Theoretically, these variations could shift & compress the ostiomeatal complex
components, preventing mucus drainage & thus predispose to chronic rhinosinusitis.
On nasal endoscopy, her right ostiomeatal complex
is widely patent without mucopurulent drainage.
Age, year 9 [+ or -] 4(3-20) (c) Gender, % Male 53 Ethnic group, % White 25 Mulatto 74 Black 2 Body mass index, kg/[m.sup.2] 16 [+ or -] 2(11-22) (c) Shwachman score 85 (65-100) (d) Endoscopic exam, % Middle meatus purulent secretion 38 Adenoid hypertrophy 18 Polyps 12 CT scan, % Maxillary opacification (a) 73 Ethmoid opacification (a) 61 Ostiomeatal complex
opacification (b) 61 Note.
However, ostiomeatal complex
obstruction is not correlated with the growth of maxillary fungus ball which contradicts these hypotheses .
In our case, the main complaints were facial swelling and pain developing secondary to complicated chronic sinusitis associated with ostiomeatal complex
Inflammation of the sinonasal mucosa leads to obstruction of the ostiomeatal complex
(Stammberger 1986) coupled with gravity and decreased mucociliary clearance, and inspissation of secretions occurs in the sinuses forming a culture medium for bacterial growth.
The etiology of the disease is based on the primary predisposing factor, which is an obstruction of the ostiomeatal complex
that results in hypoventilation of the maxillary sinus gases.
Presence of CB not only limits the exposure of surgical field, but may also block ostiomeatal complex
(OMC) and, hence, sinus disease.
An ideal surgical correction of the nasal septum should satisfy the following criteria 1) should relieve nasal obstruction (2) should be conservative (3) should not produce iatrogenic deformity (4) should not compromise the ostiomeatal complex
(5) must have the scope for a revision surgery.
Although endoscopic sinus surgery was originally intended to address the ostiomeatal complex
in sinusitis, (1) its use has extended to other indications, including dacryocystorhinostomy, (2) pituitary gland surgery, (3) and excision of sinonasal tumors.
So the guiding principle of management is to reverse the pathology at the ostiomeatal complex
and hence new modalities of treatment have dramatically changed standards in the case of patients with rhinosinusitis.
CT scan of the nasal cavity and paranasal sinuses showed a blocked right ostiomeatal complex
and a soft-tissue lesion expanding the right nasal cavity with posterior nasopharyngeal extension and a right concha bullosa.