Anatomic variations of the bone in sinonasal CT

Area of Science:

• Otolaryngology
• Radiology
• Medical Imaging

Background:

• Coronal computed tomographic (CT) scanning is a vital preoperative assessment tool for functional endoscopic sinus surgery (FESS).
• CT imaging provides detailed visualization of mucosal abnormalities and bony anatomical variations within the paranasal sinuses.
• Understanding these findings is essential for surgical planning and improving patient outcomes.

Purpose of the Study:

• To investigate the incidence of mucosal abnormalities and bony anatomical variations in patients undergoing FESS.
• To compare these findings between patients with chronic sinusitis and those without symptoms.
• To identify potential associations between anatomical variations and the pathogenesis of chronic sinusitis.

Main Methods:

• Coronal CT scans of 75 patients were analyzed.
• Mucosal abnormalities in each paranasal sinus were documented.
• The prevalence of specific bony anatomical variations (e.g., agger nasi cells, Haller's cells, middle turbinate variations, uncinate pneumatization) was recorded.
• Patients were categorized into chronic sinus and non-sinus groups based on clinical symptoms.

Main Results:

• Mucosal abnormalities were most prevalent in the anterior ethmoidal sinus (86.0%) in the chronic sinus group.
• No statistically significant difference in the overall incidence of bony anatomical variations was observed between the chronic sinus and non-sinus groups.
• Certain anatomical variations were identified as potentially pathogenic in the chronic sinus group, possibly contributing to disease recurrence.

Conclusions:

• Coronal CT is indispensable for evaluating mucosal status and bony anatomy in FESS candidates.
• While overall bony variation prevalence may not differ, specific variations appear linked to chronic sinusitis development and persistence.
• These insights can guide surgical strategies to address underlying anatomical factors contributing to chronic sinusitis.