A computed tomographic study on the morphological variants of the uncinate process in a selected Nigerian population

Abstract

Introduction: The variants of the uncinate process (UP) influence the patency of the osteomeatal complex. They impair the paranasal sinus drainage hence, predispose to chronic rhinosinusitis. They also make endoscopic sinus surgery challenging and increase the risk of iatrogenic complications. This study investigated the different anatomical forms of the UP using computed tomography.

Materials and Methods: Non-contrast cranial Computed Tomographic images of adult patients were
obtained from digital archives of a Teaching Hospital (Radiology department) in Nigeria (Delta State) after ethical clearance. The site of superior attachment, orientation, deviation, atelectasis and aeration of the UP were evaluated. The data were reported in frequencies and further compared using the Chi-square test. A p-value of <0.05 implied statistical significance.

Results: The UP commonly inserted superiorly onto the lamina papyraecea (208,61.9%) followed by the middle turbinate (81,24.1%) and the skull base (47,14%). Horizontally oriented UP was more common (197,58.6%) compared to vertical UP (139,41.4%). The prevalence of the uncinate tip deviation was 38.7% (130) medially and 10.7% (36) laterally, with significant sex differences (p<0.05). The uncinate bulla was present in 9.5% (32).

Conclusion: This study enlightens on the existing forms of the UP among patients evaluated, thus the need for their identification prior to functional endoscopic sinus surgery to minimize iatrogenic complications.