Abstract
The clinical significance of the osteomeatal complex has been deeply appreciated among otolaryngologists due to the increasing popularity of functional endoscopic sinus surgery in recent years. In this study, we have examined the morphological features of surface epithelium covering this area in 35 cases with chronic sinusitis. Surface cell types were identified and thier relative proportion was measured by using scanning electron microscopy (SEM). Coronal CT scan assessment was achieved preoperatively in every case, and disease extent of each sinus system including the presence of anatomic variants was scored in compliance with the staging system proposed by Lund and Mackay (1993).
Severity of the pathological changes to surface epithelium in the osteomeatal complex was categorized into three groups on the basis of the relative dominance of the ciliated cells (more than 80%, 50 to 80% and less than 50%). The average values of radiological grading scores in the three group were 3.53±1.2SD, 6.5±1.5SD and 9.16±1.9SD respectively, and statistical differences were noted between the groups. The osteomeatal unit has been considered as the key region for mucociliary drainage from anterior paranasal sinuses. Our results showed a close relationship between pathological changes in this area and the degree of disease extension to the peripheral sinuses. This fact might also support Messerklinger's basic FESS concept that most infections of the larger sinuses are rhinogenic.
