Common Anatomic Variant Research Articles

Prevalence and characteristics of lumbar ribs: a meta-analysis with anatomical and clinical considerations.

Lumbar ribs (LR) are a rare and relatively unknown anatomical abnormality of the lumbar spine. The literature provides better understanding regarding other spinal congenital variations like cervical ribs or lumbosacral transitional vertebrae, which are rather commonly recognised conditions. Thus, this meta-analysis aimed to provide data on prevalence and key characteristics of LR. Relevant databases were systematically searched for studies reporting the prevalence, laterality and geographic distribution of LR. No exclusion criteria based on language and date of original articles were employed. The pooled prevalence estimates (PPE) were calculated using a random-effects model. To assess the between-study heterogeneity, the I2 statistic and Chi-square test were utilized. Throughout the investigation, the PRISMA guidelines were adhered to scrupulously. Evaluation of the included studies' reliability was made with the AQUA tool. In total, 9 studies were included in this meta-analysis. The pooled prevalence estimate (PPE) of LR was 2.1% (95%CI: 1.0-4.6). In studies based on CT imaging, LR were found in 1.6% (95%CI: 0.6-4.3) of patients and in Xray based studies in 2.1% (95%CI: 0.4-11.1) of patients. Lumbar ribs were bilateral in majority of individuals (65.4%, 95%CI: 39.4-84.6) and could be most frequently encountered in Europe with PPE of 2.8% (95%CI: 3.0-20.0), then in East Asia with PPE of 1.5% (95%CI: 1.0-19.2) and Middle East with PPE of 1.1% (95%CI: 0.6-20.0). The findings of our study indicate that LR are a common anatomical variation of lumbar spine, contrary to previous beliefs. In a clinical practice, when a patient presents with a non-specific low back pain, a possible occurrence of LR should be taken into consideration. The presence of LR may be misleading for surgeons and result in wrong-level spine surgeries.

Atrial septal pouch in cats: first report on interatrial septum anatomical variations.

The atrial septal pouch was first recognised in humans in 2006 and, since 2010, has been described in more detail. The first reports on the left-sided atrial septal pouch linked its occurrence with a higher risk of thromboembolic stroke resulting from left atrial thrombus formation. However, subsequent studies have challenged this theory; therefore, the consequences of septal pouch occurrence remain disputed. Currently, in veterinary species, septal pouch occurrence and morphology have been described in sheep and pigs, showing species-related differences. No studies have been conducted on cats. As cats show a species-related risk of aortic thromboembolic disease resulting from left atrial thrombus formation, we aimed to describe the interatrial septum anatomical variations as the first step in the investigation of the relationship between the septal pouch presence and left atrial thrombus formation. The study was conducted on hearts collected post mortem from 80 cats. After formalin fixation and dissection, a detailed anatomical description of the interatrial septum for all cases was followed by a histopathological analysis of the heart in 25 cases. After dissection, the specimens were embedded in paraffin blocks and stained with haematoxylin and eosin, Masson-Goldner trichrome, Picrosirius Red and Movat pentachrome in a routine manner and evaluated via light microscopy. Our study showed a very high prevalence (95%) of the left-sided septal pouch in cats with a lower incidence (29%) of the right-sided septal pouch. We noted a high morphological variety of the left-sided septal pouch and described anatomical variants not previously reported in the literature. The septal pouch is a common anatomical variation of the interatrial septum in cats. Although, based on the current study, we cannot draw further conclusions on the relationship between the left-sided septal pouch and thromboembolic events in cats, the high prevalence of this anatomical entity points to a need of further studies on the topic.

Clinical implications of aberrant anatomy of the common hepatic duct in liver surgery: a systematic review and meta-analysis.

