Osteomeatal complex disease (OMD) is an inflammatory mucosal disease which affects the anterior ethmoid cells, the ethmoid infundibulum
, and the drainage pathways leading to the middle meatus.
This exposes the ethmoid infundibulum
. Using a back-biting forceps (figure, B) a section of the uncinate is removed (figure, C), creating a rough edge of tissue to allow dissection with the microdebrider (figure, D).
It is orientated almost sagitally and runs from anterosuperior to posteroinferior and forms the medial border of the ethmoid infundibulum
. The lateral border of the infundibulum is the lamina papyracea (Fig.
The presentation of an enlarged pneumatized bulla ethmoidalis (BE) that obstructs the ethmoid infundibulum
has not been previously reported.
(9) have defined the osteomeatal complex as a complex including the maxillary sinus ostium, ethmoid infundibulum
and middle meatus; in other words, as the final site of drainage from the frontal and maxillary sinuses and anterior ethmoidal cells.
(3) Yanagisawa and his group also have stated that the ostium of the ethmoid bulla is often found in the hiatus semilunaris superior, but that it can also be found in the anterior or lateral wall of the bulla, the ethmoid infundibulum
, the hiatus semilunaris inferior, or the retrobullar recess.
The drainage pathway, or ostium, of a pneumatized uncinate process may open directly into the middle meatus, the ethmoid infundibulum
or, as seen in this patient, into the ethmoid sinus.
Computed tomography (CT) of the sinuses revealed minimal findings, with only a slight clouding in the left ethmoid infundibulum
Therefore, it is important to remove any obstruction of the natural ostium of the maxillary sinus or the ethmoid infundibulum
The ethmoid bulla, the largest cell of the anterior ethmoid sinus, usually drains into the ethmoid infundibulum
. (2) Visible ostia on the anterior surface of the ethmoid bulla are not frequently seen on endoscopic exam as in the 6 cases presented in this article.
Computed tomography (CT) of the sinuses demonstrated prominent Haller cells impinging on the ethmoid infundibulum
and the maxillary sinus outflow tracts (figure, A).
A prospective, multicenter research study is under way to demonstrate long-term improvement in chronic rhinosinusitis symptoms after transantral balloon dilation of the ethmoid infundibulum
. Trial results from an interim analysis of symptomatic status using the Sino-Nasal Outcome Test 20 survey demonstrate significant and sustained improvement through post-procedure 1-year follow-up.