Maxillary Sinus Research Articles

Assessment of Vidian canal morphology in axial section and its associated structures using cone beam computed tomography: A descriptive study

The Vidian Nerve (VN), a branch of the trigeminal nerve, passes by the Vidian Canal (VC), located at the base of the skull. The VC branches into the greater petrosal nerve and the VN in the pterygopalatine fossa, where the greater petrosal nerve carries parasympathetic fibers to the lacrimal glands and nasal mucosa, and the VN carries sensory fibers from the nasopharynx, nasal cavity, and palate. In this study, 60 subjects of both sexes who underwent cone beam computed tomography (CBCT) were selected by a convenient sampling technique. The data were subjected to statistical analysis following the examination of the various parameters in the axial sections. Among the various morphological characteristics appraised in the axial section, there was no significant sexual dimorphism, except for the angle between the VC and the medial wall of the maxillary sinus, which shows statistical significance. The present study aims to investigate morphometric analysis and its associated structures, offering insightful information about the complex structure of the Vidian canal (VC), which provides adequate knowledge for surgeons to plan with more caution complex skull base procedures, and eventually to lower the therapeutical risks associated with it.

Closure of persistent oroantral fistula: Utilizing buccal fat pad, sticky bone, and buccal advancement flap in a three-layered approach – Case report

Oroantral communication (OAC) is a pathological connection between the oral cavity and the maxillary sinus, commonly caused by various factors such as tooth extractions and pathology. Various techniques have been employed to address oroantral fistulae (OAF), predominantly focusing on soft tissue closure and neglecting the bony defect, which is crucial for prosthetic rehabilitation. This case report highlights a novel three-layered closure technique utilizing buccal fat pad (BFP), Guided Tissue Regeneration (GTR) membrane, and a sticky bone graft composed of autogenous and xenograft with i-Platelet Rich Fibrin (PRF), combined with buccal advancement flap and collagen membrane for OAF reconstruction. This innovative approach offers promising outcomes for OAF closure, enhancing patient outcomes and minimizing postoperative complications.

Displacement of maxillary dental implants: a case series on various scenarios.

Oral rehabilitation with dental implants is a common procedure in modern dentistry due to its high success rates. However, complications such as implant displacement can occur, particularly in the maxillary region due to factors like atrophied maxilla, thin alveolar bone, and low bone density. This case series explores scenarios of maxillary dental implant displacement, emphasizing the impact of immediate preoperative imaging on patient outcomes. Three cases of maxillary implant displacement are presented, each illustrating a different scenario. Complications resulting from the displacement of implants into adjacent structures such as the maxillary sinus and nasal cavity are described. All cases involved implants that were displaced during second-stage surgery, occurring four to six months post-implantation. Removal attempts used transnasal endoscopic, intraoral, or combined approaches, with only one implant successfully retrieved. Delays in surgery ranged up to 72h, leading to one implant being swallowed and another unlocated. Outcomes varied, with some patients requiring hospitalization for up to five days. This series highlights the crucial role of immediate preoperative 3D imaging in precisely locating displaced implants to ensure their safe and efficient removal. While implant displacement may not always be preventable, optimizing the timeframe between diagnostic imaging and surgical intervention can significantly enhance management. Accurately locating the implant minimizes treatment invasiveness and patient discomfort, thereby improving clinical outcomes.

Evaluation of thin-threaded implants primary stability in type IV bone right after maxillary sinus floor elevation: A human cadaver study.

The bone-implant interface plays a crucial role in obtaining sufficient primary stability for dental implants in weak bone supports. The aim of this human cadaver study was to evaluate the primary stability of new thin-threaded implants when placed in type IV bone right after maxillary sinus floor elevation. The study followed the CACTUS (ChAracteristics of Cadaver Training and sUrgical Studies) guidelines. Twenty-four edentulous maxillary posterior zones with type IV bone and a residual bone height of 4mm were selected using computed tomography scans. First, an osteotome sinus floor elevation was performed (C.M.C Tech, IBS IMPLANT, Daejeon, South Korea). Implants with thin threads (MagiCore, IBS IMPLANT, Daejeon, South Korea) were placed simultaneously. Samples were divided into two groups: Group 1 (G1): 11mm-long implants with an elevation of 8mm; Group 2 (G2): 7mm-long implants with an elevation of 4mm. Primary stability was assessed using resonance frequency analysis (RFA). The average primary stability values in the mesiodistal (MD) direction were 45.67±3.09 Implant Stability Quotient (ISQ) for G1 and 38.76±16.94 ISQ for G2, and in the buccolingual direction were 43.33±13.23 ISQ for G1 and 38.47±16.14 ISQ for G2. The primary stability of the thin-threaded implants was compatible with clinical osseointegration in sinus sites with limited bone contact area in both experimental situations. Clinical studies are needed to confirm these encouraging results.