Knowledge of anatomical variants that affect the hepatic duct (HD) are of particular clinical relevance during hepatobiliary surgical procedures. More specifically, the aberrant anatomy of the common HD is the most common anatomical variation affecting the biliary tree. Below, we describe different classifications of anatomical variants that affect this canal. According to Huang's classification, variations are determined depending on the insertion of the right posterior hepatic duct (RPHD). Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases were investigated until January 2024. The methodological quality was assessed with an anatomical studies assurance tool (AQUA). Pooled prevalence was estimated using a random effects model. For the subgroup analysis, Student's T-test was used. The prevalence rate of aberrant hepatic duct (AHD) was 15% (confidence interval [CI] of 7-22%). The first subgroup had cadavers and images. For the cadavers, the prevalence was 15.83% (CI: 11.22-18.3%), while the images had a prevalence of 22.06% (CI: 18.12-25.33%). This subgroup analysis showed no statistically significant difference between these groups (p = 0.127). The second subgroup comprised the continents where the included studies were from. In this subgroup, no statistically significant differences were found (p = 0.613). Finally, regarding the right or left laterality of the HD variant, there were no statistically significant differences (p = 0.089). A AHD corresponds to a finding that can occur in a significant percentage of our society, which could be an accidental discovery during surgeries or present asymptomatically throughout life and be a cadaveric discovery later. We believe it is important for surgeons to have prior knowledge of the possible variants of HD to prevent possible complications during and after surgery.

Paresis of the Oculomotor nerve due to neurovascular conflict with Superior Cerebellar Artery

Background: Neurovascular conflict between the Oculomotor nerve (CN III) and any of the posterior circulation cerebral arteries is a relatively frequent radiological finding, however, it does not manifest clinically or manifests itself only minimally (slowly reacts to light on the ipsilateral side). Sustained paresis of CN III arose directly due to neurovascular conflict between the Superior Cerebral Artery (SCA) and CN III, resolved after microvascular decompression, is extremely rare and has not yet been published. Aim: This case report aims to present a case of a scarce clinical condition caused by a generally common anatomical variation. This variation was proved to be the only cause of the clinical status and the symptoms did resolve after microsurgical restoration of the neuroanatomy. Case description: A 34-year-old female patient presented with an advancing ptosis and a downward gaze on one side. Differential diagnostics ruled out all other causes of the Oculomotor paresis, MRI showed significant oppression of the Oculomotor nerve by an aberrant SCA on the ipsilateral side. Neurovascular decompression performed microsurgically has resulted in near complete resolution of the symptoms. Conclusions: Oculomotor nerve paresis caused directly by neurovascular conflict is an extremely rare diagnosis, but microvascular decompression should be considered in these cases, especially if other reasons have been excluded.

The effects of myocardial bridging on two-dimensional myocardial strain during dobutamine stress echocardiography.

Myocardial bridging (MB) is a common anatomic variant in coronary arteries with unclear functional significance. We evaluated regional myocardial strain by speckle tracking during dobutamine stress echocardiography (DSE) in patients with MB in the left anterior descending coronary artery (LAD). We studied 11 patients with MB in the LAD and no obstructive coronary artery disease (CAD), 7 patients without MB, but obstructive CAD in the LAD, and 12 controls without MB or obstructive CAD. MB was defined as either > 1mm (superficial) or > 2mm (deep) intramyocardial course of the LAD in coronary CT angiography. Regional longitudinal, radial and circumferential strains and strain rates as well as post-systolic strain index (PSI) were measured at rest, peak stress, and early recovery (1min after stress). Strain parameters during DSE were similar in the myocardium distal to MB and other myocardial regions of the same patients as well as the LAD territory in controls. However, patients with obstructive CAD showed impaired LS and strain rate as well as increased PSI at peak stress. None of the MB was associated with systolic compression in invasive coronary angiography and strain parameters were similar between superficial and deep MB. Stress myocardial blood flow by positron emission tomography correlated with LS and RS at peak stress in the myocardium distal to MB (r = -0.73, p = 0.03, and r = 0.64, p = 0.04, respectively). Myocardial strain is not reduced during DSE in patients with MB in the LAD and no significant systolic compression.

Sinonasal Anatomic Variations in Headache Etiology

Abstract Purpose: Headache is a frequent clinical symptom with multiple etiologies. Our purpose is to investigate the correlation between variations in sinonasal anatomy and headaches. Methods: We retrospectively evaluated the paranasal computed tomography (CT) scans of patients with and without headaches. 118 patients presenting with headaches were included in the study group and 63 patients without headaches were included in the control group. Eight common anatomic variations were clarified and recorded in both groups regardless of whether unilateral or bilateral. Statistical analyses were performed with NCSS (Number Cruncher Statistical System) 2007 software. The results were evaluated at a significance level of p

Abstract P202: Excess of anything is detrimental - unraveling role of multiple accessory renal arteries in Pickering syndrome.

