Correlation of ethmoid bulla morphology and bone changes around anterior ethmoid sinus ostium with severity of chronic ethmoid sinusitis

Abstract

Objective To investigate the correlation of the morphological parameters of ethmoid bulla and bone changes around anterior ethmoid sinus ostium by CT scanning with the severity of chronic ethmoid sinusitis. Methods Clinical data of 48 patients with chronic ethmoid sinusitis undergoing high resolution CT of the nose in our hospital from January 2017 to August 2020 were collected and retrospectively analyzed. The CT data of 32 normal individuals were also collected as control. According to the soft tissue thickness of ethmoid sinus (0, 1, 2~3, ≥4 mm), the subjects were divided into subgroups 0, 1, 2 and 3. The CT data of normal control group and chronic ethmoid sinusitis group were used for three-dimensional reconstruction of ethmoid sinus and ethmoid bulla. The morphological parameters of ethmoid bulla and the CT value of bone around ethmoid sinus were compared between the 2 groups to analyze the correlation of the parameters with severity of sinusitis. Results ① Ethmoidal morphological parameters: ethmoidal volume, surface area, anteroposterior diameter, mediolateral dimension and vertical diameter were significantly greater in the chronic ethmoid sinusitis group than the normal control group (P < 0.01), and the bubble related parameters were obviously higher in subgroups 2 and 3 than the subgroup 1 in chronic ethmoid sinusitis patients (P < 0.05). Ethmoidal infundibulum diameter and anterior ethmoidal outflow tract cross-sectional area were notably larger in the chronic ethmoid sinusitis group than the normal control group (P < 0.01). The volume of ethmoid bulla in individuals was negatively correlated with the anterior ethmoidal outflow tract cross-sectional area (r=-0.325, P < 0.05). ② The CT value of the bone around the ethmoid sinus opening was significantly higher in the chronic ethmoid sinusitis group than the normal control group (P < 0.01). The CT value of the bone around the ethmoid sinus opening was significantly higher in subgroups 2 and 3 than the subgroup 1 in chronic ethmoid sinusitis patients (P < 0.05). Conclusion Morphological parameters related to ethmoid bubble and CT value of bone around ethmoid sinus opening in the anterior ethmoid can lead to ethmoid funnel stenosis and affect the unobstructed drainage of ethmoid sinus, and are positively correlated with the severity of chronic ethmoid sinusitis.

Keywords

• chronic ethmoid sinusitis
• ethmoid bulla
• three-dimensional reconstruction
• ethmoidal infundibulum
• anterior ethmoid bone changes