Anatomical Variations of the Paranasal Sinuses In Chronic Rhinosinusitis

Abstract

Chronic rhinosinusitis (CRS), an extremely persistent illness, is surgically best treated by Functional Endoscopic Sinus Surgery. There are normal anatomical variants of paranasal structures, with septal deviation and concha bullosa of the middle turbinate being the most common. It is assumed that these anatomical variants contribute to chronic sinusitis by blocking normal sinus drainage. Aim: The aim of this study was to assess the relative frequency and concurrence of variations in paranasal sinus anatomy in chronic rhinosinusitis patients. Materials and Methods: All patients over 16 years of age referred to Department of Ear, Nose, and Throat Surgery, MGIMS, Sewagram, Wardha, Maharashtra, India,with a clinical diagnosis of chronicsinusitis were considered for this study. After excluding those with altered anatomy(iatrogenic or pathologic), scans of unaltered patients were meticulously analyzed forvariations in sinus anatomy. Findings were recorded on the patient's data sheet. All findings were analyzed, and tested with Chi square, whereapplicable. Results: Overall 143 patients were analyzed (48.3% male and 51.7% female). Thefrequency of major sinus variations was: Aggernasi cell in 56.7%, Haller cell in 3.5%,Onodi cell in 7%, nasal septal deviation in 63%, andConcha bullosa in 35%, of the studied cases. Conclusion: The frequency of anatomic variations in sinus anatomy may be related torace and heredity. A lower number of cases in addition to the use of low yield imagingmay explain the discrepancies observed between our results and other investigations. The findings of the present study were based on computed tomography.