Flash pulmonary edema (FPE) appears to be more common in patients with bilateral renal artery stenosis (RAS) as compared to those with unilateral disease. The combination of bilateral RAS and recurrent FEP has been named the Pickering syndrome. Here, we present a case of Pickering syndrome caused by unilateral RAS in combination with multiple accessory renal arteries (ARA). To our knowledge, this case marks the inaugural report within the literature. A 68-year-old woman presented to ER with her third episode of FPE in two months, accompanied by hypertensive emergency, BP 232/127 mmHg. Initial evaluation, including laboratory tests and RA ultrasound, showed no abnormalities. However, a CTA of the abdomen revealed a single heavily calcified L main RA with severe atherosclerosis extending into the lumen of the aorta and the proximal L main RA. Three RAs supply R kidney with questionable stenosis of superior, smaller R RA. Atherosclerotic plaque is present at the origin of the inferior R RA, but no definitive significant stenosis is detected. Unilateral RAS and multiple ARAs were suspected to cause HTN and FPE. An aortogram with possible RA stenting was recommended by vascular surgery. It confirmed > 75% stenosis in the L RA, prompting stent deployment. However, no significant stenosis was observed in R ARAs. Post-procedure BP control was achieved with a single agent. FPE is a life-threatening syndrome. Cardiac systolic or diastolic dysfunctions usually accompany it. Recurrent FPE due to bilateral RAS was described by Pickering et al. in 1988. Although its exact mechanism is not completely understood, it is believed to result from excessive fluid volume due to decreased sodium excretion. A similar mechanism was proposed in RAS in a single functional kidney. Could the presence of an ARA mimic the pathophysiology of RAS? It has been theorized that an ARA may lead to HTN due to reduced blood flow to the kidney, caused by its longer and narrower caliber, which increases resistance and may lead to stenosis. The Poiseuille equation, rearranged to R=8μL/ΔPπR4 (where R=resistance, μ=viscosity, L=vessel's length, P=pressure, R=vessel's radius), suggests that both the radius and the length of ARAs may play a role in our patient's condition. In summary, ARAs are a common anatomical variation, and depending on their specific characteristics, they may contribute to resistant HTN and FPE through renin-dependent hyperaldosteronism.

BERTOLOTTI'S SYNDROME: DIAGNOSIS AND TREATMENT

IntroductionLumbosacral transitional vertebrae (LSTV) are increasingly recognized as a common anatomical variant and is the most common congenital anomaly of the lumbosacral spine. Patients can have symptomatic LSTV, known as Bertolotti's Syndrome, where transitional anatomy can cause back, L5 distribution leg, hip, and groin pain. We propose an outline for diagnosis and treatment of Bertolotti's Syndrome.MethodsWe retrospectively reviewed over 500 patients presenting to the primary author with low back, buttock, hip, groin and/or leg pain from April 2009 through April 2024. Patients with radiographic findings of an LSTV and clinical presentation underwent diagnostic injections to confirm diagnosis of Bertolotti's syndrome. Treatment was determined based on patient's LSTV classification. 157 patients with confirmed Bertolotti's syndrome underwent surgical treatment.ResultsOver 500 patients presented with an appropriate clinical presentation and radiographic findings of an LSTV. Diagnostic injections were targeted into the transitional anatomy confirming the LSTV as the primary pain generator to make the diagnosis of Bertolotti's syndrome. The decision in the type of surgical intervention, resection or fusion, was made based on patient's LSTV anatomy. 157 patients with confirmed Bertolotti's Syndrome underwent surgical treatment (121 fusions (77%), 36 resections (23%)). The classification system and surgical outcomes, in part, have been previously published in World Neurosurgery.ConclusionWe have outlined the best practice of diagnosis and treatment selection for Bertolotti's syndrome. We have shown significant improvement in outcomes based on this method. We hope to aid in both patient education and provide an outline on how clinicians can become knowledgeable on Bertolotti's syndrome.Conflicts of interestNo conflicts of interestSources of fundingNo funding obtained

Sinonasal Anatomic Variations in the Adult Population: CT Examination of 1200 Patients.

