Study of anatomical variations of ostiomeatal complex in chronic rhinosinusitis patients

Abstract

<p class="abstract"><strong>Background:</strong> Anatomical variations like nasal septal deviations, concha bullosa, paradoxical middle turbinate, pneumatized or medially bent uncinate etc. can encroach upon the ostiomeatal unit and narrow ostiomeatal channels. The aim of the study was to study the anatomical variations of ostiomeatal complex commonly associated with paranasal sinus disease among patients with chronic sinusitis using computed tomography.</p><p class="abstract"><strong>Methods:</strong> A prospective longitudinal study was conducted in the ENT department of our hospital for a period of one year. All the adult patients with complaints suggestive of chronic rhinosinusitis for a period of more than 12 weeks, patients with acute exacerbation of chronic rhinosinusitis and with persistent chronic rhinosinusitis requiring surgical intervention are included in our study. Based on our inclusion and exclusion criteria a total of 138 patients were involved in the study. </p><p class="abstract"><strong>Results:</strong> In our study we saw the association between various sinusitis and the anatomic variations of the ostiomeatal complex and we found that concho bullosa found to have a strong significant association with maxillary sinusitis (43.6%) and anterior ethmoid sinusitis (42.1%). Most of the patients with posterior ethmoid sinusitis (53.8%) had a statistical significant association in developing deviated nasal septum type of anatomical variant and majority of the patients with sphenoidal sinusitis had a onodi cell type of anatomical variant and their association was found to be statistical significant (p<0.05).</p><p><strong>Conclusions:</strong> The importance of CT scan and nasal endoscopy is emphasized in patients with persistent symptoms to identify the anatomical variations that may contribute to the development of chronic sinus mucosal disease. </p>

Correlation of sinonasal anatomical variations with relevant sinus involvement in chronic rhinosinusitis: a prospective observational study

“…These results are similar with the study conducted by Fadda et al, Senniappan and Raja et al in 2018 which showed maxillary sinus is the most common sinus involved followed by anterior ethmoid, frontal, posterior ethmoid and sphenoid sinus. 11,12 Other researchers have reported slightly variable results, Kim et al 15 have also shown that maxillary sinus was the most commonly involved sinus but they found frontal sinus is least commonly involved sinus. Whereas similar studies conducted by Maru et al, Zinreich et al and Bolger et al found that anterior ethmoid sinus involvement was the most common followed by the maxillary sinuses.…”

“…23 However, a recent study by Senniappan and Raja et al in 2018 showed slightly different results. 12 They have found that Septal deviation is more likely to cause posterior ethmoid sinusitis (p<0.01) than maxillary sinusitis. However, they too have reported that concha bullosa is significantly associated with maxillary and anterior ethmoid sinusitis and agger nasi cell with frontal sinusitis (but not with anterior and posterior ethmoid sinusitis as in our study).…”

“…5,11 While other like Rashi et al, Shivakumar Senniappan, Komathi Raja et al found maximum number of patients were of age group 21-30 years. 7,12 In our study we had 57 patients with CRSwNP and 4 patients CRSsNP. According to EPOS 2012 CRSsNP comprises more than two-thirds of cases whereas CRSwNP represents 20-25% of cases.…”

Characteristics of Chronic Sinusitis Based on Non-Contrast CT Scan at the ENT-Head and Neck Surgery Polyclinic of Regional General Hospital Dr. Zainoel Abidin Banda Aceh

“…This is in accordance with Shivakumar et al, that the most common anatomical variation was the septal deviation among 98 people (71%). 36 Moreover, Ratnawati 37 stated that septal deviation was the most common anatomical variation among 24 people (77%). 37 Aramani et al 38 also found that 40 people (74.1%) had a deviated septum and 18 people (33.3%) were chronic sinusitis patients.…”

Anatomical Variations of the Nose and Paranasal Sinuses Found on CT Scans Images of Adult Chronic Rhinosinusitis Patients

“…Septal deviation is the predominant anatomical variations of the nose and paranasal sinuses in CRS patients, accounting for 90.8% of cases. Research by Hamid (2019) 25 and Shivakumar (2018) 26 found 75% (from 100 subjects) and 71% septal deviation. Additional research by Maru et al (2011) 27 and Fadda et al also identified septal deviation as one of the most common anatomical variations of the nose and paranasal sinuses, with prevalence rates of 55% and 60%, respectively.…”