Anatomical Variants Of Paranasal Sinuses Research Articles

Evaluation of paranasal sinus anatomic variations and mucosal changes with cone beam computed tomography

Background/Aim: Anatomical variations of paranasal sinuses are common and play an role in disrupting the drainage of the sinuses, which often causes chronic sinusitis. In this article, anatomical variations of the paranasal sinuses and its relationship with mucosal changes were evaluated retrospectively by cone beam computed tomography (CBCT) which is also known as dental volumetric tomography. Material and Methods: CBCT data of 500 patients who applied to Cukurova University Faculties of Dentistry for any reason were retrospectively evaluated by maxillofacial radiologist. Anatomical variants of paranasal sinuses were included in the study. Mucosal thickening greater than 2 mm in the maxillary sinus was considered pathological. Results: The most common anatomic variation in the study was the nasal septal deviation, found in 302 (60.4%) patients. The least common anatomic variation in the study was lower concha pneumatization found in 3 (0.6%) patients. Mucosal thickening of the maxillary sinus was observed in 271 (54.2%) cases in the right sinus and 260 (52%) cases in the left sinus (p>0.05). Conclusions: Nasal septum deviation was the most common variation in the study. According to the results of our study, concha bullosa, haller cell and the uncinate process had no definite effect on mucosal thickening in the maxillary sinus.

Multi Detector Computed Tomographical Assessment of Anatomical Variants of Paranasal Sinuses

Multi detector computed tomography (MDCT) scan of paranasal sinuses has become mandatory for all patients undergoing functional endoscopic sinus surgery. It depicts the anatomical variations in much simpler way and acts as a roadmap for endoscopic sinus surgery. In this study the maximum of participants were in the age group of 41- 50 years (32 %). The mean age of the study participants was observed to be 43.8 ± 15.6 years. HRCT PNS results shows nasal septum was found to be the most common anatomical variant (DNS- 94%). Concha Bullosa in right side were seen in 37.5% and left side were 21.9% (total unilateral cases- 59.4%) and bilateral Concha Bullosa were seen in 40.6% of the cases. Agger nasi were found to be present in 58% of the CRS cases among which right AN was 41%, left side was 30.8%, and bilateral AN were seen in 28.2% of the cases and Paradoxical Middle Turbinate were seen in 42% of cases in our study. Medialised uncinate was seen in 22% of the cases.

Incidence of Agger Nasi cells and Haller cells in Computed Tomography of Paranasal Sinuses

Introduction Agger nasi and haller cells are few of the common anatomical variants of Paranasal Sinuses (PNS) . They can cause obstruction of osteomeatal complex and frontal recess and can cause refractive sinusitis. Also these variants can lead to complications during procedures like Functional Endoscopic Sinus Surgery (FESS). Hence, complete knowledge about these variants and imaging features help in early diagnosis and also helps in avoiding complications during surgery. Materials and Method A retrospective study of 100 patients conducted during the period from January 2021- April 2021 in Saveetha Medical College and Hospital. All the patients included in the study were referred from the department of otorhinolaryngology for Computed Tomography of PNS. All the images were individually analysed and evaluated for occurrence of Agar Nasi cells and Haller cell variants. Results Out of the study population of 100 patients, 56% of the patients were observed for Agger Nasi cells and 19% of the patients were observed for Haller cells. Conclusion Our study concludes that agger nasi and haller cells are found in a significant proportion of the study population. Hence, Identifying these anatomical variants with great accuracy will help in diagnosing and appropriate management of refractive sinusitis and also be critical in supporting surgeons in tailoring surgery for patients when done preoperatively and thereby avoid fatal complications during procedures (1).

Frequency of Anatomical Variants of Paranasal Sinuses (PNS) on Computed Tomography (CT)

Background: The para nasal sinuses be collection of air filled spaces adjoining the nasal cavity. Para nasal sinuses build up as of the primitive choana at 25–28 weeks of gestation. Three projections ascend from the lateral wall of the nose and work as the commencement of the growth of the para nasal sinuses. The Frequency of Anatomical Variants of Para nasal Sinuses (PNS) may be illustrated on Computed Tomography (CT) by using double slice CT machine. Aim: To reveal the anatomy of the para nasal sinuses as shown on the CT along with point out the variants lead to chronic sinusitis and escort obstacles in sino nasal operations. Methodology: This study was conducted in Ibnae-e Sieena Hospital and MMDC Multan during September 2019 to December 2019. In 50 patients without para nasal sinus diseases symptoms, head computed tomography studies were carried out after having consent from them and IRB. Para nasal sinuses coronal sections were taken. The CT studies were performed by using Dual Source multi slice CT Scanner. Results: 50 participants included in the study, 25 men with 25 women. Out of them, 22 having anatomical variants were noticed. Most common anatomical variants found were pneumatisation of center nasal turbinates (30%) then agger nasi cells 25%, Haller’s cells 20%, along with septal deviation 13% and sphenoid sinus septation (12%). Conclusion: This study shows that nasal cavity and para nasal sinuses anatomical variations are common. For the radiologic analysis of the para nasal sinuses, as of diagnosis of the pre and post -surgical evaluation and sino-nasal lesions, CT is the gold standard procedure. It can outline and explain the anatomical variants in para nasal sinuses. CT not only detect the lesion to vital constitutions which lined the para nasal sinuses but also repeated lesions that extra mural cells. CT of the para nasal sinuses has vital importance and should be passably analyze before FESS. Keywords: Para nasal sinuses, Computed tomography, Nasal turbinate, Ostiomeatal complex