The nasal cavity and paranasal sinuses are one of the most frequently anatomically varied regions. Their size and shape vary from person to person, and ethnic origin may have a role in this variety. Recognizing this variations is so important for ear nose throat (ENT) specialists because they predispose to sinonasal pathologies and affect the complication rate and success of endoscopic sinus surgery. This study aimed to determine the frequency of sinonasal anatomic variations on paranasal sinus computed tomography (CT) in the Turkish population. Patients who had undergone paranasal sinus CT with any complaints between 2013 and 2020 and aged over 18 years were included in the study. A total of 1209 patients who had undergone paranasal sinus CT were examined for coronal, axial, and sagittal plans retrospectively by two ENT professionals, and anatomical variations were evaluated. To assign the frequency of anatomic variations in a healthy population, patients who had previously undergone paranasal sinus and nasal surgery, who had nasal polyposis, and for whom CT evaluation was not possible due to intense sinusitis were excluded from the study. Among 1209 patients, 644 were male and 565 were female. The mean age of the patients was 33.7 years. The most common sinonasal anatomical variations were nasal septal deviation and agger nasi cells, while the least common variation is the supreme turbinate. No variation was found in 48 (3.9%) CTs. Almost all patients had at least one sinonasal anatomical variation. These variations should be known by the professionals who have interest in sinonasal disease and surgery.

Incomplete Transverse Pulmonary Fissures: Embryological Basis, Clinical, and Surgical Implications: A Cadaveric Case Report

Incomplete pulmonary fissures (IPF) represent a common anatomical variation in the human lung. While often considered silent, incomplete pulmonary fissures can have notable clinical and surgical implications, necessitating a comprehensive understanding of their anatomical characteristics. IPF may have significant implications in both clinical practice and surgical interventions. We report a case of an incomplete transverse fissure of the right lung from an adult male cadaver, exploring the embryological basis, clinical significance, and surgical implications. The findings underscore the importance of understanding the lung embryology and resulting normal anatomy, and associated anatomical variations to ensure accurate diagnosis, appropriate management, and optimal surgical outcomes.

Neonatal cerebral ultrasound: anatomical variants and age-related diseases.

Cerebral ultrasound is a non-invasive imaging technique widely used for the assessment of brain anatomy and diseases in neonates and infants. Indeed, it allows a precise characterization of common variants such as cavum septum pellucidum or diseases like intraventricular hemorrhage. The aim of this pictorial review is to provide a comprehensive overview of the main ultrasound features of the most common cerebral anatomical variants and disorders detectable by cerebral ultrasound using an age-related approach which could support non-subspecialized radiologists.

Prevalence of Chronic Rhino Sinusitis in Patients with Concha Bullosa.

This study aims to investigate the prevalence of chronic rhino sinusitis in patients with concha bullosa, a common anatomical variation characterised by pneumatization of the middle turbinates. Chronic rhino sinusitis is an inflammatory disorder of the paranasal sinuses and the linings of the nasal passages that lasts for 12weeks or longer. The incidence of chronic rhino sinusitis was assessed among patients with diagnosed concha bullosa, focusing on the presence of symptoms, and severity. There seems to be a strong relationship between concha bullosa and the development of chronic rhino sinusitis To screen the patients of concha bullosa for chronic rhino sinusitis. To find out of the percentage of chronic rhino sinusitis in patients with concha bullosa. To determine the sinuses affected and their respective sides. This is a retrospective study to investigate the incidence of chronic rhino sinusitis in patients diagnosed with concha bullosa. The study was conducted at Vydehi institute of medical science and research centre, Whitefield, Bangalore and the data from 01/02/23 to 01/09/23 were analyzed. Medical records of patients with diagnosed concha bullosa were identified through electronic medical records and imaging databases (CT scan paranasal sinuses). Inclusion criteria consisted of patients with a confirmed diagnosis of concha bullosa based on radiological imaging (CT scans) and clinical assessment.Exclusion criteria: patients with previous sinus surgeries and malignancy. The study's methods focused on retrospectively assessing the incidence of chronic rhino sinusitis in patients diagnosed with concha bullosa. In the above study it is concluded that concha bullosa plays major role in development of chronic rhino sinusitis. Thus after confirming the presence of concha bullosa practitioner should keep in mind the possibility of development of chronic rhino sinusitis.

Liver ultrasound: Normal anatomy and pathologic findings

The goal of this article is to give an overview of intraoperative liver ultrasound, including the indications, different ultrasound techniques, and the ultrasound appearance of normal anatomy, more common anatomic variations, and common hepatic tumors.