Giant Complex Odontoma Occurring Independently Within the Maxillary Sinus

Previous reports on complex odontomas in the maxillary sinus describe cases that are associated with the alveolar process and extend into the maxillary sinus. This report presents a rare case of giant complex odontoma in the maxillary sinus, arising entirely within the maxillary sinus and unassociated with the alveolar process. In this case, the lesion was surgically removed through Caldwell-Luc operation. under general anesthesia, and the bony window was closed with titanium mesh.

Impact of Different Orthodontic Appliances on Mandibular Condyle, Anterior Region of Mandibular, and Maxillary Sinus Using Panoramic Radiography.

BACKGROUND This retrospective study of 44 patients requiring removable functional dental appliances aimed to compare the use of a maxillary expansion device, twinblock/monoblock, face mask, and chincup on maxillary sinus dimensions, mandibular anterior region bone density (MABD), and mandibular condyle head bone formation (MCBF) using panoramic radiography. MATERIAL AND METHODS The patients were divided into 4 groups based on the treatment modalities used: group A, maxillary expansion device (n=11); group B, twinblock/monoblock (n=11); group C, face mask (n=11); and group D, chincup (n=11). MABD and MCBF were assessed using the fractal analysis method, while maxillary sinus dimensions were compared using the ImageJ program. Different groups of patients were tested by the Mann-Whitney U test, with Bonferroni correction. RESULTS Group A showed an increase in MABD, MCBF, and average maxillary sinus indentation base length (MSIL) and a decrease in average planar base length (MSPL) and maxillary sinus area (MSA) (P<0.05). Group B showed an increase in MABD, MSIL, MSPL, MSA, and MCBF (P<0.05). Group C showed an increase in MABD, MSIL, MSPL, and MCBF, with a decrease in MSA (P>0.05). Group D showed an increase in MCBF, MABD, MSIL, and MSA, with a decrease in MSPL at the end of treatment, compared with pretreatment (P<0.05). CONCLUSIONS Orthodontic treatment with different removable functional dental appliances has varying effects on the mandible and maxilla. Possible changes in the maxilla and mandible should be considered before treatments with removable functional dental appliances.

Infantile Sinonasal Tract Myxomas with Orbital Involvement: Presentation of Two Cases and Comprehensive Literature Review

Objective: Our aim is to present two cases of infantile sinonasal tract myxoma with orbital involvement and conduct a comprehensive literature review of the topic. We aim to provide a summary of the presentation of infantile sinonasal tract myxomas to effectively aid clinicians in considering this rare entity as a potential diagnosis. Methods: We present a case series and a retrospective review of the published literature in the English language. A search was conducted between 1945 and 2023 on sinonasal myxoma. Cases of infantile (&lt;3 years) sinonasal myxoma in the literature were reported as well as two cases of our own. Data was collected from each of the identified articles on the age of presentation, sex, initial presentation, tumor location, imaging, pathology, and treatment. Results: Forty-eight cases of sinonasal myxoma in children &lt;3 years of age were identified. These cases had a slight male preponderance (F:M, 1:1.39) and an average age of diagnosis of sixteen months. Of the cases included, the majority involved the maxilla and maxillary sinuses (83.3%) and commonly presented with a painless slow-growing mass in the region of the tumor. Characteristic CT findings are homogenous solid masses with heterogeneous contrast enhancement. On MRI, these lesions appear hypointense on T1 with highly variable contrast enhancement and hyperintense on T2. Conclusions: We present two cases of infantile sinonasal myxoma with secondary orbital involvement followed by a major review. Treatment of these cases with surgical excision (confirmed clear margins) provided 0% rates of recurrence in the reported cases. Due to the rarity of these tumors and recent histological reclassification, a comprehensive review of this condition will assist clinicians in their management of it.

