Variations Of Paranasal Sinuses Research Articles

Characterising Sinonasal Pneumatization in Patients with Nasal Septal Deviation: A CBCT-Based Study.

This study aimed to investigate the presence and correlation of paranasal sinus pneumatization among patients with and without nasal septal deviations (NSD), to enhance clinical understanding of sinonasal anatomical variations. It is descriptive, retrospective study under a monocentric, utilizing institutional archives. 30 subjects with NSD and 30 without NSD were selected. Inclusion criteria required diagnostic quality Cone Beam Computed Tomography (CBCT) images, while exclusion criteria included developmental anomalies, central pathology, previous sinonasal surgery, fractures, and non-diagnostic images. The Assessment of Pneumatization of the Paranasal Sinuses (APPS) score was used to evaluate anatomical variations in paranasal sinuses based on CBCT scans. Statistical analysis was performed using the Chi-square test and independent t-test via SPSS version 23. A significant association between NSD and certain anatomical variations was observed. Notably, higher prevalence rates of variations such as pneumatization of the maxillary floor, middle turbinate concha bullosa, and superior frontal sinus wall were found in subjects with NSD. Statistical significance was confirmed in seven out of nine parameters, with p-values < 0.001 for most comparisons. The left side exhibited greater pneumatization than the right. The total APPS scores showed strong statistical significance between groups (p < 0.001). The study reveals a significant relationship between nasal septal deviation and paranasal sinus pneumatization, suggesting that septal deviations may influence the extent of pneumatization in the sinonasal complex.

Investigating Anatomical Variations in Paranasal Sinuses: A Comprehensive Analysis through Retrospective CT among the Indigenous Population at Multi - Speciality Hospital, Shillong

Investigating Anatomical Variations in Paranasal Sinuses: A Comprehensive Analysis through Retrospective CT among the Indigenous Population at Multi - Speciality Hospital, Shillong

Paranasal sinuses in patients with chronic rhinosinusitis,Tanzania

Introduction: Chronic rhinosinusitis is inflammation of the nasal cavity and paranasal sinuses that lasts for at least twelve weeks. Paranasal sinus variations account for various pathologies, including chronic rhinosinusitis. This study assessed the anatomical variations of paranasal sinuses among patients with chronic rhinosinusitis attending otorhinolaryngology services in a tertiary hospital in Tanzania.&#x0D; Method: This was a descriptive prospective cross-sectional study of 120 patients aged 15 years and above who fulfilled the Rhinosinusitis Task Force criteria. A structured checklist was used to collect socio-demographic characteristics and clinical presentations. Cone-beam computed tomography scan and the Lund-Mackay scoring system were used. Data analysis was done using SPSS version 26, and p-values &lt;0.05 were considered statistically significant.&#x0D; Results: A total of 120 patients were enrolled with a median age of 37 (IQR 27-52) years, with 40% aged 30-49 years. There were 65 (54.2%) males, and 55 (45.8%) females. Maxillary sinuses were affected in 85.8% of all patients with chronic rhinosinusitis. The overall proportion of anatomical variation was 53.3%, with concha bullosa, deviated nasal septum, Onodi cells, and septal spur being the most common, accounting for 40.6%, 25.0%, 23.4%, and 20.3%, respectively. Twenty-four patients with concha bullosa had chronic maxillary rhinosinusitis, with 14 (58.3%) having ipsilateral rhinosinusitis.&#x0D; Conclusion: Half of the patients had one or more paranasal sinus anatomical variations. The most common variants were concha bullosa followed by deviated nasal septum. Onodi cells and septal spurs were rarely identified. Most patients with concha bullosa had ipsilateral maxillary sinusitis.

The anatomical variations of paranasal sinuses may be related to the formation of antrochoanal polyp by computed tomography imaging study.