A Case of Quadrivial Pattern of Right Upper Lobe Bronchus

Abstract The knowledge of the tracheobronchial tree is fundamental for a bronchoscopist, especially for diagnostic, therapeutic, and surgical options that are under consideration. Among all lobes, the right upper lobe (RUL) has a relatively high incidence of tumor and airspace diseases. Most bronchial anomalies are on the right side. Bifurcation is the most common anatomical variation. Quadrification has a very low prevalence. We report the case of a 54-year-old male who came with complaints of hemoptysis and showed a quadrivial type of bronchial division of RUL during a bronchoscopic examination after which three-dimensional computed tomography bronchography showed a supernumerary lateral or axillary segment bronchus. Awareness of this variant may explain otherwise confusing findings and its clinical implication is important for every pulmonologist.

Study of Anatomical Divergences in Facial Artery Endings

Facial artery supplies musculocutaneous tissue, visceral organs, and salivary glands at the upper cervical and facial level. This artery has wide range of anatomical variations in its course. Objective: To find the anatomical divergences in facial artery endings. Methods: It is a cross sectional study conducted at Jinnah international hospital, Abbottabad from January 2023 to July 2023 for duration of 6 months after taking approval from the ethical review committee. A group of 86 people were selected and anatomical course of facial artery was categorized in to four types. Angiographic images of each participant were evaluated by radiologist to categorize the course of facial artery. Results: The average Body Mass Index (BMI) of the participants was 28.3 ± 5.6. The study of angiographic images has concluded that 38.37% (n=33) has Type I course of facial artery, 47.67% (n=41) participants has Type II, 9.3% (n=8) participants has Type III and 4.65% (n=4) has Type IV category (p=0.01. Of the type I category of facial artery, 5 (15.2%) participants met the criteria of type IA, 7(21.2%) has Type IB and 21(63.6%) participants Type IC course of facial artery (p=0.01). Conclusions: This study has concluded that there exists vast variation in the anatomical course of facial artery in local population that streamlines with other studies conducted internationally. Facial artery with a nasal branch with or without alar endings is the most common anatomical variation.

Evaluation of the Accessory Canals of Canalis Sinuosus Via Cone Beam CT

Objective: Canalis sinuosus (CS) is a common anatomical variation in the anterior maxilla that originates from the infraorbital canal and carries the anterior superior alveolar nerve and vessels. This study aimed to examine the presence, frequency, and features of CS and its accessory canals (ACs) using cone beam computed tomography (CBCT) images.
 Methods: A total of 495 CBCT images were retrospectively analyzed in axial, sagittal, and coronal sections. Patient age and sex, presence or absence of CS, location as right, left, or bilateral if CS was present, and number of ACs were recorded. In addition, the end regions of the ACs were recorded as central incisor, central-lateral incisor, lateral incisor, lateral incisor-canine, and canine regions. All recorded data were statistically analyzed.
 Results: At least one CS was found in 54 (10.9%) of 495 CBCT images. CS(s) were bilateral in 26 (48.2%) cases and unilateral in 28 (51.8%; 25 on the left and 3 on the right side). The ACs of the CS predominantly terminated in the lateral incisor region (p =.025). The frequency of CS was not statistically different between males and females (p =.313).
 Conclusion: Accessory canals in the anterior maxilla are mostly associated with branches of the CS. In the current study, the prevalence of CS was 10.9%, and most of the CSs were opening in the lateral incisor region. Detection of accessory canals in the anterior maxilla and examination of this region with CBCT will prevent misdiagnoses and postoperative complications arising from damage to these structures.

Neuro-Interventional Diagnosis and Treatment Using the Right Transradial Approach in Patients with Aberrant Right Subclavian Artery

BackgroundAberrant right subclavian artery (ARSA) is a common anatomical variation that presents challenges in cerebral angiography and interventions through the transradial approach (TRA). ARSA is often identified during surgery using the right transradial approach (R-TRA), and this necessitates a change in the approach. ObjectiveTo assess the effectiveness and safety of neurological interventions using R-TRA in patients with ARSA. MethodsWe retrospectively analyzed cases that underwent cerebral angiography and interventions at Huangpi District People’s hospital from January 2023 to July 2023. Out of 335 cases, five patients with ARSA were identified. ResultsAll five cases underwent diagnostic cerebral angiography via R-TRA. Two of the patients received interventions via R-TRA: one underwent right internal carotid artery balloon dilation angioplasty, while another underwent left vertebral artery stenting. No surgery-related complications were observed during these procedures. ConclusionsR-TRA proves to be a safe and effective option for neuro-interventional surgery in patients with ARSA.

Split Anterolateral Thigh Flap: A New Classification of Anatomical Variants and a Surgical Planning Algorithm.

