Anatomical Variations in Superior Attachment of Uncinate Process

Abstract

Introduction: Uncinate process (UP) is a part of ethmoid bone, projects as sickle shaped bone from lateral wall. Uncinate process is a key landmark principal to Functional Endoscopic Sinus Surgery (FESS). Preoperative detection of anatomic variations of the uncinate helps avoid intra-operative damage to the nasolacrimal duct, medial orbital wall and even sphenopalatine artery. This study was done to assess the variations of Uncinate Process  in Nepalese population using CT Scan of Nose and Paranasal sinuses.

Methods:A cross sectional study was carried out at Department of ENT & Head and Neck surgery. Total 200 CT Scan of Nose and Paranasal sinuses in axial and coronal section 0.6 mm section were analyzed for variations in superior attachment of uncinate process.

Results: Out of 200 patients,112 were male and  88 were female. The age group distribution was from 16-70 years(mean age group was 32±4.2 years). Type 1 was most common type ,61%(n=244) followed by Type 3 which accounting for 18%(n=72).Type 2 was seen in 14%(n=56).Type 4 was least common type i.e. 7%(n=28).

Conclusion: Studying anatomical variations in superior attachment of uncinate process on CT scan of Nose and Paranasal sinuses helps in understanding the sinus drainage pathways as well as knowing superior attachment of uncinate process pre-operatively . This ultimately minimizes the possible complications post FESS.

Keywords: CT scan, FESS, Paranasal sinuses , Uncinate process