A COMPUTERIZED TOMOGRAPHIC STUDY OF UNCINATE PROCESS OF ETHMOID BONE

Background: The uncinate process is an important landmark in the anatomy of osteo-meatal complex of frontal recess which also plays a vital role in the ventilation of middle meatus and sinuses. Its superior attachment shows great anatomic variability. The aim of this study was to observe and classify superior attachment and presence of pneumatisation in uncinate process. Materials and methods: Computed tomographic images of paranasal region from 100 patients were studied retrospectively. In 100 patients, 54 belonged to male and 46 female and were in the age group of 11 to 75 years with an average of 32.7 years. The superior attachment of uncinate process was observed and tabulated according to Landsberg and Friedman classification and pneumatisation of uncinate process was also noted. The results were analysed statistically. Results: The superior attachment of uncinate process was observed in 200 sides out of 100 patients and its attachment to the agger nasi cells (type - 2) was found in 36% while its attachment to lamina papyracea (type ? 1) and to middle turbinate (type ? 6) were found in 19% and 20% respectively. Uncinate process ending at the junction of middle turbinate with cribriform plate (type ? 4), at the ethmoid skull base (type ? 5), bifurcating towards lamina papyracea and junction of middle turbinate with cribriform plate (type ? 3) were seen in 2%, 8% and 5% respectively. In 11%, the superior end showed no attachment to surrounding structures. The uncinate process was pneumatised in 34 of 200 sides (17%), among which 45.5% was unilateral and 54.5% bilateral. Conclusion: Preoperatively evaluating variations of uncinate process and its pneumatisation helps to avoid intraoperative damage to surrounding structures. The detailed knowledge of extent of uncinate process may also help to deduce the reason for refractory chronic sinusitis.