There is little investigation into the connection between anatomic variations and the development of antrochoanal polyp (ACP), and the etiology of ACP remains unclear. The study aims to explore the relationship among anatomic variations, maxillary sinus volume, nasal meatus-related parameters, and the occurrence of ACP. There were 127 patients included in this retrospective cross-sectional study with unilateral ACPs hospitalized at Shandong Provincial ENT Hospital between February 2010 and February 2020. Evaluation indicators included anatomic variations, maxillary sinus volume, and nasal meatus-related parameters in 45 children and 82 adults, which were evaluated twice by 3DSlicer software. Parameters were assessed using the Kolmogorov-Smirnov test, followed by paired t-test and Chi-squared test for multiple comparisons. Significant differences were found in the accessory maxillary ostium (AMO) and maxillary sinus retention cyst between two sides (both P<0.001). Maxillary sinus volume and sex had an association of statistical significance on adults' ACP side (P=0.026) and non-antrochoanal polyp (non-ACP) side (P=0.032). The affected side's maxillary sinus volume was significantly larger than the healthy side (P<0.001). The length from the maxillary sinus orifice to the plane of the most lateral margin of the middle turbinate of the ACP side was larger than the non-ACP side in children (P=0.044). Males' length from the maxillary sinus orifice to the plane of the most lateral margin of the middle turbinate of the ACP side was considerably greater than the healthy side (P<0.001). The length from the maxillary sinus orifice to the plane of the most lateral margin of the middle turbinate (P=0.014) and the length from the inferior turbinate to the nasal septum (P=0.013) on the non-ACP side was higher than the affected side in adults. Males' length from the inferior turbinate to the nasal septum was higher on the healthy side than the affected side (P<0.001). Males had a greater maximum length from the maxillary sinus lateral wall to the nasal septum (P=0.024) and the length from the inferior turbinate to the nasal septum (P=0.003) on the non-ACP side than females. Males had a larger maximum length from the maxillary sinus lateral wall to the nasal septum on the ACP side than females (P=0.011). In our study, the occurrence of the AMO, the maxillary sinus's expanded size, and the stenosis of the associated channels around the ostiomeatal complex and common meatus are regarded as probably connected to the formation of ACPs. In addition, the anatomic variations that involve the ostiomeatal complex and may lead to a change in maxillary sinus pressure and nasal ventilation are important factors in the formation of ACPs.

Frequency of Accessory Maxillary Ostium in Patients With/Without Sinusitis, and Its Correlation with Anatomical Variations of Paranasal Sinuses: A Cone Beam Computed Tomography Study.

This study assessed the frequency of accessory maxillary ostium (AMO) in patients with/without sinusitis and its correlation with anatomical variations using cone-beam computed tomography (CBCT).In this cross-sectional study, 244 CBCT scans were evaluated in two groups: with maxillary sinusitis having > 2mm mucosal thickening and without max sinusitis as a normal group having normal or less than 2mm mucosa. The CBCT scans of each group were carefully evaluated for the presence/absence of AMO, patency/obstruction of the primary maxillary ostium (PMO), and the presence of anatomical variations of the paranasal sinuses. Data were analyzed by independent t-test, Pearson Chi-square test, and Fisher's exact test (alpha = 0.05).CBCT scans of 134 females (54.9%) and 110 males (45.1%) with a mean age of 34.16 ± 19.01 years were evaluated. The presence of AMO had no significant correlation with maxillary sinusitis (P = 0.104). The two groups had no significant difference in the frequency of Haller cell, nasal septal deviation, and concha bullosa (P > 0.05). However, the frequency of paradoxical concha (PC; P < 0.001) and bifid concha (BC; P = 0.017) was significantly higher in the normal group, and the frequency of PMO obstruction was significantly higher in the sinusitis group (P < 0.001). AMO had no significant correlation with any anatomical variation in any group (P > 0.05). Gender had a significant effect on the presence of AMO (P = 0.013).The presence of AMO had no significant correlation with maxillary sinusitis. However, its frequency was significantly higher in females in normal group and males with sinusitis. The presence of AMO had no significant correlation with anatomical variations.

Unravelling the Complex Relationship Between Frontal Sinus Pneumatization and Paranasal Sinus Anatomical Variants: Insights from CT Imaging.

The aim of this study was to analyse the relationship between frontal sinus pneumatization and its effect on various variations of paranasal sinuses on paranasal sinus CT scan. A total number of 100 patients (51 males, 49 females) were included in this study. Patients were divided into three groups on the basis of 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 like pneumatization of upper and middle turbinate, presence of agger nasi, Haller and Onodi cell, maxillary sinus hypoplasia, extent of sphenoid sinus pneumatization, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid sinus, dehiscence and protrusion of internal carotid artery and optic nerve types were ascertained and compared within each group. The prevalence of Onodi cell, anterior clinoid process and greater wing of sphenoid pneumatization and optic nerves type 3 and 4 were higher in Type 3 frontal sinus pneumatization group as compared with other groups. Excessive pneumatization of frontal sinus has various effects on paranasal sinus variations. Surgeons dealing with endoscopic sinus surgery, maxillofacial and skull base surgery must be vigilant of association between these variations preoperatively for avoiding complications.

