CBCT Imaging Assessment of Sinonasal Variations and Pathologies in Rhinoplasty Candidates a Cross-Sectional Study

Understanding sinonasal anatomical variations and pathologies is essential in rhinoplasty candidates to avoid surgical complications and ensure optimal outcomes. Cone-beam computed tomography (CBCT) offers detailed imaging of sinonasal structures, making it a valuable tool for preoperative assessment.

A cross-sectional study was conducted on 156 rhinoplasty candidates (90 males, 66 females; mean age: 34.2 years) in Blinded. CBCT scans were used to evaluate the maxillary, ethmoid, and frontal sinuses, as well as nasal septal deviation, which was categorized as mild (0-5°), moderate (6-10°), or severe (> 11°). Chi-square tests assessed associations with age and gender (significance set at p < 0.05).

Septal deviation was found in 83.6% of participants, with moderate (43.6%) and severe (31.4%) forms being most prevalent. Maxillary sinus pathology was present in 44.9%, mostly due to mucosal thickening (37.8%). Ethmoid sinus pathology occurred in 12.8%, and supraorbital cells were observed in 55.8%. Frontal sinus pathology was uncommon (7.7%); normal size was most frequent (61.5%), followed by bilateral hyperplasia (18.6%). Significant associations were noted between age and maxillary sinus pathology size (p = 0.008), nasal cavity pathology (p = 0.042), and frontal sinus size (p = 0.022). Supraorbital cells showed significant correlation with both age (p = 0.035) and gender (p = 0.017).

CBCT effectively identifies sinonasal variations and pathologies in rhinoplasty candidates. The high prevalence of septal deviation and maxillary sinus pathology underscores the need for comprehensive imaging prior to surgery. Frontal sinus variation and demographic associations can inform more personalized surgical planning.

Incorporating CBCT into preoperative assessment enhances surgical planning by revealing individual anatomical differences. Recognizing age- and gender-related patterns can improve patient-specific approaches, reduce intraoperative risk, and contribute to better aesthetic and functional outcomes.