@article{70e1a5c8282c4619ab3645015aad3492,
title = "Ancestry-based variation in maxillary sinus anatomy: Implications for health disparities in sinonasal disease",
abstract = "Paranasal sinus drainage is mediated by mucociliary transport and gravity. However, human orthograde posture, along with the superior positioning of the maxillary sinus (MS) ostium, increases reliance on the mucociliary system. Previous research has thus suggested that differences in MS size and shape may impede mucociliary clearance, potentially contributing to disparities in sinusitis susceptibility. To further investigate this hypothesis, this study collected 29 three-dimensional (3D) coordinate landmarks and seven linear measurements of MS morphology from 167 computed tomography (CT) scans of crania of European, East Asian, or Equatorial African ancestry. MANOVA results reveal the Asian-derived individuals are characterized by both a significantly taller MS (F = 14.15, p < 0.0001) and a significantly greater distance from the MS floor to the ostium (F = 17.22, p < 0.0001) compared to those of European and African ancestry. A canonical variate (CV) analysis conducted on 3D landmark data provides corroborative results, distinguishing Asian-derived individuals predominantly on the basis of a relatively lower MS floor. As a greater distance between the MS floor and ostium may impede mucociliary clearance, our results suggest MS anatomy may be a more prominent factor in chronic sinusitis among individuals of Asian ancestry compared to those of European and African ancestries. This provides tentative evidence of an anatomical etiology for chronic sinusitis even in the absence of anatomical variants/abnormalities (e.g., nasal polyps, concha bullosa, Haller's cells, and Agger nasi cells). Further research into the relationship between MS anatomy and sinusitis, in addition to socioeconomic inequalities of healthcare, is warranted to continue evaluating possible contributions to health disparities.",
keywords = "minority health, nasal Fontanelle, ostium, paranasal sinuses, sinusitis",
author = "Suhhyun Kim and Ward, {Lyndee A.} and Butaric, {Lauren N.} and Maddux, {Scott D.}",
note = "Funding Information: We thank the associate editor and two anonymous reviewers for comments that improved this manuscript. We would also like to thank the following curators and staff for permissions and assistance in CT data collection: G. Garcia at the American Museum of Natural History, New York and P. Som at Mount Sinai, Head and Neck Radiology; B. Frohlich and D. Hunt at the Smithsonian Institution, National Museum of Natural History, DC; J. Monge and T. Schoenneman at the Open Research Scan Archive, Penn University, Philadelphia; and the NESPOS society (www.nespos.org). We also thank Lynn Copes at Quinnipiac University for access to CT scans from the Terry Collection. This research was supported by a Grant (# RP170301) from the Cancer Prevention and Research Institutes of Texas (Suhhyun Kim, J.K. Vishwanatha). This project is taken in part from a dissertation submitted to the UNT Health Science Center in partial fulfillment of the requirements for the degree Doctor of Philosophy. Funding Information: We thank the associate editor and two anonymous reviewers for comments that improved this manuscript. We would also like to thank the following curators and staff for permissions and assistance in CT data collection: G. Garcia at the American Museum of Natural History, New York and P. Som at Mount Sinai, Head and Neck Radiology; B. Frohlich and D. Hunt at the Smithsonian Institution, National Museum of Natural History, DC; J. Monge and T. Schoenneman at the Open Research Scan Archive, Penn University, Philadelphia; and the NESPOS society (www.nespos.org). We also thank Lynn Copes at Quinnipiac University for access to CT scans from the Terry Collection. This research was supported by a Grant (# RP170301) from the Cancer Prevention and Research Institutes of Texas (Suhhyun Kim, J.K. Vishwanatha). This project is taken in part from a dissertation submitted to the UNT Health Science Center in partial fulfillment of the requirements for the degree Doctor of Philosophy. Publisher Copyright: {\textcopyright} 2021 American Association for Anatomy.",
year = "2022",
month = jan,
doi = "10.1002/ar.24644",
language = "English",
volume = "305",
pages = "18--36",
journal = "Anatomical Record",
issn = "1932-8486",
publisher = "John Wiley and Sons Inc.",
number = "1",
}