Journal of Isfahan Dental School

Prevalence of Haller Cells and Its Relationship with Inflammatory Sinus Diseases on Cone Beam Computed Tomogram (CBCT) Images in an Iranian Population

Document Type : مقاله‌های پژوهشی

Authors

1 Assistant Professor, Department of Oral and Maxillofacial Radiology, Tabriz University of Medical Sciences, Tabriz, Iran

2 Assistant Student, Department of Oral and Maxillofacial Surgery, Tabriz University of Medical Sciences, Tabriz, Iran

3 Dentist, Tabriz University of Medical Sciences, Tabriz, Iran

4 Assistant Professor, Department of Operative Dentistry, Zanjan University of Medical Sciences, Zanjan, Iran

Abstract

Introduction: The facial oral pain and symptoms of sinusitis is one of the concerns of patients especially dentists which can be associated with Haller cells. The aim of this study was to evaluate the prevalence of Haller cells of an Iranian population and its relationship with inflammatory sinus disease using CBCT images.
Materials and Methods: In this descriptive- analytical research (in 2018) samples were selected from all available CBCT images of patients referring to Tabriz school of dentistry. Haller cells cases were selected and the samples were examined for the presence of inflammatory sinus disease in the coronal and axial sections. The data from CBCT images were entered in NNT viewer version 2.17 and the images were reviewed by two oral and maxillofacial radiologists. Then agreement between the two observers was measured by Kappa coefficient. Data were analyzed using SPSS 20 and Chi-Square test and p value < 0.05 was considered.
Results: For total sinuses, the prevalence of Haller cells was 44.5% and it was 70.3% for chronic sinusitis. Haller cells were 48.4% unilateral and 52.6% bilateral. There was no significant difference in the frequency of Haller cells between men and women. Statistical analysis showed there was significant correlation between Haller cells presence and sinusitis (p value < 0.05).
Conclusion: According the results of this study, people with Haller cells are more likely to develop inflammatory sinus disease.
Key words: Ethmoid sinus, Maxillary sinusitis, Cone beam computed tomography

