Preoperative computed tomography evaluation of the paranasal sinuses: what should the physician know? - pictorial essay

Abstract

The introduction of functional endoscopic sinus surgery in the 1980s brought about a drastic change in the treatment of patients with rhinosinusitis, improving quality of life through the removal of pathological processes or anatomical variations that obstruct the drainage pathways of the paranasal sinuses. However, despite the routine use of computed tomography in the anatomical evaluation of the paranasal sinuses, most radiological reports still do not provide sufficient information to guide the surgical planning. The objective of this pictorial essay was to demonstrate, through computed tomography, the main anatomical variations of the paranasal sinuses, the recognition of which is fundamental for preoperative planning, in order to avoid treatment failure and iatrogenic complications.

Anatomical Measurement as a Reference for Functional Endoscopic Sinus Surgery Based on CT Scans and Dissections

“…Computed tomography scans are used in the surgical practice to "map" the anatomy of the paranasal sinuses to define the surgical approach. 14,18 This exam helps with the diagnosis, the decision of the surgical treatment, and the surgeon can identify the anatomical changes and the regions with the highest risk of iatrogenic outcomes. 9 Fig.…”

Clinically Significant Variation of Paranasal Sinuses on CT-Scan

“…Its location is of great importance during FESS. Adequate presurgical evaluation with CT scan imaging technique is important to assess the ethmoidal roof and its nearby structures 29,30 .…”

“…CT scanning is better in identifying anatomical landmarks of PNS preoperatively and thereby reduces the complications of FESS. CT imaging technique is now established as the overall best method for evaluation of patients who are suspected of having a complex anatomy and any aggressive lesion of the paranasal sinuses (PNS) 3,4,5,6,37,38 .…”