scholarly journals Correlation Between the Opacification Degree of Paranasal Sinuses on CT, Clinical Symptoms and Anatomical Variations of the Nose and Paranasal Sinuses in Patients with Chronic Rhinosinusitis

Author(s):  
Mahdi Niknami ◽  
Elham Emami ◽  
Abdolhosein Mozaffari ◽  
Hashem Sharifian ◽  
Sanaz Safari

Objectives: This study aimed to evaluate the correlation between the opacification degree of the paranasal sinuses on computed tomography (CT) with clinical symptoms, and anatomical variations of the nose and paranasal sinuses in patients with chronic rhinosinusitis (CRS). Materials and Methods: This descriptive prospective study evaluated 100 patients (60 males and 40 females), who were diagnosed with CRS by ENT specialists according to the clinical findings, and were scheduled for a CT scan. The patients were requested to express the severity of their symptoms using a visual analog scale. The CT scans of the paranasal sinuses were assessed for the presence of anatomical variations and scored using the modified Lund-Mackay scoring system for the opacification degree of each sinus. The correlations between the anatomical variations and sinusitis, and also between the severity of symptoms/disease severity and CT scores were statistically analyzed. P<0.05 was considered statistically significant. Results: The most common symptoms were purulent (discolored) nasal drainage and nasal obstruction. Septal deviation was the most common anatomical variation. The maxillary and anterior ethmoid sinuses were the most commonly involved areas. The Spearman’s correlation coefficient showed a significant correlation between the sinus involvement and some of the evaluated symptoms, as well as certain types of anatomical variations (P<0.05). Conclusion: Some specific anatomical variations of the paranasal sinuses may predispose them to sinusitis. The CT scan score can predict the severity of many symptoms such as purulent (discolored) nasal drainage, nasal obstruction, hyposmia/anosmia, halitosis, cough, and fatigue, among the other symptoms of CRS.

Author(s):  
Nachiketa Ghosh ◽  
Debabrata Das ◽  
Sayantani Majumdar ◽  
Arijit Dey ◽  
Debdutta Haldar

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis (CRS) is a common condition characterized by inflammation of nose and paranasal sinuses and is associated with significant morbidity and healthcare expenditure. The study was undertaken to evaluate the endoscopic findings in different cases of CRS and correlating those findings with the clinical features and severity of symptoms.</p><p class="abstract"><strong>Methods:</strong> A cross-sectional study was carried out at the outpatient Department of Otorhinolaryngology, R. G Kar Medical College and Hospital, Kolkata in a span of 18 months. A total of 56 patients who attended the outpatient department during the study period and met the inclusion criteria as well gave consent for participating in the study were taken as the sample size. The data was collected using history taking proforma.  </p><p class="abstract"><strong>Results:</strong> Out of 56 patients, 51.8% were female, the most commonly affected age group was 31-40 years with 28.57% of patients. Majority of the patients 30.40% presented within one year of onset of symptoms, all the variables of clinical symptoms shows positive correlation statistically with the endoscopic findings, the most common anatomical variation was deviated nasal septum (DNS) present in 51.78% patients.</p><p><strong>Conclusions:</strong> A more extensive and detailed study needs to be done to determine conclusively whether the severity of symptoms can be used to predict the severity of disease in patients diagnosed as having chronic rhinosinusitis</p>


Author(s):  
Prakash S. Handi ◽  
Mallikarjun N. Patil

<p class="abstract"><strong>Background:</strong> The anatomy of paranasal sinuses is very complicated. Evaluation of the location, extent of sino nasal diseases and anatomical variations by preoperative radiologic evaluation of the paranasal sinuses is essential in planning surgical intervention. Meticulous radiographic delineation of the small structures in this region, coupled with endoscopic evaluation, provides detailed preoperative information regarding morphology and pathology.</p><p class="abstract"><strong>Methods:</strong> Patients with sinonasal symptoms indicating requirement of CT scan evaluation and aged more than 10 years were included in the study. Each CT scan was interpreted by an otolaryngologist and a radiologist and interpretation was by consensus. The data collected was evaluated and results are reported as rates and proportions.  </p><p class="abstract"><strong>Results:</strong> Sinusitis (single or multiple sinus involvement), nasal polyposis, frontal mucocele and ethmoidal carcinoma with destruction of medial wall of maxilla were the pathologies observed in these CT scans with sinusitis [22 (43.1%)] being the most common pathology observed. Deviated nasal septum [21 (41.2%)] was the most common anatomical variation observed. All patients who had concha bullosa [5 (9.8%)] were observed to have sinusitis involving multiple bilateral PNS. Based on Keros’ classification, olfactory fossa depth type I was most commonly observed followed by type II and type III.</p><p><strong>Conclusions:</strong> CT scan is important in patients undergoing endoscopic sinus surgery for sinonasal diseases where it acts as a road map in identifying the presence, extent of disease and any anatomical variations. This pre-operative CT scan evaluation improves planning and helps in significantly reducing morbidity and possible complications during surgery. </p>


