Co-Existence of Anatomical Variants and Rhinosinusitis on Multi-Sliced Computed Tomography


ABSTRACT:BACKGROUND:Computed tomography (CT) is mandatory and a medicolegal requirement to evaluate rhinosinusitis and provides a road map regarding anatomical variants and endoscopic treatment of rhinosinusitis. OBJECTIVE: To identify coexistence between anatomical variants of nasal constituents and rhinosinusitis by using multi-sliced CT and to ascertain the value of CT as a road map prior to functioning endoscopic sinus surgery. PATIENTS AND METHODS: This is a cross sectional study was done on 87 patients referred for CT scan of the paranasal sinuses. The patients were clinically suspected to have sinonasal diseases. The sample of this study was consist of 52 males and 35 females. The age of patients ranged from 12 - 60 years. All patients were examined by using 64 multi-slice CT scan of paranasal sinus including axial sections and coronal reformat. RESULTS: 76 patients were had diseased sinuses, we discovered 5 abnormalities; mucosal thickening, opacification, air fluid level, mucosal polyp and cyst. The most commonly involved sinus was the maxillary (62 patients) followed by anterior ethmoid, and the commonest abnormality was mucosal thickening. Types of variations include; nasal septal deviation(52.4%), concha bullosa(49%), enlarged ethmoidal bullae (15.9%), large Aggar nasi (15.9%), Haller cells(19.1%), bent uncinate process(11.4%), Onodi cells (11.4%), paradoxical middle turbinate(9.1%), maxillary sinus hypoplasia (7.9%), pneumatized crista galli (6.8%), and both pneumatized nasal septum and asymmetrical ethmoid roof were of (3.4%). The total number of patients having anatomical variants but not associated with sinonasal mucosal abnormalities were (17.1%), while (82.9%) of patients were associated with sinonasal abnormalities. CONCLUSION: The study reveals correlation between certain anatomical variations and specific sinonasal mucosal abnormalities that may interfere with the drainage of the sinus secretions and subsequent secondary infection. Another group of variants were discovered that may lead to intra-operative complications if surgery indicated.