CT evaluation of congenital anatomical variations in paranasal sinuses
DOI:
https://doi.org/10.7439/ijbar.v7i12.3816Abstract
Introduction: A good knowledge of the anatomy of the paranasal sinuses is essential for the clinician to understand sinonasal diseases. Conventional radiology does not permit a detailed study of the nasal cavity and paranasal sinuses, and has now largely been replaced by computerized tomographic (CT) imaging. Currently, CT scanning is the standard imaging in the evaluation of the paranasal sinuses. Objective : To evaluate the congenital anatomical variations of paranasal sinus by CT scan. Materials and Methods: Over a period of 18months, 80 patients referred for CT scan of PNS region to Al-Ameen medical college hospital were evaluated for the presence of normal variants of the paranasal region. Unenhanced CT of the PNS was performed for these patients in the coronal plane, complemented by axial views in selected cases. Results: Deviated nasal septum was the most common variation in 72(90%) followed by concha bullosa in 31 (38.75%) patients. Other variations found were curved uncinate process in 16 (20%), hypoplastic frontal sinus in 14 (17.5%), overpneumatized ethmoidal bulla or giant bulla 13 (16.25%), Paradoxical middle turbinate in 12 (15%), prominent Agger Nasi cells in 11 (13.75%), superior concha bullosa in 07 (8.75%), ariated cristagali in 07(8.75%), haller cells in 05 (6.25%), onodi cells in 03 (3.75%), and pneumatization of uncinate process in 03 (3.75%) patients. Conclusion : The presence of anatomical variants does not indicate a predisposition to sinus pathology but these variations may predispose patients to increased risk of intraoperative complications. The radiologist must pay close attention to anatomical variants in the preoperative evaluation and provide a road map to the surgeon and help avoid possible complications and improve success of management strategies.Downloads
References
Kopp W, Stammberger H, Fotter R. Special radiologic image of the paranasal sinuses. European Journal of Radiology 1998; 8:152-156.
Zinreich J, Mattox DE, Kennedy DW, Chisholm HI, Diffey DM, Rosenbaum AE. Concha bullosa: CT evaluation. Journal of computer assisted tomography 1988; 12:778-784.
Perez-Pinas I, Sabate J, Carmona A, Catalina H C J, Jimenez C J. Anatomical variations in the human paranasal sinus region studied by CT. Journal of Anatomy 2000;197(2):221
Driben J S, Bolger W E, Robles H A, Cable B, Zinreich S J. The reliability of computerized tomographic detection of the Onodi (sphenoethmoid) cell. Am. J. Rhinol 1998; 12:105
Dua K, Chopra H, Khurana AS, Munjal M. CT Scan variations in Chronic Sinusitis. Ind J Radiol Imag 2005; 15:315-320.
Zinreich S. Imaging of inflammatory sinus disease. Otolaryngol Clin North Am 1993; 26:535-547.
Rao V M and El-Noueam K I, Sinonasal imaging. Anatomy and pathology. Radiol. Clin. North Am 1998; 36:921
Mecit K, Mural K, Fatih A, Omer O, Adnan O, Adem K. Remarkable anatomic variations in paranasal sinus region and their clinical importance. European Journal of Radiology 2004; 50(3): 296-303.
Zinreich S. Paranasal sinus imaging. Otolaryngol Head Neck Surg 1990; 103:863-868.
Asruddin, Yadav SPS, Yadav RK, Singh J. Low dose CT in chronic sinusitis. Indian Journal of Otolaryngology and Head Neck Surgery 2000; 52: 17-21.
Kennedy D.W. and Zinreich S.J., Functional endoscopic approach to inflammatory sinus disease: current perspectives and technique modifications. Am. J. Rhinol 1988; 2:89
M.H. Daghighi, A. Daryani, K. Chavoshi Nejad: Evaluation of Anatomic Variations of Paranasal Sinuses. The Internet Journal of Otorhinolaryngology 2007 7; 1:8-12.
Bolger W E, Woodruff W and Parsons D S, CT demonstration of pneumatization of the uncinate process. Am. J. Neuroradiol 1990; 11:552.
Delbert A B, Jocyline L M, Mutsuhisa F, Kook S O, Lionel W . Radiologic Imaging in Otorhinolaryngology. Pediatric Clinics of North America 1981; 28(4):16-19.
Downloads
Published
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).