Importance of CT Scan of Paranasal Sinuses in the Evaluation of the Anatomical Findings in Patients Suffering from Sinonasal Polyposis

Abstract

Sinonasal polyps are benign lesions arising from nose and/or sinuses mucosa. Paranasal sinuses computed tomogram (CT) scan are important for functional endoscopic sinus surgery (FESS) as their information assist the surgeon in pre-operative planning. This study aimed to show importance of CT scan in evaluation of anatomical variations to prove a correlation with disease process and extent of disease in sinonasal polyposis patients. A study was done from Sept, 2010 to Sept, 2011 with 33 patients presenting with nasal polyps. All recruited patients, after thorough history, general examination and thorough ENT examination, were examined by nasal endoscopy and sinus CT scans. All scans were carried out using a 3 mm thickness in axial and coronal planes with sagittal reconstruction. An analysis was then carried out to see anatomical variations and disease extent in CT scans. Maxillary sinus was the most commonly and most severely affected sinus, while the sphenoid sinus was the least involved sinus. Ostiomeatal complex (OMC) was found to be blocked in 84.85 % cases. There were few anatomic variations (57.58 %) found as hypertrophied uncinate process (30.30 %), septal deviation (21.21 %), skull base type-2, Concha bullosa, Haller's cell, Paradoxical middle turbinate, Onodi cell, pneumatized crista galli and dehiscent skull base. Hyperdense and heterogeneous opacification in paranasal sinuses was seen in 12.12 % patients. Importance of CT scans is to know anatomical variations as etiology, fungal etiology, to know extent of polyposis and anatomical variations to prevent complications during FESS and Navigation sinus surgery.

Computed Tomographic Findings of Nasal and Paranasal Sinuses in Patients Scheduled for Rhinoplasty in Shahid Mostafa Khomeini Hospital during 2011-13

“…[9] This prevalence has been reported as between 21% and 75% in different studies. [7,[10][11][12][13][14][15] In our study, the prevalence of a nasal spur was 33.33% and nasal septal deviation was found in 69.04% of cases. The prevalence of nasal septal deviation in our study was very similar to that found in reports from other parts of Iran.…”

“…The prevalence of concha bullosa in our study was 45.23%, while it has been reported to be between 9.09% and 61% in the literature. [7,[10][11][12]15,16] The reason for the apparently varying prevalence is that different definitions of the concha bullosa are in use. In studies reporting a higher prevalence, any air in the middle turbinate was considered concha bullosa, whilst in our study, only air in the bullous part of the middle turbinate was counted as concha bullosa.…”

Fibrosarcoma arising in the paranasal sinus: a clinicopathological and radiological analysis

“…They are usually bilateral with an appearance that is commonly bags-shaped, and have a characteristic semi-translucent appearance. 26,27 However, the diagnosis of patients with a unilateral mass should be based on radiographic imaging, possible biopsy, and careful follow-up. It is to be noted that chronic sinusitis such as mucoceles may also present with bone erosion, an expansile process, and low T 2 signal intensity due to the dehydration of retained secretions.…”

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

“…Since there are varied views with regarding to associations between sinonasal anatomical variants and rhinosinusitis in the literature this study was proposed. [18][19] The purpose of this study is to investigate the prevalence of sinonasal anatomic variants and to determine their relationship to chronic rhinosinusitis. Very few Indian studies are available for associations between anatomical variants and rhinosinusitis and this study also established the prevalence of sinonasal anatomical variants in suburban population of kancheepuram district, Tamilnadu.…”