Anatomical Variations Of Paranasal Sinuses Research Articles

Role of computed tomography in identifying anatomical variations in chronic sinusitis: An observational study

Background/Aim: Clear visualization of bony wall, mucosal layer, sinus contents, and compartment by computed tomography (CT) helps to identify the anatomical variations in chronic sinusitis (CS). We describe the clinical and radiological features in CS. Materials and Methods: We included patients of both genders aged ≥15 years, with CS. Unenhanced CT images of the nasal cavity and paranasal region were taken in coronal, complemented by axial and sagittal reconstructions. Analysis of anatomical variants was performed using a soft tissue window and a bone window. Results: Headache (64%), nasal obstruction (53%), and nasal discharge (38%) were common complaints of 100 patients (male = 52) whose mean ± standard deviation age was 32.55 ± 10.9 years. Significant mucosal thickening in at least one of the paranasal sinuses (PNSs) was seen in all except four patients. All had a minimum of one anatomical variant, 72% had >1 variant. Maxillary antra were most commonly involved (62.0%), followed by ethmoid sinuses (36.0%). Deviated nasal septum (60%) was most common, followed by concha bullosa (38%); paradoxical middle turbinate (18%), ethmoidal bulla (20%), agger nasi cells (33%), Haller cells (21%), and onodi cells (10%) were other features. All had optic nerve involvement with Type I (84%) involvement being common. Kero's classification Type I was noted in 71%. None had Type IV. Cribriform plate and carotid canal wall were normal in all while 2% had dehiscence of lamina papyracea. Conclusion: CT plays an important role in visualization of anatomical variations in PNSs, and anatomical variations particularly in the ostiomeatal complex are the key factors in the causation of CS.

Ophthalmic comlications of functional endoscopic sinus surgery

Functional endoscopic sinus surgery (FESS) is an effective and safe surgical technique, which revolutionized the surgical management of nasal cavity and paranasal sinus diseases. The intimate connection between paranasal sinuses and the orbit places the orbital content at a risk of injury during sinus surgery, especially that of ethmoid sinuses. The orbit, the optic nerve, extraocular muscles and the lacrimal drainage system could be damaged during FESS. The risk of injury correlates to anatomical variations, degree and severity of disease, previous procedure results, and surgical experience. Ophthalmic complications can vary in severity from minor ones, such as localized hematomas, to extremely dangerous, such as optic nerve injury, that could lead to complete blindness. In order to minimize the risk of such complications, it is necessary to consider probable anatomic variations of paranasal sinuses and orbit, which are to be detected by CT scan before surgery.

Role of anatomic variations of paranasal sinuses on the prevalence of sinusitis: Computed tomography findings of 350 patients.

The aim of this study was to determine the frequency of anatomic variations of the paranasal sinuses and their roles in the development of sinusitis. Computed tomography of paranasal sinuses of 350 patients was assessed in terms of anatomic variations and inflammatory sinus pathology. The coexistence of anatomic variations with sinusitis was statistically investigated. At least one anatomical variation of paranasal sinuses was detected in 325 patients (92.9%). In 297 (91.4%) of these patients, sinusitis was observed at rates varying depending on the types of anatomic variations. A statistically significant relationship was found between agger nasi cells, Onodi cells, hypertrophy of middle concha, concha bullosa, uncinate bulla, and the medial and lateral deviations of uncinate process and sinusitis. On the other hand, there was no statistically significant relationship between septal deviation, paradoxical middle concha, secondary middle concha, great ethmoidal bulla, and sinusitis. Certain types of paranasal sinus variations create a susceptibility to sinusitis.

CT evaluation of congenital anatomical variations in paranasal sinuses

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.

Evaluation of Anatomical Variations of Paranasal Sinuses in Cone-beam Computed Tomography (CBCT) of Patients with Chronic Rhinosinusitis in Comparing with Normal Individuals

Evaluation of Anatomical Variations of Paranasal Sinuses in Cone-beam Computed Tomography (CBCT) of Patients with Chronic Rhinosinusitis in Comparing with Normal Individuals

Pictorial essay: Anatomical variations of paranasal sinuses on multidetector computed tomography-How does it help FESS surgeons?

With the advent of multidetector computed tomography (MDCT), imaging of paranasal sinuses prior to functional endoscopic sinus surgery (FESS) has become mandatory. Multiplanar imaging, particularly coronal reformations, offers precise information regarding the anatomy of the sinuses and its variations, which is an essential requisite before surgery.