2021 ◽  
Vol 17 (1) ◽  
pp. 49-60
Author(s):  
Rani Rahmawati

This study aims to determine the correlation between the anatomical variations of nasal cavity and paranasal sinuses and the quality of life based on SNOT-22 score in the patients who underwent paranasal sinuses CT scan. The samples are 36 patients with age ≥ 18 years. The method is Chi Square test / Fisher's test and Spearman’s rho test. The results showed that anatomical variations of the nasal cavity and paranasal sinuses from most of the patients who underwent paranasal sinuses CT scan had septal deviation n = 29, p = 0.007 (p <0.05) and concha bullosa n = 15, p = 0.029 (p <0.05). There was a significant correlation between total anatomical variation and quality of life based on SNOT-22 score in the patients who underwent paranasal sinuses CT scan p = 0.025 (p <0.05). There was no correlation between the anatomical variations of frontal cells, agger nasi cells, ethmoid bulla, uncinate process and haller cells and the quality of life based on SNOT-22 score in the patients who underwent paranasal sinuses CT scan.  


2019 ◽  
Vol 12 (04) ◽  
pp. 2083-2086
Author(s):  
Luh Made Ratnawati ◽  
I Putu Yupindra Pradiptha

The anatomical abnormalities of the nose and paranasal sinuses are the most common causes of rhinosinusitis. These anatomical variations can cause obstruction of the ostiomeatal complex (OMC) and interfere with the mucociliary clearance which allows the occurrence of chronic rhinosinusitis. Knowing the anatomic variations of the nose and paranasal sinuses in rhinosinusitis patients whose undergo operative procedure at Sanglah Provincial General Hospital is important because it can be used as a reference for proper intervention to treat rhinosinusitis. This research is a descriptive study in the Ear Nose Throat - Head Neck Departement, Udayana University Medical School / Sanglah Provincial General Hospital Denpasar, from January 2018 to December 2018. The research location is at the ENT clinic, Sanglah Hospital, Denpasar. This research will be conducted in approximately 2 months (January 2019 to February 2019). The sample from this study was all rhinosinusitis patients who underwent operative procedure, both male and female for the period of 1 January – 31 December 2018. Based on the results of the research data, it was found that the most anatomic variation was septal deviation which was 24 people Anatomic variations cause chronic sinusitis by causing obstruction in the ostiomeatal complex (OMC) and affecting the mucociliary transport pattern. The most anatomical variation in this study is septal deviation.


Author(s):  
G. Ramesh Babu ◽  
G. Ravi Kumar ◽  
V. Krishna Chaitanya

<p class="abstract"><strong>Background:</strong> Drainage and ventilation of paranasal sinuses are important for normal function which depends on effective mucociliary clearance. In present study we tried to emphasize variations in lateral wall of nose and clinical features leading to nose and paranasal sinus disease using diagnostic nasal endoscopy and variations in CT scan of paranasal sinuses. The objectives of the study are to observe various anatomical variations in nose and paranasal sinuses and their clinical presentation using diagnostic nasal endoscopy and CT scan of paranasal sinuses and to compare various anatomical variations in nose and paranasal sinuses.</p><p class="abstract"><strong>Methods: </strong>Present study included 54 patients presenting in Department of ENT, Head and Neck Surgery, during February 2015 to February 2017.   </p><p class="abstract"><strong>Results:</strong> Diagnostic nasal endoscopy findings reveal that most common finding was polypoidal changes in nasal mucosa in 36 (66.67%) of patients, followed by mucopurulent discharge in 26 (48.14%), postnasal discharge in 20(37.03%) and 4 (7.40%) patients showed prominent agger nasi cell. CT scan of paranasal sinuses revealed multiple sinus involvement in 41 (75.92%) of patients with partial involvement of sinuses. Complete sinus opacification with pan sinusitis was observed in 9 (16.67%), blockade at osteomeatal complex was observed in 46 (85.18%), paradoxical middle turbinate was observed in 5 (9.25%), Concha bullosa was observed in 12 (22.23%) of patients.</p><p class="abstract"><strong>Conclusions:</strong> Each variation have an anatomic and surgical significance, hence each and every case should be individually studied in detail before undergoing functional endoscopic sinus surgery to maximize patient benefit and to prevent unnecessary complications. Diagnostic nasal endoscopic examination is clinical guide to evaluate disease.</p>


