Emanuele Neri MD, Presenter: Nothing to Disclose

Francesca Cerri, Abstract Co-Author: Nothing to Disclose

Francesca Turini, Abstract Co-Author: Nothing to Disclose

Matteo Barattini, Abstract Co-Author: Nothing to Disclose

Luca Muscatello MD, Abstract Co-Author: Nothing to Disclose

Carlo Bartolozzi MD, Abstract Co-Author: Nothing to Disclose

Three anatomical variations of the UP are described: Type 1, is the upper insertion at the level of lamina papiracea (medial wall of the orbit); type 2, is the upper insersion at the the level of the olfactory fossae; type 3, is the upper medial insertion, approximately at the level of the nasal septum. We aimed to evaluate the incidence of the three UP variations at coronal MPR of MRCT.

We investigated 168 patients referred to MRCT for the suspect of nasal polyposis and chronic synusitis. The MRCT study (16th row CT) was performed with a volume acquisition of the maxillo-facial complex on the axial plane, using 0.63mm row thickness, 120 kVp and 100 mAs. MPR were performed on the coronal plane with 1mm thickness and spacing. Two experts radiologists evaluated in consensus the axial and coronal MPR on a dedicated workstation (ADW 4.2; GE/Healthcare) and established the superior site of attachement of the UP. The pneumatization of the ethmoid bullae and the depth fo the olfactory fossae were evaluated as well.

Type 1 variation of the UP was found in 123/168 cases (73%), type 2 in 27 (16%) and type 3 in 18 (10%). The other anatomical variations of the frontal recess were found as follows: flat (112/168; 66%) and deep (56/168; 34%) olfactory fossae; enlarged ethmoid bullae (63/168; 37%).

The superior attachement of the UP occur more frequently at the level of the lamina papiracea, however the superior and medial attachement, if combined with deep olfactory fossae and enlarged ethmoid bullae causes a stenosis of the frontal recess; this combination of anatomical variants is a difficult task for FESS, that the surgeon needs to known prior intervention.

Multirow CT of the paranasal sinuses, performed with volumetric acquisition and integrated by coronal MPR, is essential for planning FESS.

Neri, E, Cerri, F, Turini, F, Barattini, M, Muscatello, L, Bartolozzi, C, Anatomical Variants of the Uncinate Process (UP): Incidence at Coronal MPR Multi-Row CT (MRCT).  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6017874.html