This paper explores variation in maxillary sinus (MS) anatomy between individuals of East Asian, European, and African ancestry, and how these differences may contribute to health disparities in chronic sinusitis. The MS drains mucus through a small opening called the maxillary sinus ostium (MSO), which is located high on the sinus wall. This positioning makes drainage heavily reliant on mucociliary action, rather than gravity. If mucus can’t drain efficiently, it builds up and can lead to infection. The study used 3D CT scans of 167 adult skulls to measure MS and nasal fontanelle (NF) shape and size, especially the vertical distance from the sinus floor to the MSO.
The results showed that East Asian individuals tend to have significantly taller and larger MSs, with the MS floor positioned farther below the MSO. This increased vertical distance means that mucus has to travel farther to be cleared, possibly increasing the risk of chronic sinusitis. In contrast, individuals of European and African ancestry had shorter MSs and shorter distances between the MS floor and MSO, which may allow for more efficient drainage. Despite these differences, the NF—which is used as a bony landmark for the MSO—was similarly sized and positioned across all ancestry groups, suggesting that surgical approaches to sinus treatment can be standardized.
Importantly, the study emphasizes that these anatomical features do not directly cause disease based on ancestry. Rather, individuals with taller MSs—regardless of ancestry—may be more susceptible to sinus infections. The findings help explain why nonallergic (noneosinophilic) sinusitis is more common in East Asian populations and suggest that internal anatomy, along with socioeconomic and environmental factors, contributes to global health disparities.
The authors conclude that anatomical variation, especially MS height, may play a role in sinusitis risk and should be considered in both clinical treatment and future research. This paper highlights the need to study not just pathology or healthcare access, but also how normal anatomical differences between populations might shape disease vulnerability.
This is the paper I read:
https://anatomypubs.onlinelibrary.wiley.com/doi/full/10.1002/ar.24644
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