Monday, August 29, 2022

Radiological anatomical variations of the lateral nasal wall and anterior skull base amongst different populations: A systematic review and meta‐analysis

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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 1st 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 I 2 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

56 articles were included with a total of 11805 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: 0.00-100). 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.

Conclusions

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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