Anatomical variations of the Paranasal sinuses in Javanese patients with Chronic Rhinosinuitis

Variations in paranasal sinuses anatomy are common and vary among populations. Having clear picture of paranasal sinuses anatomy of a chronic rhinosinusitis patients is essential in surgical planning. This study was done to know paranasal sinuses anatomical variations of chronic rhinosinusitis in Javanese patients by Ct-scan. Retrospective chart survey from medical record of the ORL-HNS outpatient unit at Dr. Soetomo hospital Surabaya during the period January 2019 to December 2020. The data of age, gender, anatomical variations of paranasal sinuses and Keros classification of 55 patients who met the inclusion and exclusion criteria were obtained and recorded. The most common paranasal sinuses anatomical variations were deviated nasal septum (71%), concha bullosa (27%) and ager nasi (22%). Genderwise, anatomical variations were seen more in males. Based on Keros classification, type II(47%) is the most frequently found. The high incidence of paranasal sinuses anatomical variations, emphasize the need for proper preoperative assessment for safe and effective endoscopic sinus surgery.

Computed Tomography Based Evaluation of the Anterior Group of the Paranasal Sinuses

Objective: The study aims to ascertain the prevalence of paranasal sinus variations among healthy adults in the Turkish population, as well as to analyze the symmetry of these variations. Methods: The CTIs of 200 adult patients who did not have any trauma, carcinoma, tumor, surgery, or a condition that could affect the paranasal anatomy, such as chronic rhinosinusitis, were included. The prevalences of the Agger nasi cell (ANC), supraorbital ethmoid cell (SOEC), Haller's cell (HC), middle turbinate pneumatization, and frontal sinus (FS) agenesis variations in the adult Turkish population were revealed. Results: Bilateral SOECs were found 38.5% of 200 patients, and at least 53% of patients had SOECs on one side. In 21.5% of instances, LCs were observed on both sides; in 35% of instances, they were observed on at least one side. ANCs were observed bilaterally in 68.5% of the total, the rate of patients with ANC on at least one side was 84.5%. The rate of bilaterality of the Haller cell (HC) was 24%, it was observed at least one side in 43% of the cases. Bilateral concha bullosa (CB) were observed in 19% while CB variation on at least one side was 42%. Bilateral absence of the FS was found to be 8.5%, and unilateral absence was 2.5%. Conclusion: The most common paranasal sinus variation was ANC, while the least was FS agenesis. Bilateral inheritance was found to be most prevalent in SOEC. The findings of our study hold significance for interventional procedures involving the paranasal region.

A comparative study of paranasal sinus and nasal cavity anatomic variations between the Polish and Turkish Cypriot Population with CBCT

BackgroundGenetic and environmental factors especially climatic conditions are thought to influence the shape and size of the paranasal sinuses and anatomic variations may create both a diagnostic and therapeutic challenge. However, no study has been published about the climatic adaptation of the paranasal sinus region in different populations. This study aimed to compare the prevalence of anatomical variants in the paranasal sinus and nasal cavity using Cone-Beam Computed Tomography (CBCT) between Polish and Turkish Cypriot populations.MethodsThe material consisted of volumes acquired utilizing Galileos (Sirona, Germany) as well as Newtom 3G (QR Verona, Newtom, Italy) CBCT units. There were examined 356 Polish and 359 Turkish Cypriot patients in whom paranasal sinuses were included in the field of view. Paranasal sinus anatomic variations were assessed in both populations.ResultsIn the Polish population, the most common anatomic variation was septum deviation followed by the Agger nasi cell and concha bullosa with a prevalence of 87.7%, 83.2%, and 54.8% respectively. For the Turkish Cypriot population, the most common anatomic variation was Agger nasi cell followed by concha bullosa and supraorbital ethmoid cells with a prevalence of 81.6%, 68%, and 57.8% respectively. Many anatomic variations were found to show substantial differences among both populations. Incidence rates of hyperpneumatization of the frontal sinus, septum pneumatization, supraorbital ethmoid cells, concha bullosa, uncinate bulla, and internal carotid artery protrusion into the sphenoid sinus were significantly higher in the Turkish Cypriot group, while the incidence of Haller cell, frontal sinus hypoplasia, maxillary sinus hypoplasia, ethmomaxillary sinus, sphenomaxillary plate, and septum deviation were significantly higher in Polish population.ConclusionAccording to the Köppen-Geiger world climatic map, the climate is warmer and drier in Turkish Cypriote populations than in the Polish population. These climatic differences influence the paranasal sinus variations between the Turkish Cypriot and Polish populations that must be taken into account by rhinologic surgeons especially when performing frontal and sphenoid sinus surgery.