Importance of CBCT diagnostics in dental implantology

ABSTRACT In today's world, the aesthetic demands of patients in dentistry are very high, followed by functional requirements. CBCT diagnostics facilitate the achievement of these goals. Modern dentistry involves replacing missing teeth with dental implants. In dental implantology, precise imaging techniques are essential to accurately capture the area where implants will be placed, in order to avoid damaging adjacent vital structures during surgery. Today, radiological analysis of CBCT scans is considered the best method of choice, or the gold standard, in the pre-implantation procedure. On CBCT scans, we can visualize the height, width, and density of the available bone for implant placement, the precise location of the maxillary sinus, mandibular canal, mental foramen, incisive canal, and diagnose certain present pathological changes.

PREVENÇÃO E TRATAMENTO DA COMUNICAÇÃO BUCO-SINUSAL EM PROCEDIMENTOS ODONTOLÓGICOS: REVISÃO DE TÉCNICAS CIRÚRGICAS E BIOMATERIAIS

Oroantral communication (OAC) is a frequent complication in dental procedures, especially in extractions of upper posterior teeth due to the anatomical proximity to the maxillary sinus. This review addresses the main surgical techniques and the use of biomaterials in the treatment of OAC, based on articles published between 2010 and 2024, found in databases such as PubMed and Scielo. Risk factors like the proximity of dental roots to the floor of the maxillary sinus and advanced age increase the likelihood of OAC, with cone-beam computed tomography (CBCT) being an effective tool in preoperative evaluation. Minimally invasive surgical techniques, such as controlled osteotomy and piezosurgery, have been effective in preventing perforations, while biomaterials like collagen membranes and bone grafts are widely used in treating larger perforations, promoting bone regeneration and healing. The combination of appropriate sutures and biomaterials is essential to avoid postoperative complications such as chronic sinusitis and fistulas. The review concludes that despite advances in surgical techniques and the use of biomaterials, gaps remain in the literature regarding the management of complex perforations, highlighting the need for more comparative studies to optimize OAC treatment. An integrated approach—including preoperative evaluation, appropriate surgical techniques, and postoperative follow-up—is crucial for treatment success and the reduction of long-term complications.

Internal septa of the maxillary sinus and their significance in the planning of endodontic interventions, sinus lifting and dental implantation using a collagen matrix scaffold

INTRODUCTION. The study of the structure of the septa in the area of the maxillary sinus floor is important when planning implantation and sinus lifting operations. The height, number and location of the septa can affect the course of the sinus lifting operation. The aim is to study the structure of the maxillary sinus septa, their height, size, localization in order to prevent complications during surgical interventions.MATERIAL AND METHODS. The article analyzes CBCT data from 444 patients for the presence of septa in the area of the lower wall of the maxillary sinus. The subjects were divided into two groups: with the presence of premolars and molars (288 CBCT) and with the absence of at least one chewing tooth (156 CBCT). A study of 48 passportized skulls was conducted, the anterior wall of the maxillary sinus was sawed out, the structure of the sinus floor and septa was studied in detail. The ratio of the volume of compact and spongy bone substance in the premolar and molar areas was also measured.RESULTS. The obtained research data allowed us to obtain new information about the number of septa in the case of a complete dentition and partial tooth loss. Due to changes in the processes of sinus pneumatization, the number of septa increases with partial tooth loss. Their presence increases the risk of perforation of the Schneiderian membrane during sinus lift surgery, including the use of scaffolds based on a collagen matrix. However, when installing an implant in the base of the septum, its stability can be ensured, since the septa are some kind of buttresses of the maxillary bone. The ratio of the volume of spongy and compact bone substance in the premolar and molar area changes with age.CONCLUSION. The study found that the presence of coronal septa can cause complications of sinus lift surgery in the form of perforation of the Schneiderian membrane. At the same time, septa, being buttresses of the maxillary bone, can serve as a basis for installing an implant. With partial loss of teeth, the number of coronal septa increases. With age, the ratio of spongy and compact bone substance changes, towards a decrease in the volume of trabecular and an increase in the volume of compact bone.

Maxillary Sinus Mucosa Preservation Versus Mucosal Sacrifice: Radiographic Outcomes After Inferior Maxillectomy and Soft-Tissue Free Flap Reconstruction.