1. Proetz AW. Essays on the applied physiology of the nose. AMA Arch Otolaryngol 1954; 60(2): 261.
2. Stammberger H, Wolf G. Headaches and sinus disease: the endoscopic approach. Ann Otol Rhinol Laryngol 1988; 134: 3-23.
3. Stackpole SA, Edelstein DR. The anatomic relevance of the Haller cell in sinusitis. Am J Rhinol 1997; 11(3): 219-23.
4. Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable anatomic variation in paranasal sinus region and their clinical importance. Eur J Radiol 2004; 50(3): 296-302.
5. Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 1991; 101(1 Pt 1): 56-64.
6. Kainz J, Braun H, Genser P. [Haller’s cells: morphologic evaluation and clinico-surgical relevance]. Laryngorhinootologie 1993; 72(12): 599-604. [In German].
7. Milczuk HA, Dalley RW, Wessbacher FW, Richardson MA. Nasal and paranasal sinus anomalies in children with chronic sinusitis. Laryngoscope 1993; 103(3): 247-52.
8. Mathew R, Omami G, Hand A, Fellows D, Lurie A. Cone beam CT analysis of Haller cells: prevalence and clinical significance. Dentomaxillafac Radiol 2013; 42(9): 20130055.
9. Sebrechts H, Vlaminck S, Casselman J. Orbital edema resulting from Haller cell pathology: 3 case reports and review of literature. ActaOtorhinolaryngolBelg 2000; 54(1): 39-43.
10. Earwaker J. Anatomic variants in sinonasal CT. Radiographics 1993; 13(2): 381-415.
11. Yenigun A, Fazliogullari Z, Gun C, Uysal II, Nayman A, Karabulut AK. The effect of the presence of the accessory maxillary ostium on the maxillary sinus. Eur Arch Otorhinolaryngol 2016; 273(12): 4315-9.
12. Genc S, Ozcan M, Titiz A, Unal A. Development of maxillary accessory ostium following sinusitis in rabbits. Rhinology 2008; 46(2): 121-4.
13. Mladina R, Vuković K, Poje G. The two holes syndrome. Am J Rhinol Allergy 2009; 23(6): 602-4.
14. Kane KJ. Recirculation of mucus as a cause of persistent sinusitis. Am J Rhinol 1997; 11(5): 361-9.
15. Gutman M, Houser S. Iatrogenic maxillary sinus recirculation and beyond. Ear Nose Throat J 2003; 82(1): 61-3.
16. Ali IK, Sansare K, Karjodkar FR, Vanga K, Salve P, Pawar AM. Cone-beam computed tomography analysis of accessory maxillary ostium and Haller cells: Prevalence and clinical significance. Imaging Sci Dent 2017; 47(1): 33-7.
17. Capelli M, Gatti P. Radiological Study of Maxillary Sinus using CBCT: Relationship between Mucosal Thickening and Common Anatomic Variants in Chronic Rhinosinusitis. J Clin Diagn Res 2016; 10(11): MC07-MC10.
18. Ameri AA, Eslambolchi A, Bakhshandeh H. Anatomic variants of paranasal sinuses and chronic sinusitis. Iran J Radiol 2005; 2(3,4): 121-4.
19. Caughey RJ, Jameson MJ, Gross CW, Han JK. Anatomic Risk Factors for Sinus Disease: Fact or Fiction? Am J Rhinol 2005; 19(4): 334-9.
20. Bijani B, Qasemi Barqi R, Najjari Alamooti J. Radiologic association between chronic sinusitis and anatomical variations of the nasal cavity. J Qazvin Univ Med Sci 2018, 22(3): 13-22. [In Persian].
21. Dahieni HR. Cone beam CT analysis of Haller cells: prevalence and relationship with orbital floor dehiscence in CBCT of patient’s referred to Shahid Beheshti dental school in 2014. [Thesis]. Tehran, Iran: School of Dentistry, Shahid Beheshti University of Medical Sciences; 2014. [In Persian].
22. Moreidi M. Prevalence of Haller's cells in Cone Beam Computed Tomography. [Thesis]. Ahvaz, Iran: School of Dentistry, Ahvaz Jundishapur University of Medical Sciences; 2018. [In Persian].
23. Davoodi L, Ghaffari R, Sheykhi M, Sarikhani KH. Prevalence of infraobital Ethmoid (hallers) Air cells on panoramic radiographs in patients older than 4 years referred to dental school of Islamic Azad University Khorasgan Branch. J Shahid Sadoughi Univ Med Sci 2016; 24(2): 119-26. [In Persian].
24. Khojastepour L, Haghnegahdar A, Valipour E. Prevalence of haller’s cell by using panoramic radiography. J Mashhad Dent Sch 2016; 40(1): 27-36.
25. Sakhdari S, Mehralizadeh S, Mohammadi Bina S, Taheri MS, Masoumi S, Heshmati L. Frequency and apparent characteristics of infraorbital ethmoid (Haller's) cells and its correlation with related factor in panoramic radiography. J Res Dent Sci 2019; 15(4): 256-61. [In Persian].
26. Ghaffari R, Sheikhi M, Zarrabi H, Safi H. Prevalance of Infraorbital Ethmoid (Haller’s) Air Cell on CT Image in Patients over 6 years of age. J Res Dent Sci 2010; 7(2): 14-9.
27. Solanki J, Gupta S, Patil N, Kulkarni V, Singh M, Laller S. Prevelance of haller’s cells: a panoramic radiographic study. J Clin Diagn Res 2014; 8(9): RC01-RC04.
28. Lorkiewicz-Muszyńska D, Kociemba W, Rewekant A, Sroka A, Jończyk-Potoczna K, Patelska-Banaszewska M, et al. Development of the maxillary sinus from birth to age 18. Postnatal growth pattern. Int J Pediatr Otorhinolaryngol 2015; 79(9): 1393-400.
29. Khayam E, Mahabadi AM, Ezoddini F, Golestani MA, Hamzeheil Z, Moeini M, et al. The prevalence of ethmoidal infraorbital cells in panoramic radiography. American Journal of Research Communication 2013; 1(2): 109-18.
30. Friedrich RE, Fraederich M, Schoen G. Frequency and volumetry of infraorbital ethmoid cells (Haller cells) on cone-beam computed tomograms (CBCT) of the mid-face. GMS Interdiscip Plast Reconstr Surg DGPW 2017; 11(6): Doc 07.
31. Fadda GL, Rosso S, Aversa S, Petrelli A, Ondolo C, Succo G. Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis. Acta Otorhinolaryngol Ital 2012; 32(4): 244-51.
Journal of Isfahan Dental School
Volume 16, Issue 4 - Serial Number 4
January 2021
Pages 427-436