognize hypoplasia or absence of the uncinate process could lead to inadvertent intraoperative damage to the adjacent medial orbital wall.
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            Acquired maxillary sinus hypoplasia: a consequence of endoscopic sinus surgery?

            The effects of functional endoscopic sinus surgery (FESS) on sinus and midfacial development remain unclear. The authors report five children who, at a median age of 30 months, underwent FESS for refractory sinusitis. Three of the children had cystic fibrosis, and two had asthma. Preoperative computed tomographic (CT) scanning showed symmetric maxillary sinus development with varying degrees of mucosal disease. At a mean of 42 months after surgery, CT scans were obtained to evaluate recurrent symptoms in the five children. The scans showed unilateral maxillary hypoplasia in four children and bilateral maxillary sinus hypoplasia in one child. No child had clinically apparent facial asymmetry or midfacial hypoplasia. The authors also discuss the factors involved in maxillary sinus pneumatization, the possible effects of sinus surgery on sinus development, and the clinical implications of "acquired" maxillary sinus hypoplasia.
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              Maxillary sinus hypoplasia.

              Maxillary sinus hypoplasia (MSH) is an uncommonly encountered condition by otolaryngologists. The computerized tomography (CT) scans provide valuable data about the anatomic details of the paranasal sinuses. MSH may be misdiagnosed as an infection or a neoplasm of the maxillary sinuses. Variations of the other paranasal structures, especially the uncinate process associated with MSH were defined. MSH shows three distinct hypoplasia patterns. Type I MSH characteristics are mild hypoplasia of the maxillary sinus, normal uncinate process and a well-developed infundibular passage. Significant hypoplasia of the maxillary sinus, hypoplastic or absent uncinate process and absent or pathologic infundibular passage are seen in Type II MSH. Type III MSH is characterized by the absence of an uncinate process and cleft-like maxillary sinus hypoplasia. In this study a series of 18 patients with MSH were presented. Twelve cases of unilateral and 6 cases of bilateral maxillary antrum hypoplasia were evaluated and 13 MSH type I, 7 MSH type II and 4 MSH type III were detected. Three ethmomaxillary sinuses, an overpneumatized posterior ethmoid cell into the orbit and the maxillary sinus were determined. Our series showed that the uncinate process anomalies related to MSH may lead to inadvertent orbital complications and therefore should be kept in mind.
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                Author and article information

                Journal
                Case Rep Radiol
                Case Rep Radiol
                CRIRA
                Case Reports in Radiology
                Hindawi Publishing Corporation
                2090-6862
                2090-6870
                2014
                8 December 2014
                : 2014
                Affiliations
                1Era's Lucknow Medical College, C-149, Indiranagar, Lucknow 226016, India
                2Era's Lucknow Medical College, Room No. B-14, P.G. Boys' Hostel, Hardoi Road, Sarfarazganj, Lucknow 226003, India
                3Era's Lucknow Medical College, P.G. Girls' Hostel, Hardoi Road, Sarfarazganj, Lucknow 226003, India
                Author notes

                Academic Editor: Ruben Dammers

                Article
                10.1155/2014/148940
                4274671
                Copyright © 2014 Sachin Khanduri et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Case Report

                Radiology & Imaging

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