The Prevalence of Onodi Cells and Analysis of Relationship With Optic Nerve in Koreans

Background and Objectives It is important to identify variations of paranasal sinuses during sinus surgery. The Onodi cell (OC), a variant of the paranasal sinuses, is the most posterior ethmoid cell with a close relationship with the optic nerve (ON). The purpose of this study is to evaluate the prevalence of OCs and analyze the relationship of OCs with ON in Koreans.Subjects and Method This retrospective study utilized CT images of 526 slides from 263 Korean adults. The prevalence of the OCs and the degree of indentation of the ON within the OC was determined using binary logistic regression analysis.Results The OCs were observed in 37.3% of 263 subjects and in 27.6% of 526 slides. The OCs are found more frequently in males than in females (p=0.01), and also more frequently in the right side than in the left side (p=0.001). Binary logistic regression analysis revealed that the ON protrusion in female was 0.339 times lower than in male and 1.052 times higher with the increased age. The ON protrusion within the OC in the postsellar type was 10.214 times higher than that in the presellar.Conclusion The OCs were observed in 37.3% of the Koreans. The protrusion of the ON within the OCs increased in male and in the postsellar type of the sphenoid sinus.

Frontal sinus pneumatization: An isolated finding or a sign of concomitant anatomical variation?

To determine the association between frontal sinus pneumatisation and concomitant anatomical variations in paranasal sinuses as seen on computed tomography. A total of 403 patients who underwent paranasal sinus computed tomography were allocated to three groups according to the degree of frontal sinus pneumatisation (type 1 - hypoplasia; type 2 - medium size; and type 3 - hyperplasia). In this unique model, the prevalence of ipsilateral variations on paranasal sinuses on each side of the head were analysed separately within each pneumatisation group. The type 3 frontal sinus pneumatisation group showed a greater association with ipsilateral variations of the sphenoid bone. Variations included pneumatisation of the anterior clinoid process, lateral sphenoid recess, pterygoid process and greater wing, and exposure of Vidian canal. This group also showed significant associations with male gender, and the presence of frontal and Onodi cells. Interpretation of the paranasal sinus variations is imperative for pre-operative evaluation in functional endoscopic sinus surgery, particularly in patients with frontal sinus hyperplasia. Attention to variation on the ipsilateral side is informative.

Anatomic variations of para-nasal sinuses in patients undergoing CT scan: spectrum, prevalence and implications

Anatomic variations of para-nasal sinuses in patients undergoing CT scan: spectrum, prevalence and implications

English

BACKGROUND Computerized Tomography (CT) scan plays a very important role in decision making before planning any surgical intervention on paranasal sinuses and is also the modality of choice during management and post-surgical follow-ups. Knowledge of different morphologies of paranasal sinuses is an important prerequisite for surgical decision making. This study was done to describe the impact of gender and age on anatomical and morphological presentations of paranasal sinuses using CT in the North Indian Population. METHODS A cross-sectional type of descriptive study was conducted in the Department of Anatomy in collaboration with the Department of Radiodiagnosis of M. L. N. Medical College and Kriti Scanning and Research Centre, Allahabad (Prayagraj) Uttar Pradesh, to describe various morphological presentations of paranasal sinuses. Based on the findings, the gender and age group variations of paranasal sinuses were evaluated and discussed along with the types of the frontal air cells and concha bullosa. RESULTS Overall 120 subjects were analysed based on their CT-scan findings (72 males and 48 females). The frequencies of major sinus variations were observed as Onodi cells in 19.2 %, Concha bullosa in 47.5 %, Frontal air cells in 25 %, Maxillary sinus septation in 7.5 % and Supraorbital cells in 15 % of the study population. CONCLUSIONS Anatomical variations of paranasal sinuses are very common. These variations must be identified by the radiologists in preoperative computerised tomography evaluation to reduce the risk of intraoperative complications. CT scan provides a virtual roadmap to the surgeon and improves the success of management strategies. KEY WORDS Anatomical Variations, Paranasal Sinuses, Concha Bullosa, Onodi Cell

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&gt;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.

Effects of Nasal and Paranasal Sinus Variations on Chronic Otitis Media Development in Pediatric Patients.

