title: Maxillary sinus hypoplasia with a patent ostiomeatal complex: A therapeutic dilemma.
abstract: OBJECTIVE
  Maxillary sinus hypoplasia (MSH) is a radiologically detectable abnormality of the maxillary sinus that can be associated with sinusitis. Symptomatic MSH patients with a patent ostiomeatal complex (MSHPO) constitute a particular therapeutic challenge.
  
  
  METHODS
  Ostiomeatal unit CT scans of 1293 patients with various sinonasal symptoms such as purulent discharge, postnasal drip, facial pain or headache were reviewed to determine the incidence, clinical symptoms and outcomes of MSHPO following medical treatment.
  
  
  RESULTS
  Seventy-five cases (5.8%) were found to have MSHPO. Excluding patients with nasal septal deviation and positive allergy test, 37 of those 75 patients (2.86% of the original cohort) had MSHPO as the only definable sinonasal abnormality. Radiographs showed all patients had antral mucosal thickening. Postnasal drip (43.2%) was the most common symptom, followed by nasal obstruction (40.5%), purulent rhinorrhea (32.4%), hyposmia or anosmia (32.4%), cough (21.6%) and headache (18.9%). Medical treatment consisted of clarithromycin and ebastine for all patients. Medical treatment resulted in complete symptom resolution in only 24.3% of patients.
  
  
  CONCLUSIONS
  Primary MSHPO was present in approximately 3% of patients with sinonasal symptoms. The response rate to medical treatment was poor. MSHPO should be considered a differential diagnosis in patients presenting with non-specific sinonasal complaints.
authors.affiliation: Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Pungnap 2-dong, 388-1, Songpa-gu, Seoul, Republic of Korea.
authors.forename: Yong Ju
authors.initials: YJ
authors.lastname: Jang
authors.forename: Ho Chan
authors.initials: HC
authors.lastname: Kim
authors.forename: Ji Hyang
authors.initials: JH
authors.lastname: Lee
authors.forename: Ji Heui
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002090:Butyrophenones / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000187:drug effects; D015523:Maxillary Sinusitis / Q000151:congenital* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008875:Middle Aged; D009297:Nasal Mucosa / Q000000981:diagnostic imaging; D010880:Piperidines / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002090:Butyrophenones; D006634:Histamine H1 Antagonists; D010880:Piperidines; D017291:Clarithromycin; C058249:ebastine