Paranasal sinus development: a radiographic study.
OBJECTIVE
To demonstrate the development of the paranasal sinuses in a pediatric population by computed tomography scans.


METHODS
Radiology records at a tertiary care institution were reviewed for the computed tomography scans of the face, orbit, or paranasal sinuses in patients aged 0 to 12 years.


METHODS
Computed tomography scans were reviewed by a head and neck radiologist and otolaryngologist for the development of the frontal, maxillary, ethmoid, and sphenoid sinuses. The size of the pneumatized paranasal sinuses was measured in two planes and graded on a scale of 0 to 3. Ossification of the maxillary crest and vomer, obliteration of the foramen cecum, and development of agger nasi cells, Haller cells, and the superior turbinate were studied. Patients with syndromes, nasal stenosis, choanal atresia, or cystic fibrosis were excluded from the study.


RESULTS
In all, 91 computed tomography scans in 66 patients were studied. Serial development could be followed in 16 patients who underwent repeat scans. Patients were divided into six age cohorts based on their age at the time of the scan: 0 to 3 months (10%), 3 to 12 months (13%), 1 to 3 years (13%), 3 to 5 years (20%), 5 to 8 years (29%), and 8 to 12 years (16%). Ethmoid sinuses were the first to fully develop, followed sequentially by maxillary, sphenoid, and frontal sinuses. Each sinus has a rapid rate of development during specified age cohorts.


CONCLUSIONS
The results will aid the physician when correlating the clinical and radiographic findings of pediatric patients aged 0 to 12 years who are being evaluated for sinus disease and potential surgical intervention.
Shah
Rahul K
RK
Department of Otolaryngology-Head and Neck Surgery, Tufts-New England Medical Center, 750 Washington Street, New England Medical Center 850, Boston, MA 02111, USA.
Dhingra
Jagdish K
JK
Carter
Barbara L
BL
Rebeiz
Elie E
EE
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010256:Paranasal Sinuses / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000254:growth & development*; D012016:Reference Values; D014057:Tomography, X-Ray Computed