This study evaluates the impact of maxillary sinus mucosa preservation on radiographic outcomes after an inferior maxillectomy and soft-tissue free flap reconstruction. A total of 90 patients in two cohorts (mucosal sacrifice versus mucosa preservation) were evaluated from an institutional dataset. Imaging was reviewed at set time points and sinus scores were allotted based on a modification of the Lund-MacKay system. Patients were evaluated for changes in sinus scores. A univariate (UVA) and multivariate (MVA) analysis was performed. In gp1 (mucosal sacrifice), mean postoperative sinus score was 1.21 ± 1.30 (p = < 0.001) at 24 months. On UVA, advanced T-stage at 12 months (OR 7.143, 95% CI 1.484-34.384, p = 0.014) and 24 months (OR 5.500, 95% CI 1.219-24.813, p = 0.027), and on MVA, advanced T-stage were associated with increased odds for higher sinus score (OR 4.993, 95% CI 1.084-22.995, p = 0.039). In Gp2 (Mucosa preserved), the mean postoperative sinus score was 0.31 ± 0.47 (p = 0.021) at 24 months. On UVA and MVA, no predictors were identified for a higher sinus score. Following an inferior maxillectomy and soft-tissue free flap reconstruction, notably reduced sinus scores were seen in patients with preservation of the remaining maxillary sinus mucosa.

Histomorphometric and Micro-CT Evaluation of Cerabone and Bio-Oss in Maxillary Sinus Lifting: A Randomized Clinical Trial

Background and Objectives: The loss of teeth in the posterior maxillary region often leads to significant alveolar bone resorption and maxillary sinus pneumatization, complicating dental implant placement. Maxillary sinus grafting, typically using autogenous bone, is a common solution. However, autogenous bone grafts require additional surgical procedures, leading to increased morbidity. This study aims to compare the efficacy of two xenografts, Bio-Oss and Cerabone, in promoting new bone formation in maxillary sinus grafting through histomorphometric analysis and micro-computed tomography (micro-CT). Materials and Methods: A total of 22 maxillary sinuses (12 right and 10 left) were grafted, with 12 using Cerabone and 10 using Bio-Oss. Six months post-grafting, biopsies were collected for histomorphometric analysis to measure new bone formation, connective tissue, and residual biomaterial. Additionally, micro-CT analysis was performed to assess bone volume fraction, trabecular thickness, number, and separation. Results: Histomorphometric analysis showed that the Cerabone group had a higher average new bone formation (25.94% ± 10.55) compared to the Bio-Oss group (17.29% ± 4.61), with a statistically significant difference (p = 0.02). Micro-CT analysis revealed that the bone volume fraction in the Cerabone group was significantly higher compared to the Bio-Oss group, with significant differences in trabecular thickness (p = 0.02) but not in trabecular number or separation. Conclusions: The study demonstrates that both xenografts are effective in promoting new bone formation in maxillary sinus grafting. However, Cerabone showed superior performance in terms of new bone formation and bone volume fraction, suggesting it may be a more effective option for maxillary sinus augmentation procedures.

The Occipital Recess of the Sphenoidal Sinus-A Novel Anatomical Possibility.

There are reported here multiple rare anatomical variants of the sphenoidal sinus found in a 53-year-old male. The sinus exhibited uncommon features, including a prominent occipital recess extending bilaterally into the basilar part of the occipital bone. A narrow posterior isthmus connected the main chamber to 2 recesses: a superior postsellar recess pneumatising the dorsum sellae, and a postero-inferior occipital recess. The latter extended into the right basilar occipital bone, closely associated with the right hypoglossal canal and coursing alongside the right internal carotid artery. In addition, the sphenoidal sinus had a maxillary recess projecting above the pterygopalatine fossa and joining the right maxillary sinus and bilateral pterygoid recesses. Notably, the left vidian canal was situated superior to the pterygoid recess with no pneumatic space between it and the foramen rotundum, unlike the right side. These anatomical variants are clinically significant due to their proximity to vital neurovascular structures, increasing surgical risks. Partial ossification of the falx cerebri was also identified, potentially complicating neurosurgical procedures.

Prosthetic Rehabilitation of a Patient after Hemimaxillectomy due to Squamous Cell Carcinoma in the Maxillary Sinus: Case Report

AbstractRehabilitation of uncontrolled diabetics with impairments due to acquired defects is complex. More significant defects are more challenging to treat than smaller ones, which can often be corrected surgically. When surgical reconstruction is not possible, the preferred treatment method for facial defects is prosthetic reconstruction. An obturator prosthesis is a standard and efficient method for treating such maxillary defects. This case report aims to evaluate patients' satisfaction with uncontrolled diabetes with improved speech, swallowing, and articulation, and achieving acceptable aesthetics after rehabilitation.This case report details the ultimate obturator prosthesis therapy for an elderly male patient who had a hemimaxillectomy because of squamous cell cancer of the maxillary air sinus. The patient had uncontrolled diabetes and mobility grade 1 of the remaining upper teeth. A gauze coated with Vaseline blocked a significant medial undercut in the defect. The primary, final impression, and jaw relationships were recorded to aid postoperative speech and deglutition. Normal palatal contours were replicated to ensure functional outcomes. The obturator portion was hollowed to reduce its weight and prevent unnecessary strain on the supporting teeth and tissues. The obturator was fabricated using heat-cured acrylic resin to allow future additions in the event of tooth extraction and relining.A well-made and constructed obturator for diabetic patients can offer high adaptability and functionality. Multidisciplinary planning is essential for effective dental care and functional rehabilitation, and avoiding oroantral communication. This will significantly improve the patient's quality of life.

