Evaluation of Anatomical Variations Associated with Chronic Rhinosinusitis by Computed Tomography of Paranasal Sinuses.

BACKGROUND: Chronic rhinosinusitis (CRS) is a syndrome with multifactorial aetiology. Amongst which, anatomical variations studied by computed tomography of paranasal sinuses (CT PNS) had a high incidence which varied between 64.0% and 99.8%10 . Due to such high incidence, this study is undertaken to assess the various anatomical variations and their significant association in CRS.

METHOD: A prospective observational study was conducted in 70 CRS patients and were subjected to CT PNS. CT PNS is studied to know the various anatomical variations & other CT findings causing CRS and then findings noted down, tabulated and statistical analysis done.

RESULTS: All 70 CRS patients evaluated by CT PNS had one or more anatomical variations along with other findings like fungal sinusitis in 6 patients, dentigerous cyst and inverted papilloma in 1 case each. The anatomical variations observed in our study were septal deviation(62.8%), concha bullosa(52.8%), agger nasi(51.4%), pneumatized crista galli(47.1%), hyperpneumatized bulla(40%), suprabullar cells(37%), septal spur(34.3%), paradoxically curved middle turbinate(34.2%), supra orbital cells(32.8%), haller cells(31.4%), septal pneumatization(17.1%), pneumatized uncinate(13%), interfrontal septal pneumatization(13%), maxillary septations(10%), maxillary sinus hypoplasia(7.1%), frontal hypoplasia(5.7%), uncinate attached to lamina papyracea(40%), uncinate to middle turbinate(11%), uncinate to skull base(7.9%), free uncinate(41%), frontal cells type 1;2;3;4 (36%);(30%);(20%);(38.5%), onodi cells(27.1%), pneumatized anterior clinoid process(18.5%), lateral recess(15.7%), sphenoid septations attached to optic nerve(10%) and carotid(2.8%), pneumatized superior turbinate(1.4%), Sellar; Pre sellar; Post sellar sphenoid(42.8%);(5.7%);(51.4%). In our study only anatomical variations around the maxillary & Frontal sinus showed significant association with CRS.

CONCLUSION: Anatomical variations around the anterior group of sinuses have a significant association with CRS.