Zahedi FD, Yaacob NM, Wang DY, Abdullah B. Radiological anatomical variations of the lateral nasal wall and anterior skull base amongst different populations: A systematic review and meta-analysis.
Clin Otolaryngol 2023;
48:271-285. [PMID:
35997634 DOI:
10.1111/coa.13975]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/18/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES
To determine the anatomical variations of the lateral nasal wall and anterior skull base amongst populations in different geographical regions.
DESIGN
Systematic review and meta-analysis.
METHODS
Using PRISMA guidelines, SCOPUS and PUBMED databases were searched from inception until 1 March 2022. The regions and populations identified were from Europe, Asia, Middle East, Australia-New Zealand-Oceania, South America, North America and Africa. Random-effects model was used to estimate the pooled prevalence with 95% confidence intervals (CIs). Heterogeneity was assessed using the I2 statistic and Cochran's Q test.
MAIN OUTCOME MEASURES
Anatomical variations of the lateral nasal wall and anterior skull base confirmed by computed tomography scan.
RESULTS
Fifty-six articles were included with a total of 11 805 persons. The most common anatomical variation of the ostiomeatal complex was pneumatization of the agger nasi (84.1%), olfactory fossa was Keros type 2 (53.8%) and ethmoids was asymmetry of the roof (42.8%). Sphenoethmoidal and suprabullar cells have a higher prevalence in North Americans (53.7%, 95% CI: 46.00-61.33) while asymmetry of ethmoid roof more common in Middle Easterns (85.5%, 95% CI: .00-100). Bent uncinate process has greater prevalence in Asians while supraorbital ethmoid cells and Keros type 3 more common in non-Asians. The overall studies have substantial heterogeneity and publication bias.
CONCLUSION
Certain anatomic variants are more common in a specific population. The 'approach of analysis' plays a role in the prevalence estimates and consensus should be made in future studies regarding the most appropriate 'approach of analysis' either by persons or by sides.
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