Chronic otitis media is an inflammatory disease of the middle ear. The airflow in the nasal passage affects the development of mastoid air cells through the eustachian tube.Nasal and paranasal pathologies and their anatomical variations cause chronic sinonasal inflammation and affect the middle ear mucosa. This study aims to reveal whether the nasal and paranasal sinus variations in pediatric patients are a factor in developing chronic otitis media. Eighty patients, with unilateral chronic otitis media, who were admitted to the otorhinolaryngology clinic between May 2015 and July 2019, were included in this retrospective study. The control group (Group 2) consisted of a total of 51 patients. None of the patients in Group 2 had otorrhea history and no signs of chronic otitis in their otoscopic examination, middle ear pathologies. The patient's anatomical variations of the nasal cavity and sinuses were evaluated with CT by a radiologist Results: Nasal septum deviation was found to be 53% in children with chronic otitis media. It was found 31.4% in the control group. Since the P value was found to be .04, this rate was considered as significant. Inferior concha hypertrophy was found to be 17.6% in the control group and 38.8% in the group with chronic otitis media, and this rate was considered significant since the P value was .035 Conclusion: We detected that septum deviation and inferior concha hypertrophy increased chronic otitis media formation in children. All these studies show that cases causing nasal obstruction, such as septum deviation, have a negative effect on middle ear pressure and increase the rate of ear diseases.

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

Evaluation of paranasal sinus variations among patients with a diagnosis of sinonasal inverted papilloma

Evaluation of paranasal sinus variations among patients with a diagnosis of sinonasal inverted papilloma

Evaluation of the Association between Paranasal Sinus Osteomas and Anatomic Variations Using Computed Tomography

Objective:The pathogenesis of paranasal sinus osteoma (PSO) has not been fully elucidated. It is thought that both embryological and developmental factors play a role in the etiology. The aim of the present study was to investigate the association of frequency and localization of PSOs detected on computed tomography (CT) examination with osteoma presence.Methods:In this retrospective study conducted in December 2017 through March 2020 in Gaziosmanpaşa University Faculty of Medicine, images of a total of 18,867 patients who underwent paranasal sinus, maxillofacial CT and brain CT angiography were reviewed for the presence of PSOs. Sizes of PSOs and accompanying mucosal pathologies were identified. Associations between PSOs and paranasal sinus variations were evaluated statistically compared to the control group (200 patients without PSO).Results:A total of 176 patients (0.92%) were found to have PSO. Average age of the patients with PSO was 59.9 years (range: 18–93). PSOs were unilateral in 152 patients while 24 patients had multiple osteomas. Female/male ratio was 1.1/1. PSOs were most commonly located in the frontal sinuses. Frequencies of vertical concha bullosa, secondary middle turbinate, twisted uncinate, supraorbital ethmoid cell, intersinus septal cell, ethmoidomaxillary cell, Haller’s cell, frontal sinus hypoplasia and sphenoid sinus hypoplasia were significantly higher in the patient group compared to the control group.Conclusion:Higher or lower incidence rates of some anatomic variations in the patients with PSO could be explained by the possible effects of genetic and/or environmental factor. Additional studies are needed to evaluate these possible associations.

Evaluation of Anatomical Variations of Paranasal Sinuses in Children with Coronal Plan Computed Tomography

Aim: In this study, we aimed to evaluate the frequency of the most common anatomical variations of the paranasal sinuses and lateral nasal wall in coronal sinus CT scans of pediatric cases. Methods: Paranasal sinus CT scans of a total of 200 pediatric patients who underwent paranasal sinus coronal CT between December 2000 and June 2005 in the Department of Radiology, Faculty of Medicine, Harran University were evaluated retrospectively. Out of 200 patients, 71 patients with pansinusitis, trauma and nasal polyposis were excluded from the study and 129 patients were included in the study. Results: In our cases, the anatomical variation rates in the bone structure detected by CT in order of frequency were: septal deviation 72.9%, concha bullosa 60.5%, Agger nazi cell 45.8%, paradox middle turbinate 31.7%, pneumotized superior turbinate 26.4%, Haller cell 24.1%, maxillary sinus hypoplasia 23.3%, pneumotized uncinate prominence (UP) 21%, pterygoid recess pneumotization 20.2%, supraorbital ethmoid cell 17.1%, maxillary sinus septation 14%, uncinate process atelectasis 12.5%, Onodi cell 11.6%, paradoxical superior turbinate 10.9%, anterior clinoid pneumotization 9.3%, ethmomaxillary sinus 7.8% and pneumotized inferior turbinate 1.6%. Maxillary sinus hypoplasia existed in all cases with UP atelectasis. We detected decreased ipsilateral maxillary sinus volume in all but one of our ethmomaxillary sinus cases. At the same time, we observed the ipsilateral superior meatus to be wider than normal in these cases. Conclusions: There was no significant difference between the rates of anatomical variation in bone structure in pediatric cases that we evaluated compared to the rates of anatomical variation reported in the literature for both pediatric and adult groups.