2020 ◽  
pp. 66-70
Author(s):  
P. A. Kochetkov ◽  
V. A. Svistushkin ◽  
E. S. Shchennikova

Intriduction. Chronic rhinitis and rhinosinusitis noticeably deteriorate the patients’ quality of life and lead to the accompanying upper airway pathology development. The main purpose of treatment of this group of patients is to decrease severity of symptoms and the second one to prevent complications. The optimal therapy will help patients to maintain their lifestyle. Intranasal glucocorticosteroids are first-line drugs to treat acute rhinosinusitis or exacerbations of chronic rhinosinusitis in adults (including the elderly) and adolescents aged 12 years and older as an auxiliary therapeutic agent if treated by antibiotics, and to treat acute rhinosinusitis with mild to moderate symptoms without signs of severe bacterial infection. In the number of trials, mometasone furoate effectiveness in regard to decreasing of prominent symptoms with no side effects development has been shown.Objective: this article reviews available data on the effectiveness of intranasal corticosteroids – mometasone furoate – in the treatment of different forms of chronic inflammatory diseases of the nose and paranasal sinuses.Methods: information for this review was identified through a RISC and MEDLINE databases applying key words.Conclusions: based on the available data, treatment of chronic rhinosinusites and rhinitis should be initiated by conservative therapy. Summarizing information from the available literature we can conclude that treatment by mometasone furoate improve quality of life decreasing clinical symptoms of chronic rhinosinusitis and rhinitis.


2021 ◽  
Vol 9 (10) ◽  
pp. 1144-1149
Author(s):  
Ranjan Kumar ◽  
◽  
Rajeev Chandra ◽  
Om Prakash ◽  
◽  
...  

Objective:To evaluate role of Diagnostic Nasal Endoscopy and CT scan in various Sinonasaldiseases with regards to diagnosis and surgical intervention. Patient and methods:This prospective study was carried out in Department of ENT, A.N.M.M.C.H., Gaya on 200 patients with clinical evidence of sinonasal disease who had presented between March 2016 to February 2019. All patients were evaluated with DNE using 0 degree 4mm endoscope and CT scan with 3 mm coronal cuts. Result: Female patients(56%) were more as compared to male(44%) with majority between 21 - 40 yrs. Most common finding on Diagnostic Nasal Endoscopy(DNE) was mucopurulent discharge in middle meatuswhile on CT Scan was maxillary sinusitis(60%). Sinonasal polyp detection was better with DNE.CT has better detection rate of anatomical variation of osteomeatal complex. Conclusion : DNE has become initial tool for diagnosis as it is cost effective and office based procedure. In patients where surgical intervention is required, CT scan has advantage as it provides detailed understanding of anatomical variations. So bothDNE and CT scan should be used in collaborative fashion. Source Of Support:Patients of A.N.M.C.H., Gaya. Conflict Of Interest:None.


2013 ◽  
Vol 127 (4) ◽  
pp. 419-422 ◽  
Author(s):  
K Tsioulos ◽  
M Martinez Del Pero ◽  
C Philpott

AbstractObjective:To describe a rare case of multiple anatomical variations in the sinonasal skeleton of an adolescent with chronic rhinosinusitis, together with its successful surgical management.Case report:A 15-year-old male adolescent was referred with a 3-year history of nasal blockage and hyposmia. His symptoms did not improve on maximal medical therapy. A pre-operative computed tomography scan revealed numerous anatomical variations in his nose and paranasal sinuses. He underwent neuronavigation-assisted endoscopic sinus surgery without complication, and with subsequent resolution of his symptoms at 10 months.Conclusion:Chronic rhinosinusitis in children offers its own set of unique surgical challenges. The effectiveness and safety of sinus surgery in this population can be improved through the knowledge of anatomical variants, and is aided by the use of image guidance systems.


Sign in / Sign up

Export Citation Format

Share Document