Relationship between adenoid vegetation and anatomic variations of paranasal sinuses

Conclusion. We could not demonstrate an effect of adenoid vegetation on development of paranasal sinus anatomic variations. Objective. To investigate whether adenoid vegetation has an impact on anatomic variations of paranasal sinuses. Patients and methods. Fifty-six children with adenoid vegetation and 25 children without adenoid vegetation were enrolled in the study. The paranasal sinus anatomic variations were investigated via coronal section CT scans. Results. No statistically significant difference was noticed between children with and without adenoid vegetation. In addition, no significant correlation with respect to age of children and anatomic variations was determined.

Evaluation of Anatomic Variations of Paranasal Sinuses

Nowadays, CT-scan is used as a diagnostic modality for evaluating the Paranasal sinuses with extraordinary superiority in comparison with radiography. In this study, 292 CT-scan cliche samples were collected for evaluating the anatomic variations and their prevalence. These patients were between 15-50 years old and they didn't have any pathology in their sinuses. According to the results, the septal deviation (34.24%) was the most common and normal variation and the other cases were sequentially as follow: 1Agger Nasi cell (36.22%), 2Concha bullosa (15.90%), 3Hypo plastic frontal sinus (6.24%), 4Aerated Septum (2.62%), 5Haller cell (1.41%), 6Onodi cell (0.40%) The theory was set forth for discussing the relation between septal deviation and Concha bullosa. This theory was focused on the existence of Concha bullosa in one side that increase the plausibility of Septal deviation toward the opposite side (Pvalue<0.001). INTRODUCTION The Paranasal CT-scan is used for examining the patients with sinusitis and its complications, because of the normal variations of Paranasal sinuses that have a constant role in etiology of the chronic and recurrent sinusitis. Also there are anatomic variations in CT-scan of patients that do not have any sinusitis clinical symptoms. The plausible pathogeneses prevalence and the clinical symptoms of anatomic variations are under study and investigations. The purpose of this study was to investigate the normal variations prevalence both generally and also considering male and female cases separately .Besides, this study was underlined the importance of using the statistical information in further studies in the field of the relation between anatomic variations and chronic or recurrent sinusitis and its complications. The hypothesis was set forth for discussing the relation between septal deviation and Concha bullosa, thus, the existence of Concha bullosa in one side, lead to septal deviation toward the opposite side. Furthermore, this research could be expand byconsidering the size of Concha bullosa in complementary studies due to that the bigger size of Concha bullosa, the more plausibility of septal deviation toward the opposite side. METHODS The CT-scan cliches of the paranasal sinuses were collected from patients that were referred to Imam Hospital of Tabriz university of Medical sciences, between July 2006 and April 2007. This research was based on a cross-sectional study and after the pilot studies on 50 CT-scan cliche cases, this sample size was selected. There were 292 participants in this study, 146 male and 146 female, equally. The average age of the participants was 31 years old. The patients who had the positive pathology such as sinusitis, polyp, tumor, fractures and those who were under 15 years old were eliminated. CT-scan checklist was considered as the control and evaluating method. Also, the patient's age, sex and symptoms were registered in the checklist. The anatomic variations such as Agger Nasi cell, Concha bullosa, Haller cell, Onodi cell, Nasal septal deviation, aerated septum and hypoplastic frontal sinus were evaluated in the CT-scan Evaluation of Anatomic Variations of Paranasal Sinuses

The relationship between anatomic variations of paranasal sinuses and chronic sinusitis in children

Conclusions. Anatomical variations in the nose and paranasal sinuses are common in children. Due to the absence of a definitive relationship between anatomical variations and sinus disease, local, systemic or environmental factors appear to be more significant in pediatric sinusitis than the anatomic variations. Objective. Chronic sinusitis is increasing in the pediatric population. Following the initial reports of functional endoscopic sinus surgery (FESS) for children, the majority of patients undergoing this procedure have experienced improved quality of life. Thus, we need to know the precise anatomy and anatomical variations of the nose, as well as the relationship between such anatomy and chronic sinusitis. Patients and methods. To determine the extent and distribution of disease, as well as associated anatomic abnormalities, computed tomography (CT) scans were performed on 113 children with persistent symptoms of sinusitis after failure of medical therapies. Results. The maxillary sinus was the most commonly involved sinus, followed by the ethmoid, sphenoid, and frontal sinuses. There was no relationship between age and severity of sinusitis. Agger nasi cell was the most common anatomical variation, followed by septal deviation, Haller cell, concha bullosa, paradoxical middle turbinate, and Onodi cell. The prevalence of septal deviation increased with age. There was no significant relationship between the sinusitis and anatomic variations.

Anatomic Variations of Paranasal Sinuses: Application to Functional Endoscopic Surgery

Anatomic Variations of Paranasal Sinuses: Application to Functional Endoscopic Surgery