Observing Anatomical Variations in Para Nasal Sinuses Using MDCT And Its Correlation with Pathological Involvement Due to Anatomical Variation

Abstract

The study aims to use computed tomography (CT) to investigate sinonasal pathology and anatomic variants in Functional Endoscopic Sinus Surgery (FESS), enabling the exclusion of concomitant pathologies from anatomic variations and related pathologies.

Material and methods: The patients included in this study were individuals with diagnosis of paranasal sinus or any related diseases. This is a prospective observational study. The 100 patients identified for inclusion in the study and detailed history was taken.

Results: A total of 100 patients were included in the study, with a gender ratio of approximately 2:1, favouring males (69 males, 69.00%; 31 females, 31.00%).The predominant age group among patients was 30-40 years, constituting 24% of the total cohort. A significant majority of patients (79%) presented with DNS. Among DNS-positive individuals, right-sided DNS was observed in 44.0%, and left-sided DNS in 35.0%. Concha Bullosa was a common finding in this patient cohort, occurring in 90% of cases. A right-sided predominance was noted, with 40% of patients presenting with right-sided involvement. The highest proportion of patients (36%) displayed grade 4 CT severity. When the clinical diagnosis was compared to the final diagnosis, chronic sinusitis exhibited a sensitivity of 89% but a specificity of only 71.4%, resulting in an accuracy of 87%

Conclusion:

This investigation emphasizes the pivotal role of MDCT in the diagnosis and management of paranasal sinus pathologies. MDCT's superior spatial resolution and ability to distinguish between anatomical variants and disease processes render it the optimal imaging modality compared to conventional radiography. The results indicate a high prevalence of maxillary and anterior ethmoid sinusitis, with significant anatomical variations such as deviated nasal septum and concha bullosa being frequent occurrences among the study population.