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Nasolacrimal Duct Obstruction and Frequency of Agger Nasi Cell and other Anatomical Field Variations: A Controlled Study in Northern Iran

Nasolacrimal Duct Obstruction and Frequency of Agger Nasi Cell and other Anatomical Field Variations

Abstract

In this study, we aimed to find the frequency of agger nasi cells (ANC) and their correlation with other anatomical anomalies in dacryocystorhinostomy (DCR) candidates, compared with a control group. The study was conducted on 42 patients with nasolacrimal duct obstruction who underwent DCR surgery. Also, 80 C.T. of healthy sex- and age-matched subjects were selected as the control group. Paranasal sinuses computed tomography scanning was performed preoperatively, and abnormalities including ANC, concha bullosa, osteomeatal complex disease (OMC), nasal septum deviation, and polyposis were investigated and registered. Radiologic findings showed ANC presence in 83.3% of cases, and frequency of concha bullosa was 23.8%, and OMC disease, septal deviation, and nasal polyposis recorded as 11.9%, 85.7%, and 14.3%, respectively. In the control group, ANC was found in 52 subjects (65%), and the difference was statistically significant (P=0.036). There was no significant correlation between the presence of ANC and the coexistence of other mentioned anatomical changes as attributing factors for NLD obstruction. The frequency of ANC was much higher in patients with NLD obstruction compared with the control group, but its association with other anomalies was non-significant.

1. Hur MC, Jin SW, Roh MS, Jeong WJ, Ryu WY, Kwon YH, et al. Classification of lacrimal punctal stenosis and its related histopathological feature in patients with epiphora. Korean J Ophthalmol 2017;31:375-82.
2. Holds JB, Chang WH, Durairaj VD. Orbit, Eyelids, and Lacrimal System Basic and Clinical Science Course, Lifelong education for the ophthalmologist revised. New York: Amer Academy of Ophthalmology 2013;P124-211.
3. Singh S, Alam MS, Javed Ali M, Naik MN. Endoscopic intranasal findings in unilateral primary acquired nasolacrimal duct obstruction. Saudi J Ophthalmol 2017;31:128-30.
4. Liang J, Hur K, Merbs SL, Lane AP. Surgical and anatomic considerations endoscopic revision of failed external dacryocystorhinostomy. Otolaryngol Head Neck Surg 2014;150:901-5.
5. Kaplan M, Fiahin E, Gürsel AO. Examination of lateral nasal wall pathologies associated with distal lacrimal duct obstruction. ENT Updates 2015;5:68-71.
6. Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol 2004;50:296-302.
7. Aramani A, Karadi RN, Kumar S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients-CT findings. J Clin Diagn Res 2014;8:KC01-4.
8. Liu X, Zhan G, Xu G. Anatomical variations of osteomeatal complex and correlation with chronic sinusitis: C.T. evaluation. Chin J Otorhinolaryngol Head Neck Surg (Zhonghua Er Bi Yan Hou Ke Za Zhi) 1999;34:143-6.
9. Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: C.T. analysis for endoscopic sinus surgery. Laryngoscope 1991;101:56-64.
10. Eyigör H, Unsal AI, Unsal A. The role of accompanying sinonasal abnormalities in the outcome of endonasal dacryocystorhinostomy. Am J Rhinol 2006;20:620-4.
11. Gökçek A, Argin MA, Altintas AK. Comparison of failed and successful dacryocystorhinostomy by using computed tomographic dacryocystography findings. Eur J Ophthalmol 2005;15:523-9.
12. Woo KI, Maeng HS, Kim YD. Characteristics of intranasal structures for endonasal dacryocystorhinostomy in Asians. Am J Ophthalmol 2011;152:491-8.
13. Soyka MB, Treumann T, Schlegel CT. The Agger Nasi cell and uncinate process, the keys to proper access to the nasolacrimal drainage system. Rhinology 2010;48:364-7.
14. Zhang L, Han DM, Ge WT, Zhou B, Xian JF, Liu ZY, et al. Anatomical and computed tomographic analysis of the interaction between uncinate processand aggernasi cells. Otolaryngol Head Neck Surg (Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi) 2005;40:912-6.
15. Al-Shaikh S, Javed F, Fincham G, Latif M, Bhutta M. U.K. survey of the present role of ear, nose and throat surgeons in lacrimal surgery. Ann R Coll Surg Engl 2010;92:583-6.
16. Onwuchekwa RC, Alazigha N. Computed tomography anatomy of the paranasal sinuses and anatomical variants of clinical relevant in Nigerian adults. Egypt J Ear Nose Throat Allied Sci 2017;18:31-8.
17. Dua K, Chopra H, Khurana AS, et al. C.T. scan variations in chronic sinusitis. Indian J Radiol Imaging 2005;15:315-20.
18. Rashid A, Deep B, Wameedh A, Al-Badaai Y, Sawhney S. Clinically significant anatomical variants of the paranasal sinuses. Oman Med J 2014;29:110-13.
19. Erfanian Salim R, Mohammadi S. Results of Endoscopic Endonasal Dacryocystorhinostomy; Necessity of Teamwork and Patient Selection; Med Hypothesis Discov Innov Ophthalmol 2015;4:114-9.
20. Watkins LM, Janfaza P, Rubin PA. The evolution of endonasal dacryocystorhinostomy. Surv Ophthalmol 2003;48:73-84.
21. Dinis PB, Matos TO, Angelo P. Does Sinusitis Play a Pathogenic Role in Primary Acquired Obstructive Disease of the Lachrymal System? Otolaryngol Head Neck Surg 2012;148:685-8.
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IssueVol 59, No 4 (2021) QRcode
SectionArticles
Published2021-05-18
DOI https://doi.org/10.18502/acta.v59i4.6218
Keywords
Agger nasi cells Nasolacrimal duct obstruction Dacryocystorhinostomy

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How to Cite
1.
nemati shadman. Nasolacrimal Duct Obstruction and Frequency of Agger Nasi Cell and other Anatomical Field Variations: A Controlled Study in Northern Iran. Acta Med Iran. 59(4):203-205.