scholarly journals Correlation : Anatomical Variations of Nasal Cavity and Paranasal Sinuses and the Quality of Life Based on SNOTT-22 Score

2021 ◽  
Vol 17 (1) ◽  
pp. 49-60
Author(s):  
Rani Rahmawati
Keyword(s):  
Quality Of Life ◽  
Ct Scan ◽  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Paranasal Sinuses Ct ◽  
Snot 22

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.  

scholarly journals Evaluation of nose and paranasal sinus disease, anatomical variations by computerized tomography

2017 ◽  
Vol 3 (4) ◽  
pp. 898
Author(s):  
Prakash S. Handi ◽  
Mallikarjun N. Patil
Keyword(s):  
Ct Scan ◽  
Paranasal Sinuses ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Sinus Surgery ◽  
Type I ◽  
Deviated Nasal Septum ◽  
Radiologic Evaluation ◽  
Road Map ◽  
Preoperative Information

<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>

scholarly journals CT evaluation of anatomical variations of paranasal sinus region and their clinical importance

2019 ◽  
Vol 7 (6) ◽  
pp. 2260
Author(s):  
Tapendra Nath Tiwari ◽  
Narendra Kumar Kardam
Keyword(s):  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Anatomical Variation ◽  
Intraoperative Complications ◽  
Preoperative Evaluation ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Concha Bullosa ◽  
Increased Risk ◽  
Mucosal Changes

Background: Paranasal sinuses are air filled spaces present within the skull and facial bones. Paranasal sinuses region anatomy is highly variable. Knowledge of these variations is very important for radiologists as well as endoscopic surgeons for preoperative evaluation to avoid damage to adjacent vital structures. CT is the best modality to delineate the sinus anatomy as well as soft tissue structures. Thus, this study was undertaken to evaluate the anatomical variations of paranasal sinus region and ascertain their clinical importance.Methods: A total of 142 patients, those referred from various outdoor/indoor departments with the symptoms related to nose and paranasal sinuses were included. Detailed history, appropriate clinical examinations, biochemical investigations and X-ray PNS were recorded. Unenhanced CT scan of the PNS was performed for these patients in the axial planes and reformatted coronal planes. Observation was made and analysed using descriptive tools and scientific methods.Results: Deviated nasal septum was the most common variation followed by middle concha bullosa, Paradoxical middle turbinate, curved uncinate process, overpneumatized ethmoidal bulla, superior concha bullosa, prominent Agger Nasi cells, haller cells, onodi cells, maxillary sinus septae and pneumatization of uncinate process. Incidence of anatomical variation was 75% among the patients showing PNS mucosal changes while it was 94% among patients showing no mucosal changes. Chi square statics revealed that presence of anatomical variation does not mean a predisposition to mucosal changes.Conclusions: The presence of anatomical variants does not indicate predisposition to sinus pathology but may predispose to increased risk of intraoperative complications. It is important to pay close attention to anatomical variations in the preoperative evaluation to avoid possible complications.

scholarly journals Early Internal Branch of Superior Laryngeal Nerve Bifurcation Passes Through Double Thyroid Foramen

2021 ◽  
pp. 014556132110291
Author(s):  
George K. Paraskevas ◽  
Alexandros Poutoglidis ◽  
Nikolaos Lazaridis ◽  
Nikolaos Anastasopoulos ◽  
Nikolaos Tsetsos
Keyword(s):  
Quality Of Life ◽  
Thyroid Gland ◽  
Anatomical Variation ◽  
Superior Laryngeal Nerve ◽  
Anatomical Variations ◽  
Laryngeal Nerve ◽  
Sensory Innervation ◽  
Internal Branch ◽  
Thyrohyoid Membrane

Internal branch of superior laryngeal nerve (ibSLN) provides sensory innervation mostly to the supraglottic part of the larynx and thus prevents aspiration during ingestion. Normally, it is distributed to the larynx after piercing the thyrohyoid membrane above the superior laryngeal artery. Multiple anatomical variations in the course of ibSLN have been reported. An early ibSLN bifurcation and course through double thyroid foramen constitutes an interesting anatomical variation that may easily lead to an injury during procedures in the thyroid gland and the larynx. Knowledge of the anatomical variability is essential in order to prevent surgical complications that could potentially impact the patient’s quality of life.

scholarly journals Clinically Significant Variation of Paranasal Sinuses on CT-Scan

