The role of uncinate process in odontogenic rhinosinusitis: a case-controlled radiologic anatomy study

Objective: This study aimed to assess the uncinate process (UP) behavior in patients with unilateral odontogenic rhinosinusitis (UOR) and to compare it with a control group of healthy patients. It also aimed to investigate if these modifications could have a clinical role in UOR. Methods: We retrospectively analyzed the head computed tomography (CT) scans of 21 patients with UOR and 53 healthy subjects. A total of 2 independent observers calculated UP inclination on each side with a reproducible anatomical model. All the data were statistically analyzed to assess significant differences between sides and groups. Results: All the patients with UOR showed antero-medialization of the UP. A significant difference was seen in the mean UP deviation values between the diseased sides of UOR and the control groups and between the healthy and diseased sides in patients with UOR. There were no significant differences in UP inclination when comparing all healthy sinuses. Conclusion: Patients with UOR show antero-medialization of the UP with an unclear cause-effect relationship. This study provides a reproducible model for anatomical CT study of the nasal cavities. It remains open to debate whether odontogenic disease is the cause of the UP antero-medialization and whether this deviation has a role in maintaining odontogenic disease and spreading it to other sinuses.