Closure of buccosinusal communication with rotation of a palatal flap: case report

An buccosinusal communication is an abnormal pathway between the oral cavity and the maxillary sinus. It is usually caused by surgical procedures such as the extraction of premolars and maxillary molars, due to the proximity of the roots to the floor of the maxillary sinus. The aim of this study is to report a surgical treatment for the closure of an buccosinusal communication with the advancement of a palatal flap. The patient was a 45-year-old female adult with no systemic comorbidities and no allergies. She reported pain in the left cheek and nasal discharge. Intraoral examination revealed an area of fistula in the region of element 26 measuring approximately 4-5mm. The CT scan showed a hyperdense image in the left maxillary sinus suggestive of sinus infection and a hypodense image in the region corresponding to the alveolus of element 26, suggestive of an buccosinusal communication. Initially, preoperative laboratory tests were requested and antibiotic therapy was prescribed. Intra- and extra-oral antisepsis, infiltration anesthesia were performed, fistulectomy, demarcation of the palatal flap, incision and full-thickness mucoperiosteal detachment, rotation of the palatal flap to obliterate the fistula and stabilization of the fistula using single-stitch sutures in the raw donor region with fibrin sponges under the suture, for later installation of surgical cement to help protect the wound. The patient is well, with complete closure of the communication and no evidence of post-operative complications.

Blast injury with foreign body in maxillary sinus: A case report

Abstract BACKGROUND. Foreign bodies of paranasal sinuses are very rare in ENT clinical practice. CASE REPORT. We will discuss the case of a 38-year-old gentleman who showed up at our Emergency Room with loss of vision in his left eye following a blast injury. The initial physical examination identified a ruptured globe in the left eye, which caused left-eye blindness. An immediate plain X-ray revealed a metallic object lodged in the left maxillary sinus, reaching up to the left sphenoid sinus. The external approach was used to manage the patient surgically, with no intra- or postoperative complications. CONCLUSION. Inadequate managing of foreign bodies in the paranasal sinuses might result in significant morbidity. They must be removed surgically, either endoscopically or via an external method.

Impact of fast-track on recurrence and malignant transformation of patients with inverted papilloma

Background Inverted papilloma is a benign epithelial tumour located in the sinonasal tract with a high recurrence rate and a potential of malignant transformation. From 2017, patients with IP were included in our fast-track regime similar to head and neck cancer patients, including follow-up at 2, 6, 12, 18 and 24 months after surgery, then yearly for a total of 5 years. Aims/objectives This study aims to compare the recurrence rate and malignant transformation of patients with IP treated at a university centre following the implementation of a fast-track regime including a close follow-up. Methods A retrospective study was performed on all patients with IP diagnosed between 2018 and 2022. Results The study included 125 patients, all surgically treated for IP. Eight patients (6%) also presented with SCC at the time of diagnosis. The recurrence rate of benign IP was 17%. Most tumours originated in the maxillary sinus (48/117, 41%). No cases of metachronous cancer were seen during the follow-up. Conclusions and significance The majority of recurrences (90%) occurred within the first 2 years after treatment. No cases of malignant transformation were seen in the follow-up period. The rigorous follow-up program potentially contributed to the detection of recurrence before malignant transformation.

Influence of Schneiderian membrane perforation during maxillary sinus floor augmentation with lateral approach on dental implant survival rates: a retrospective study in a university setting.