2021 ◽  
Vol 10 (02) ◽  
pp. 152-157
Author(s):  
Maryam Faiz Qureshi ◽  
Ambreen Usmani
Keyword(s):  
Ct Scan ◽  
Nasal Cavity ◽  
Paranasal Sinuses ◽  
Structural Changes ◽  
Anatomical Variations ◽  
Causative Factor ◽  
Anatomical Variants ◽  
Important Diagnostic Tool ◽  
History Of ◽  
Clinically Significant

Anatomical variations are not diseases and can be found in every individual. Due to the anatomical variations, the structural changes occur in nearby anatomical relations. By keeping in mind, the vast range of anatomical variations in nasal cavity and paranasal sinuses (PNS), every case of sinusitis must be planned carefully to avoid dreadful complications of surgical procedures. Sinus anatomical variations have been associated with the etiology of sinusitis. In this regard computed tomography (CT) imaging has become an important diagnostic tool. CT Scan imaging of nose and para nasal sinuses is mandatory in patients with history of sinusitis in order to evaluate the detailed anatomy which includes normal anatomy, anatomical variations, bony details and the extent of the disease pathology. Certain anatomical variants are supposed to be a causative factor for development of sinus pathology and hence it becomes compulsory for the radiologist to be aware of the anatomical variants of nasal cavity and PNS especially if the subject is considered for surgical intervention.

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

2021 ◽  
Author(s):  
Mahdi Niknami ◽  
Elham Emami ◽  
Abdolhosein Mozaffari ◽  
Hashem Sharifian ◽  
Sanaz Safari
Keyword(s):  
Ct Scan ◽  
Chronic Rhinosinusitis ◽  
Nasal Obstruction ◽  
Paranasal Sinuses ◽  
Clinical Symptoms ◽  
Anatomical Variation ◽  
Anatomical Variations ◽  
Clinical Findings ◽  
Nose And Paranasal Sinuses ◽  
Ethmoid Sinuses

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.

scholarly journals Mucosal Eosinophilia and Neutrophilia Are Not Associated With QOL or Olfactory Function in Chronic Rhinosinusitis

2021 ◽  
pp. 194589242098743
Author(s):  
Nyssa F. Farrell ◽  
Jess C. Mace ◽  
David A. Sauer ◽  
Andrew J. Thomas ◽  
Mathew Geltzeiler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyposis ◽  
Cross Sectional Study ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
Small Subset ◽  
Cross Sectional ◽  
Snot 22

Background Chronic rhinosinusitis (CRS) is often differentiated by histopathologic phenotypes (eosinophilic versus neutrophilic), which may impact disease severity measures and outcomes. As such, it has been suggested that counts of cellular elements be included as part of a standard pathological report following endoscopic sinus surgery (ESS). Objectives This cross-sectional study evaluated associations of mucosal eosinophilia and neutrophilia with measures of quality-of-life (QoL) and olfactory function. Methods Patients with medically refractory CRS completed the SNOT-22 survey and Brief Smell Identification Test (BSIT) at enrollment. In addition, baseline Lund-Mackay computed tomography (CT) and Lund-Kennedy endoscopy scores were collected. Ethmoid mucosa was biopsied during ESS and reviewed using microscopy to quantify densest infiltrate of eosinophils or neutrophils per high-powered-field (HPF). Eosinophilic CRS (eCRS) and neutrophilic CRS (nCRS), both with and without nasal polyposis (NP), were compared across SNOT-22 and BSIT scores. Results 77/168 patients demonstrated mucosal eosinophilia (eCRS) while a total of 42/168 patients demonstrated mucosal neutrophilia (nCRS). After adjusting for polyp status, 35/168 had eCRSsNP, 42/168 eCRSwNP, 75/168 non-eCRSsNP, 16/168 non-eCRSwNP. Additionally, 22/161 were noted to have nCRSsNP, 20/161 nCRSwNP, 84/161 non-nCRSwNP, and 35/161 non-nCRSsNP. A small subset of patients demonstrated both eosinophilia and neutrophilia: 14 CRSwNP and 7 CRSsNP. When evaluating average Lund-Mackay Scores (LMS), significant differences existed between non-eCRSsNP and eCRSsNP (p = 0.006). However, after controlling for nasal polyps, eosinophilia did not significantly associate with differences in the Lund-Kennedy Score. Neutrophilia did not significantly associate with any changes in LMS or LKS after controlling for NP. Eosinophilic and neutrophilic histopathologic subtypes did not significantly associate with differences in baseline SNOT-22 or BSIT measures after controlling for NP. Conclusion Neither the presence of mucosal eosinophilia nor mucosal neutrophilia demonstrated significant associations with SNOT-22 quality-of-life or BSIT olfactory function scores when controlling for comorbid nasal polyposis.

