title: The association of superior attachment of uncinate process with pneumatization of middle turbinate: a computed tomographic analysis.
abstract: The frontal sinus outflow pathway is complex and can be influenced by the configuration of the uncinate process (UP). The UP can attach superior to the lamina papyracea, skull base, and middle turbinate. The factors associated with superior attachment remain unclear. This study analyzed the relationships between different types of superior UP attachment and characteristics of the surrounding structures including the agger nasi cell, skull base, and middle turbinate. This retrospective study utilized computed tomography images of 836 sides with identifiable sinus structure from 434 Taiwanese patients. Types of superior UP attachment, height of the ethmoid cribriform plate, prevalence of agger nasi cell, and degree of pneumatization of the middle turbinate were analyzed. In the current study, neither the presence of an agger nasi cell nor height of the cribriform plate had significant relationship with superior UP attachment type. However, UP attachment type was statistically significantly associated with pneumatized middle turbinate (PMT) type (p < 0.01). The PMT group had a higher incidence of UP attachment to the middle turbinate (38%) than the non-PMT group (18%). In the extensive PMT group, the incidence of UP attachment to the middle turbinate was high to 49%. In conclusion, superior UP attachment to the middle turbinate was associated with pneumatization of the middle turbinate. The UP has a greater tendency to attach to the middle turbinate in cases with more PMT.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Chenggong Road, Taipei, 114, Taiwan, ROC.
authors.forename: Sheng-Yao
authors.initials: SY
authors.lastname: Cheng
authors.affiliation: Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Chih-Jen
authors.initials: CJ
authors.lastname: Yang
authors.affiliation: Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Chiao-Hua
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Chenggong Road, Taipei, 114, Taiwan, ROC.
authors.forename: Shao-Cheng
authors.initials: SC
authors.lastname: Liu
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Chenggong Road, Taipei, 114, Taiwan, ROC.
authors.forename: Chao-Yin
authors.initials: CY
authors.lastname: Kuo
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Chenggong Road, Taipei, 114, Taiwan, ROC.
authors.forename: Jih-Chin
authors.initials: JC
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Chenggong Road, Taipei, 114, Taiwan, ROC. zhengping@mail.ndmctsgh.edu.tw.
authors.forename: Cheng-Ping
authors.initials: CP
authors.lastname: Shih
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005004:Ethmoid Bone / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005005:Ethmoid Sinus / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005260:Female; D005626:Frontal Sinus / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D019291:Skull Base / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D014420:Turbinates / Q000033:anatomy & histology* / Q000000981:diagnostic imaging
keywords: Agger nasi cell; Concha bullosa; Middle turbinate; Skull base; Uncinate process