Split anterolateral thigh flap is a versatile reconstruction option, yet long underestimated as no practical perforator classification and no optimal strategy were present. Harvesting "capillary nonsizable perforators" could potentially expand flap splits to those with no existing multiple sizable perforators. Concerns over defect characteristics, recipient vessels, pedicle length, and split timing should all be weighted equally in designing the suitable flap. Refinement is thus required to enable precise reconstructions. All patients undergoing anterolateral thigh flap harvests between 2014 and 2021 performed by a single surgeon were included. The perforator patterns of sizable pedicle, course, origin, and further successful flap-split methods were documented. Surgical outcome of flap survival was analyzed. Anatomical variants of 134 (48.4%) dual, 123 (44.4%) single, and 20 (7.2%) no sizable perforators were found in a total of 277 anterolateral thigh flaps. The overall flap survival rate was 97.5%. Flap split was performed in 82 flaps, including 29 single and 5 no sizable perforator cases previously considered "unsplittable," by utilizing a series of direct skin paddle split, capillary nonsizable perforators harvesting, and flow-through anastomosis technique. Comparable flap survivals were found between split and nonsplit flaps as well as between split segments supplied by sizable and capillary nonsizable perforators. Primary closure was achieved in 98.9% of the thigh donor sites. A new classification of the common anterolateral thigh flap anatomical variants was proposed and a comprehensive algorithm of split flap strategy was developed along with the innovative "fabricate" concept.

The prevalence of the anconeus epitrochlearis muscle in a Central European population.

An anconeus epitrochlearis muscle (AE) is a common anatomical variant in the upper extremity, located at the medial aspect of the elbow. Its anatomical position contributes to the roof of the cubital tunnel. While it plays a role in protecting the ulnar nerve, it may also pose a risk for ulnar nerve compression. This study aimed to determine the true prevalence of AE in a Central European population. The presence of AE was evaluated in 115 cadaveric upper extremities from an undetermined number of subjects. The limbs for dissection were assumed to be healthy, and AE identification involved anatomical description and measurements. Data analysis aimed to determine the true prevalence, considering 95% confidence intervals. AE was present in 5 of the 115 cadaveric limbs (4.3%). Specimens lacking AE were observed, depicting normal cubital tunnel roof anatomy. When present, AE replaced the proximal part of the cubital tunnel roof, superficially coursing to the ulnar nerve. Morphological variations were noted. The true prevalence of AE was 4.3% (95% CI = 0.2%-8.4%), consistent with recent studies. Historical reports indicate varying true prevalence up to 26%, possibly linked to manual labor changes. Contrary to prior assumptions, our study did not find a significantly higher true prevalence in the European population. AE's association with cubital tunnel syndrome is complex, with both protective and potentially compressive roles.

Evaluation of diagnostic accuracy of cone beam computed tomography and multi-detector computed tomography for detection of anatomical variations in rhinoplasty

BackgroundDifferent imaging techniques, such as multi-detector computed tomography (MDCT) scan and cone beam computed tomography(CBCT), are used to check the structure of the nose before rhinoplasty. This study aimed to evaluate the accuracy of two imaging techniques, MDCT scan, and CBCT, in diagnosing structural Variations in rhinoplasty for the first time.MethodsThis diagnostic accuracy study was conducted on 64 rhinoplasty candidates who complained of snoring and sleep apnea or had a positive result in the examination with Cottle’s maneuver or modified Cottle technique between February 2021 and October 2022 at 15- Khordad Hospital affiliated to Beheshti University of Medical Sciences. Before rhinoplasty, patients were randomly assigned to one of the CT and CBCT techniques with an equal ratio. Scans were assessed for the presence of Nasal septum deviation (NSD), Mucocele, Concha bullosa, and nasal septal spur by two independent radiologists. The findings of the two methods were evaluated with the results during rhinoplasty as the gold standard.ResultsNSD was the most common anatomical variation based on both imaging techniques. The accuracy of CBCT for diagnosing Nasal Septum Deviation and Mucocele was 80% and 75%, respectively. The sensitivity, specificity, and accuracy of CBCT in detecting Concha bullosa were 81.3% and 83.3%, respectively. The Kappa coefficient between CBCT and intraoperative findings for diagnosing NSD and Concha Bullosa was 0.76 and 0.73, respectively (p < 0.05).ConclusionCBCT can be considered a suitable method with high accuracy and quality to evaluate the anatomical variations before rhinoplasty.