The primary objective of this study was to compare implant survival rates (ISR) in patients undergoing maxillary sinus floor augmentation (MSFA) with lateral approach with and without membrane perforation. Secondary objectives were to establish the percentage of perforations in these procedures and to evaluate the influence of perforation size on ISR. This retrospective study included patients requiring MSFA with lateral approach. Cases were assigned to two groups according to the occurrence or not of perforation. The exact size of each perforation was registered. Descriptive statistics and associations between the groups were calculated. This study analyzed data from 90 MSFA in 72 patients. Membrane perforation occurred in 24.44%. A total of 170 implants were placed; 72.35% were placed under intact membranes and 27.65% on repaired membranes. The overall ISR in MSFA procedures with intact membranes was 98.37%, and 93.62% in perforated membranes. No statistically significant relationship between groups was observed although the odds of implant failure increased by 4.125 times when perforation occurred. In turn, no statistically significant relationship was observed between perforation size and ISR. Implants inserted below repaired membranes had a lower ISR compared with implants inserted below intact membranes although the difference was not statistically significant. Moreover, no significant statistical correlation was observed between perforation size and ISR. Membrane perforation does not have a significant influence on subsequent implant survival rates. Knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.

Natural Course of the Maxillary Sinus Fungus Ball: Results From Seoul National University Hospital Healthcare Center.

The frequency of paranasal sinus fungus balls, a common form of rhinosinusitis, has increased. Although treatment and causative factors have been well investigated, the evolving nature of the fungal balls remains unelucidated. This study aimed to investigate and analyze the changing patterns of fungus balls. This retrospective study analyzed data from 35 participants selected from a pool of 41,497 patients who underwent brain magnetic resonance imaging (MRI) at a large health care center. The extent of the fungus balls was evaluated by grading them from 1 to 4 based on the MR images. The changing process of the fungus ball was analyzed based on demographics, interval between the MRI scans, comorbidities, and specific dental interventions. The fungus ball grades showed significant progression over time. In the analysis of 29 sinuses with initially low-grade (grades 0, 1, and 2) fungus balls, 15 sinuses showed a grade change <2 (no/minimal change group), whereas 14 sinuses showed grade changes of ≥2 (substantial change group). Intergroup comparison showed that only the interval between the initial and final MRI scans differed significantly (p = 0.008). However, factors, such as age, sex, comorbidities, and history of dental procedures, did not differ significantly between the two groups. This study shows the extent of change in fungus balls, primarily over time. These results offer critical insights into the natural course and progression of the maxillary sinus fungus ball. 4 Laryngoscope, 2024.

“Deciphering The Enigma Of Nasal &amp; Paranasal Anatomy Through Computed Tomography (CT) Imaging”

Introduction: the paranasal sinuses are mucosa-lined structures physically contiguous with the nasal cavity that aid in insulation, reducing cranial weight, heating &amp; humidifying the air, imparting resonance to the voice, providing airway defense and simply to replace functionless bone. Sinusitis is rarely life threatening, but the complex anatomy of the facial planes, the associated venous and lymphatic spread and the close location to the central nervous system can lead on to serious complications. It is, therefore, important to understand the normal anatomy of the paranasal sinuses in order to understand the pathogenesis of sinus disease. Hence, the aim of the present study was deciphering the role of ct as the investigation of choice for the preoperative evaluation of the nose &amp; paranasal sinuses and for delineation of obstructive inflammatory sinus disease to aid in the diagnosis and management of recurrent &amp; chronic disease and to define the bony anatomy before surgery. Materials and methods: prospective cross-sectional study was conducted on 100 asymptomatic patients who were getting investigated by computed tomography for non-sinus indications in whom the paranasal sinus region could be included in the field of study referred to department of radio-diagnosis and imaging from indoor and outdoor departments of jan sewa hospital of dr. S. S. Tantia medical college, sri ganganagar. Results: the majority of patients were in the age group of 21-40 years (42.3%) with 70% being male. Patients in the age group equaling or more than 61 years &amp; with diabetes had the most number of incidental findings (68.2 %) agger nasi was the commonest anatomical paranasal sinus variant (82.9 %) followed by concha bullosa (39.3 %), deviation of the nasal septum (35.4 %), onodi cells ( 12.2 %) &amp; haller cells ( 11.8 %). Incidental paranasal sinus abnormality in the form of mucosal thickening, sinus secretions or polyps were detected in 51.9 % patients, mucosal thickening being most common (40.1 %) followed by secretions (31.9 %) and mucosal polyps ( 3.0 %). Incidental paranasal abnormalities were most commonly noted in the ethmoid sinuses (36.7 %) followed by the maxillary sinuses, sphenoid sinuses and then frontal sinuses in descending order of involvement. Conclusion: computed tomography (ct) provides a “road map” for diagnosis and management of recurrent &amp; chronic paranasal sinus disease and to delineate the bony anatomy before sinus surgery and to get an insight into anatomical variants apropos of their clinical relevance &amp; impact on sinus disease.