Assessment of Sinonasal Anatomical Variants using 128-Slice MDCT in Patients with Chronic Rhinosinusitis

Abstract

To investigate the prevalence of anatomic variants of the sinonasal cavities using 128-slice-Multidetector CT and to determine their relation to sinonasal mucosal disease. Material and methods: A total of 200 patients were included. The inclusion criteria were patients with clinical symptoms of chronic rhinosinusitis and e exclusion criteria were patients with history of trauma, sinus surgery and sinonasal tumours and patients with contraindications for CT like pregnancy. All the patients with symptoms of chronic rhinosinusitis underwent CT on a 128-MDCT with field of view of 16cm from roof of frontal sinus till floor of maxillary sinus with reconstruction of 0.625mm. The study was acquired in axial plane and coronal, sagittal reconstructions were made.The CT scans was evaluated for the presence of anatomic variants of the sinonasal cavities and associated sinusitis. Results: The paranasal sinus anatomical variants are highly variable as proved by various previous studies. In our study the most common anatomical variant was deviated nasal septum, followed by agger nasi and concha bullosa. There was no statistically significant correlation between any of these anatomical variants and chronic rhinosinusitis in our study. Conclusion: The paranasal sinus anatomical variants are highly variable. In our study, the most commonest anatomical variant was deviated nasal septum, followed by agger nasi and concha bullosa. There was no statistically significant correlation between any of these anatomical variants and chronic rhinosinusitis in our study.

Sinonasal Anatomical Variations in Patients With Chronic Rhinosinusitis

“…This was similar to Wani et al's study, which found concha bullosa in 30% of patients [19]. However, Gouripur et al [20] found concha bullosa in 12% of cases while Mathuram et al [21] found it in 43.5% of cases.…”

Clinically Significant Variation of Paranasal Sinuses on CT-Scan

“…The frontal sinuses are located in the posterior most part of supercilliary arches, between the external and internal tables of frontal bone. Presence of bilateral frontal sinus was reported in (78.6%) subjects and presence of unilateral frontal sinus was found to be present in (17.9%) subjects 23 .…”

“…The development of PNS starts from furrows and ridges in the lateral wall of nasal cavity during 8 th week of development, and sinuses continue their formation as air cells within the cavities until early adulthood from the age of 20 to 25 years. Each sinus is named according to the skull bone in which they are located 1,23 .…”