X-ray statistical analysis of role of accessory maxillary sinus ostia in development of chronic sinusitis

Abstract. With the development of evidence-based medicine, the role of statistics becomes more significant. However, inaccuracies in the algorithms for applying statistical methods and their inconsistency with research objectives lead to questions about the conclusions obtained. This article presents an overview and analysis of the Materials and Methods section of articles about the relationship of the accessory maxillary ostia (AMO) with chronic maxillary sinusitis (CMS). The results suggest that the role of AMO in the progression of CMS remains ambiguous. Therefore, a retrospective case-control analysis of 2,500 MSCT was carried out at the Sverzhevsky Research Institute of Clinical Otorhinolaryngology. According to the criteria of compliance, 1,688 MSCT were selected from them. There were 2 groups: with signs of CMS (n = 1,115) and without them (n = 573). In each of the groups, radiological signs of the presence of AMO were determined with the determination of their localization in the anterior/posterior fontanelles. In the group with signs of CMS, 219 AMO were found in the posterior fontanelle (PF), 7 in the anterior fontanelle (AF); no AMO were found in 889 images. In the group without CT signs of CMS, 124 AMO were detected in the PF, 16 AMO in the AF; no AMO were found in 433 CT images. When assessing the presence of a connection between CMS, the absence of a connection between CMS and AMO in the PF was revealed, while data were obtained for the presence of a connection with AMO in the AF. However, upon further analysis, the strength of the bond is estimated as insignificant/weak, and the direction of the bond (odds ratio) is the opposite. Thus, for clinicians, these data mean that AMO in the PF is not a significant risk factor for the progression of CMS, and AMO in the AF is more common in healthy people than in patients and not only does not affect the progression of CMS but may not even be considered a risk factor.