Computer Tomographic study of Anatomic Variations of Paranasal Sinuses in Libyan Population and their Clinical Correlation

Introduction: In the era of Functional Endoscopic Sinus Surgery, precise knowledge of paranasal sinus anatomy and variations are essential for the surgeon. The multi-slice computed tomography is the imaging modality of choice provides accurate evictions of the anatomy, the anatomical variants and the extent of the disease in paranasal sinuses, such a method allowing their accurate identification with high anatomical details. Some of these variants may predispose to sinus diseases or become of high risk for injuries and complication during surgical procedure, therefore, the study of anatomic variants of paranasal sinuses is important in the preoperative endoscopic surgery. Objectives: The purpose of this study is to assess the frequency of anatomic variants and their clinical importance. Materials and methods: This retrospective study was conducted at the Department of Radiology, Benghazi Medical Center, Benghazi, Libya. Data comprised the paranasal sinus computed images of 112 patients (46 males and 66 females) analyzed for the presence of anatomic variants and associated sinus pathology. Results: Our results showed that the most common anatomical variants was deviated nasal septum (60.7%) with slight higher incidence on left side, followed by concha bullosa (22.3%), other variants found were absent frontal sinus (18.8%), Nasal spur (14.3%) , Agger nasi cell (16.1%), Haller cell (5.4%), Onodi cell (2.7%), accessory ostia of maxillary sinuses (10.7%), accessory middle nasal concha (1.8%), paradoxical middle turbinate (1.8%), nasal septum pneumatization (5.4%), Crista galli pneumatization (2.7%), pneumatization of hard palate (1.8%) and pneumatization of clinoid process (6.3%). (53.6%) patients suffered from sinusitis, the results showed that the most common sinus involved was maxillary sinus. Conclusion: Anatomical variations of PNS are quite common. Analysis of every paranasal CT scan obtained for sinusitis for the presence of different anatomic variants is of questionable value unless endoscopic surgery is planned to reduce the risk of intraoperative complications.

The effect of frontal sinus pneumatization on anatomic variants of paranasal sinuses.

The aim of this study is to determine the effect of frontal sinus pneumatization on various variations of paranasal sinuses on maxillofacial CT. A total number of 120 patients (62 females, 58 males) were included in this study. Patients were divided into three groups regarding their frontal sinus pneumatization extent on paranasal sinus CT as Type 1 pneumatization (aplasia and hypoplasia), Type 2 pneumatization (medium) and Type 3 pneumatization (hyperplasia). The prevalence of various variations on paranasal sinus CT like pneumatization of upper and middle concha, presence of agger nasi, Haller and Onodi cell, maxillary sinus and sphenoid sinus hypoplasia, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid sinus, dehiscence and protrusion of internal carotid artery and optic nerve and vidian canal types were ascertained and compared within each group. The prevalence of upper and middle concha pneumatization, Haller cell, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid and internal carotid artery dehiscence and protrusion was higher in Type 3 group compared with other groups. Excessive pneumatization of frontal sinus has various effects on paranasal sinus variations at maxillofacial CT. Surgeons dealing with endoscopic sinus surgery, maxillofacial and skull base surgery must be vigilant of association between certain variations when analyzing CT scan preoperatively for avoiding complications.

Multiparametric Correlation Between Anatomical Variants of the Paranasal Sinuses and Chronic Rhinosinusitis: Case-control Study

Introduction: Chronic rhinosinusitis (RSC) is a disabling disease that can affect up to 70% of people. It is very important to know which are the anatomical variants that the patient presents for surgical planning and often for the treatment of the variants that can present as a risk factor. The evidence shows heterogeneity in the prevalence of these anatomical variants and it is not described quantitatively which are the variants that present the greatest relationship as a risk factor. Establishing the multiparametric correlation between at least one of the most frequent anatomical variants of the paranasal sinuses and the development of rhinosinusitis is the most important objective of this investigation. Materials and methods: Case-control study with multiparametric correlation analysis of the anatomical variants of paranasal sinuses as a risk factor in the development of sinusitis. Analysis with measures of central tendency, Xi2, Fisher's exact test, binary logistic regression. Results: The most frequent anatomical variant was the deviation of the nasal septum on the left side (78%). The second most common variant found was the Agger Nasi cells (68%), followed by the protrusion of the Vidian nerve in the sphenoid sinus (52%). The only anatomical variant that could be determined within the regression model was the obstruction of the osteomeatal complex; which is presented as a risk factor with an OR of 16 (95% CI: 6.9-41.3). Conclusions: Obstruction of the osteomeatal complex is a very important risk factor for the development of chronic rhinosinusitis.

