DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161975

Computed tomographic evaluation of anatomical variations of paranasal sinus region

Sanyukta Gupta, Naveen Gurjar, Hemant K Mishra

Abstract


Background: With the advent of multidetector computed tomography (MDCT), imaging of paranasal sinuses prior to functional endoscopic sinus surgery (FESS) has become mandatory. CT of PNS depicts anatomical complexities of osteomeatal complex and its variations that are often found.

Methods: In the present retrospective and prospective study, we have studied anatomical variants of PNS in 200 Indian subjects with clinical suspicion of sinusitis between January 2011 to March 2016, using CT in the coronal plane complemented by axial views.

Results: In majority of patients, anatomical variations were noted with mucosal changes (78.80%). Deviation of nasal septum were the most common anatomical variation followed by Paradoxical middle turbinate, Middle concha bullosa. Other common variants included superior concha bullosa, prominent agger nasi cells, Haller's cells, bony spurs, aerated crista galli and hypoplastic frontal sinus.

Conclusions: Anatomical variations studied on CT scan are found to block the OMC and cause rhinosinusitis. Thus, knowledge of various anatomical variants is necessary for both surgeon & radiologist to avoid possible complications and improve success of management strategies.


Keywords


Anatomical variants, Paranasal sinuses, Computerized tomography, Concha bullosa, DNS, OMC (Osteomeatal complex)

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References


Janarthan R, Vinay K, Ram B, Sathavahana C, Jasvinder S, Vineeta R. Classification of nasal septum deviations - relation to sinonasal pathology. IJOHNS. 2005;57(3):199-201.

Laine F, Sinoker W. The ostomeatal unit and endoscopic surgery: anatomy, variations and imaging findings in inflammatory diseases. AM J Roentgenol. 1992;159:849-57.

Joe JK, Yangagusawa EH. Documentation of variations in sinonasal anatomy by intraop nasal endoscopy. Laryngoscope. 2000;110:223-9.

Cannon CR. Endoscopic Management of Concha Bullosa. IJOHNS. 1994;110:449-54.

Roee L, Michael F. A computer assisted study of the nasofrontal region. Laryngoscope. 2001;111:2125-30.

Bolger WE, Butzin CA, Passons DS. Paranasal sinuses bony anatomic variants and mucosal abnormalities: CT analysis for endoscopic surgery. Laryngoscope. 1991;101:56-64.

Zinreich SJ, Kennedy DW, Rosenbaum AE, Gayle BW, Kunal AJ, Stammberger H. Paranasal sinuses: CT imaging requirements for endoscopic surgery. Radiology. 1987;163:769-75.

Stammberger H, Wolf G. Headaches and sinus disease. The endoscopic approach. Am Otorhinolaryngol. 1988;134:23.

Stackpole SA, Edelstein DR. The anatomic relevance of the Haller Cells in sinusitis. Am J Rhinol. 1997;11:219-23.

Driben JS, Bolga WE, Robles HA, Cable B, Zinreich SJ. The reliability of CT detection of the onodi (sphinoethmoid cell), Am J Rhinol. 1998;12:105-11.

Birsen U, Gulsah B, Yasemin KB,Funda B, Emel AR. Anatomic variations of sphenoid sinus for surgery, Surgical and Radiologic anatomy 2006;28(2):195.

Fikuda Y, Chikamatsu K, Ninomiya H, Yasuoka Y, Miyashiuta M, Furya N. Mucosal in an onodi cell with simultaneous visual disturbance. AurisNasusLarynx. 2009;33(2):199-202.

Mamatha H, Shamasundar NM, Bharathi MB, Prasanna LC. Variation ofosteomeatal complex and its applied anatomy: a CT-Scan study. Indian J of Science and Technology. 2010;3(8):904-7.

Jaiger. CT Evaluations of Paranasal Sinus, their anatomical variation and their clinical importance. (2010).

Dua K, Chopra H, Khurana A, Munjal M. CT Scan variations in chromic sinusitis. Indian J Radiol Imaging. 2005;15(3):315-20.

Mara YK, Gupta Y. Concha Bullosa : Frequency and appearance on sinonasal CT. IJOHNS. 2000;52:40-4.

Earwakerl J. Anatomic variations in snonasal CT. Radiographies. 1993;13(2):381-415.

Tiwari R, Goyal R. Study of anatomical variations on CT in chronic sinusitis. Indian J Otolacyngol Head Neck Surgery. 2015;67(1):18-20.