scholarly journals A Radiological Study of Anatomical Variations of Uncinate Process

2016 ◽  
Vol 9 (2) ◽  
pp. 59-61
Author(s):  
Shrinath D Kamath Patla ◽  
Pretty Rathnakar ◽  
Vadisha S Bhat ◽  
Jayaramesh LNU
Keyword(s):  
Clinical Significance ◽  
Paranasal Sinuses ◽  
Intraoperative Complications ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Ct Scans ◽  
Radiological Study ◽  
Lamina Papyracea ◽  
Endoscopic Surgeon ◽  
Coronal Section

ABSTRACT Aim (a) To study the variations in the superior attachment of uncinate process. (b) Incidence of pneumatization of uncinate process was also studied. Materials and methods A total 200 sides of 100 CT scans of paranasal sinuses coronal section were studied for variations in the superior insertion of uncinate process using Landsberg and Friedman classification. Incidence of pneumatization of uncinate process was also studied. Results In our study out of 200 sides, type 6 attachment was commonest (41%) followed by types 1 and 2. Pneumatization of the uncinate was seen in very small percentage of cases. Conclusion Lateral insertion of uncinate (lamina papyracea + aggar nassi) is the commonest variant followed by the insertion into the skulbase. Pneumatization of uncinate is rare. Clinical significance Though the inferior attachment of the uncinate is almost constant the superior attachment has several variations, the knowledge of which is very important for the endoscopic surgeon to avoid intraoperative complications. How to cite this article Patla SDK, Rathnakar P, Bhat VS, Jayaramesh. A Radiological Study of Anatomical Variations of Uncinate Process. Clin Rhinol An Int J 2016;9(2):59-61.

scholarly journals EVALUATION OF DIAGNOSTICNASAL ENDOSCOPY AND CTSCAN IN VARIOUS SINONASAL DISEASES

2021 ◽  
Vol 9 (10) ◽  
pp. 1144-1149
Author(s):  
Ranjan Kumar ◽  
◽  
Rajeev Chandra ◽  
Om Prakash ◽  
◽  
...  
Keyword(s):  
Ct Scan ◽  
Surgical Intervention ◽  
Maxillary Sinusitis ◽  
Anatomical Variation ◽  
Cost Effective ◽  
Anatomical Variations ◽  
Nasal Endoscopy ◽  
Common Finding ◽  
Polyp Detection ◽  
Intervention Patient

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.

The Effects of Endoscopic Sinus Surgery on Voice Characteristics in Chronic Rhinosinusitis Patients

2019 ◽  
Vol 128 (12) ◽  
pp. 1129-1133
Author(s):  
Danny B. Jandali ◽  
Ashwin Ganti ◽  
Inna A. Husain ◽  
Pete S. Batra ◽  
Bobby A. Tajudeen
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Tertiary Care ◽  
Voice Quality ◽  
Upper Airway ◽  
Sinus Surgery ◽  
Perceptual Evaluation ◽  
Snot 22

Objectives: Functional endoscopic sinus surgery (FESS) is a standard treatment modality for patients with chronic rhinosinusitis (CRS) who have failed appropriate medical therapy. However, FESS entails modification of the upper airway tract that may alter phonatory resonance and produce voice changes. The effects of FESS on postoperative voice characteristics in patients with CRS have yet to be quantitatively assessed. Methods: Patients with severe CRS who underwent FESS at a tertiary care referral center between May and October 2017 were prospectively enrolled. The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and the Voice Handicap Index (VHI) were used to quantitatively evaluate voice characteristics and quality of life, respectively. Preoperative and postoperative CAPE-V and VHI scores were compared with postoperative scores for each patient. Sino-Nasal Outcome Test (SNOT-22) scores were also obtained to assess changes in patient symptoms. Results: 18 CRS patients undergoing FESS were enrolled. The average preoperative Lund-Mackay score was 14, indicating baseline severe CRS. Postoperative assessments demonstrated a statistically significant decrease in CAPE-V (45-27, p = .005) and VHI (10-4.7, p < .001) scores. These correlated with a statistically significant decrease in SNOT-22 scores (42-13, p < .001). Conclusions: Patients with CRS experience a significant improvement in voice characteristics and vocal quality of life following FESS. Furthermore, this appears to correlate with a significant decrease in self-reported disease severity. These findings may augment the discussion of potential benefits of FESS to a new potential domain for voice quality.

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