Evaluation of Anatomical Variations on Paranasal Sinus CT

OBJECTIVES: The purpose of this study is to analyze and assess the frequency of anatomical variants of paranasal sinuses scanned by multidetector computed tomography (MDCT). METHODS: A total number of 225 patients (122 males, 103 females) with a median age of 28 (15-77) years were included in this retrospective study. We analyzed the presence of the nasal septal deviation (NSD), variations of the nasal turbinates, ethmoidal air cells, paranasal sinus pneumatization, accessory pneumatization of the paranasal complex, variations of the sphenoid sinus related structures and the optic nerve and vidian canal classification in the paranasal computed tomography (CT) of the selected patients. RESULTS: NSD was present in 124 (55.1%) patients, superior concha pneumatization in 30 (13.3%), middle concha pneumatization in 100 (44.4%), agger nasi cells (ANC) in 192 (85.3%), Haller cells in 47 (20.9%), Onodi cells in 44 (19.6%), maxillary sinus hypoplasia in 6 (2.6%), frontal sinus hypoplasia in 29 (12.9%), frontal sinus aplasia in 7 (3.1%), sphenoid sinus hypoplasia in 7 (3.1%), uncinate process pneumatization in 12 (5.3%), anterior clinoid process (ACP) pneumatization in 60 (26.7%) and pterygoid process (PP) pneumatization in 75 (33.3%) patients. Optic nerve Type 1 was detected in 122 (54.2%) patients, Type 2 in 29 (12.9%), Type 3 in 36 (16%) and Type 4 in 38 (16.9%) patients. Vidian canal Type 1 was observed in 37 (16.4%), Type 2 in 95 (42.2%) and Type 3 in 93 (41.3%) patients. CONCLUSION: The analysis of the paranasal CT is crucial in diagnosis of miscellaneous diseases of the paranasal sinuses. The anatomical variations of the sinuses are prevalent among the population, so otolaryngologists should be aware of these variations for precise diagnosis and to avoid surgical complications.

Diagnostic Performance of Multidetector Computed Tomography (MDCT) in Diagnosis of Sinus Variations

SummaryBackgroundIn this prospective study, we looked for correlations between anatomic variants of paranasal sinuses and chronic or recurrent sinusitis.Material/MethodsTwo hundred and forty (240) patients with clinical features of chronic rhinosinusitis were examined; patients with first-onset or allergic sinusitis and pregnant females were excluded. Routine multi-slice CT of the paranasal sinuses was performed to look for mucosal disease of the paranasal sinuses, drainage pathways, and presence of anatomical variations and their relation to known sinus drainage pathways.ResultsAnatomic variations were very frequent, and we classified them into four easily recognized groups: nasal septum variations, middle turbinate variations, uncinate process variations, and ethmoidal variations. Deviated nasal septum was the most frequent variation in patients with chronic or recurrent sinusitis, and it was detected in 48.8% of cases. Agger nasi cells and concha bullosa were equally frequent (30.6%), and Haller cells were detected in 11.2%. Uncinate process variations were detected in 18.1%, and the large ethmoid bulla was detected in 10%.ConclusionsThe importance of anatomic variations is that they can compromise drainage pathway of the related sinus, which results in inflammatory sinus disease. Anatomical variations are not diseases on their own and may be present as incidental findings in patient with chronic sinusitis.

Variants of paranasal sinuses, risks during surgery and and predisposition to pathologies due to anatomical variants of paranasal sinuses

Variants of paranasal sinuses, risks during surgery and and predisposition to pathologies due to anatomical variants of paranasal sinuses

Volumetric measurements and anatomical variants of paranasal sinuses of Africans (Nigerians) using dry crania

The aim is to determine the volume of each sinus and to highlight the anatomical variants that are common in Nigerians’ dry crania. Twenty- four dried skulls of Nigerians from which the temporal bones had earlier been dissected were studied. A 0° sinus endoscopy (Telescope) was utilized to visualize the paranasal sinuses and their degree of pneumatization was noted. Vernier caliper was employed to measure the distance between the anterior and posterior nasal spine. The height, width, depth and volume of each of the sinuses were determined. The anatomical variants were noted. Aplasia of the frontal sinuses was found in 58% of the studied specimen. There was bilateral aplasia in 50% of the specimen while unilateral aplasia occurred in 8% and on the left side. The volumes of the paranasal sinuses were significantly smaller in the studied crania. In all the paranasal sinuses, the right side was found to be larger than the left except for the maxillary sinus where the left side was found to be larger. Ethmoid showed anatomic variants such as haller Cell, frontal cell, onodi cell and the supra orbital cell. Pre sellar pneumatization was found in 20% of the sphenoid while sellar pneumatization was found in 80%. Key words: Anatomical variants, paranasal sinuses, volume, dried crania, Nigerians.