Association between accessory maxillary ostium, Haller cell, and sinus pathologies in cone-beam computed tomography

Introduction
Ostiomeatal complex variations may be affected by maxillary and ethmoid sinus pathologies. Objectives: To evaluate the presence of accessory maxillary ostium (AMO), Haller cell (HC), maxillary sinus patho­logies, and ethmoid sinusitis, using cone-beam computed tomography (CBCT).

Material and methods
CBCT images of 628 patients (339 males and 289 females) between 19 and 91 years (mean age, 47.5 ± 15.3 years) were retrospectively evaluated. Presence of AMO, HC, maxillary sinus pathologies, and ethmoid sinusitis was investigated. Maxillary sinus pathologies were classified. Associations of parameters with each other, and with maxillary sinus pathologies and ethmoid sinusitis were observed. Chi-square test was applied to analyze the relationships between variables and distribution of parameters.

Results
AMO was detected in 27%, HC in 15.3%, ethmoid sinusitis in 61.5%, and maxillary sinus pathology in 47.9% of the images. The most common maxillary sinus pathology was localized mucosal thickening, with 28.8% on the right and 25.2% on the left. Statistically significant differences were determined between AMO and maxil­lary sinus pathologies with ethmoid sinusitis (p < 0.001), and HC with maxillary sinus pathologies (p < 0.05). Maxillary sinus pathology and presence of ethmoid sinusitis were more common in males (p < 0.001).

Conclusions
There was a significant association among maxillary sinus pathology, AMO, HC, and ethmoid sinusitis. Significant relationship was observed between ethmoid sinusitis and all parameters, except for HC. The presence of these variations may increase the possibility of maxillary and ethmoid sinus pathologies. CBCT is a very successful imaging method in examining the anatomy of the paranasal sinus region.