scholarly journals CT Evaluation of Anatomical Variations in Osteomeatal Complex in Patients with Deviated Nasal Septum

2016 ◽  
Vol 21 (2) ◽  
pp. 90-93
Author(s):  
Mirza Aneesa ◽  
Sajad Majid Qazi ◽  
Aijazul Haq
Keyword(s):  
Paranasal Sinuses ◽  
Nasal Septum ◽  
Complex Disease ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Inferior Turbinate ◽  
Anatomical Variations ◽  
Lateral Nasal Wall ◽  
Deviated Nasal Septum ◽  
Osteomeatal Complex

Background:The presence of septal deviation has been positively associated with sinus disease, especially osteomeatal complex disease and anterior and posterior ethmoid disease.Computerized tomographic imaging (CT) of the paranasal sinuses has become a widely accepted tool for assessing the paranasal sinuses (PNS) and providing a detailed anatomy of the lateral nasal wall.Objective:The objective of the study was to identify the anatomical variations of lateral nasal wall and paranasal sinuses in patients with Deviated nasal septum.Methods:Computerized tomographic (CT) examination was carried out using the bone algorithm in the coronal plane in 40 patients who met the inclusion criteriain the Postgraduate Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital an associated Hospital of Government Medical College, Srinagar from March 2011 to May 2012.Results:In our study, CT Nose and PNS revealed Deviated nasal septum in 40 (100%) patients, Hypertrophied Inferior turbinate in 11 (27.50%) patients, Concha bullosa in 5 (12.50%) patients, Paradoxical Middle turbinate in 8 (20%) patients, Everted Hypertrophied Uncinate in 2 (5%) patients, Aggernasi cells in 4 (10%) patients, Haller cells in 3 (7.50%) patients and Onodi cells in 2 (5%) patients.Conclusion:The most common anatomical variation associated with deviated nasal septum was Hypertrophied Inferior turbinate and the least encountered variation was Everted Hypertrophied Uncinate and Onodi cells. The CT scan provides supplementary clinical data to the history and endoscopic examination and assists in directing surgical treatment to the affected areas.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 90-93

scholarly journals Anatomical variations in patients with chronic sinusitis

2018 ◽  
Vol 4 (2) ◽  
pp. 428 ◽  
Author(s):  
Pragadeeswaran Kumarasekaran ◽  
Rajprakash Dharmapuri Yadhava krishnan ◽  
Gurumani Sriraman
Keyword(s):  
Nasal Septum ◽  
Chronic Sinusitis ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Concha Bullosa ◽  
Deviated Nasal Septum ◽  
Anatomical Variant

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">C</span><span lang="EN-IN">hronic sinusitis is repeated bouts of acute infection or persistent inflammation of the sinuses. The range of anatomic variants that can interfere with the mucociliary drainage of osteomeatal complex including concha bullosa, deviated nasal septum, uncinate process variations, ethmoid bulla, paradoxical middle turbinate, agger nasi and Haller cells. This is also important in surgeon point of view to know about detail knowledge of lateral nasal wall, paranasal sinuses, surrounding vital structures and anatomical variation. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Observational case series study in which 90 cases of chronic rhinosinusitis patients attending the ENT outpatient department from November-2015 to November-2016 in Shri Sathya Sai Medical college and Hospital, who had chronic sinusitis for more than three months duration not responding to the medical line treatment and who are willing to undergo functional endoscopic sinus surgery are studied and statistically analysed.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">In our study we found anatomical variation in 93% of chronic sinusitis patients. In our study it was observed that 52% of patients with two anatomical variation, 41% patients presented with single anatomical variation and 7% patients presented with no anatomical variation. In our study deviated nasal septum was the most common anatomical variant noted followed by unilateral concha bullosa, medialized uncinate process, paradoxical middle turbinate, haller cell and agger nasi. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">In our study it was concluded that presence of anatomical variations is common in patients with chronic sinusitis. Presence of more than one anatomical variations significantly contributes to disease process.<strong> </strong>Deviated nasal septum is the most common anatomical variation in our study followed by concha bullosa, medialized uncinate process.</span></p>

scholarly journals A rare case of nasal schwannoma of middle turbinate

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Nilam U. Sathe ◽  
Sheetal Shelke ◽  
Hetal Marfatia ◽  
Shampa Mishra
Keyword(s):  
Nasal Septum ◽  
Middle Turbinate ◽  
Inferior Turbinate ◽  
Nerve Sheath Tumor ◽  
Deviated Nasal Septum ◽  
Surgical Specimen ◽  
Nasal Blockage ◽  
Nasal Mass ◽  
Osteomeatal Complex ◽  
Slow Growing

Schwannoma is a benign, slow-growing nerve sheath tumor derived from the Schwann cells. Cases with nasal schwannoma arising from nasal septum and inferior turbinate have been reported, though being rare. A 32-yearold male patient presented to our hospital with left side progressive nasal blockage since 4 months and multiple episodes of epistaxis. Anterior rhinoscopy revealed left side smooth spherical nasal mass, which was bleeding on touch. Computed tomography was done, which was suggestive of right side deviated nasal septum. Left nasal cavity soft tissue lesion extended into anterior ethemoid cells, causing widening of the osteomeatal complex. The patient underwent endoscopic excision of nasal mass. Histopathology of nasal mass suggested nasal schwannoma. Though nasal schwannoma is rare, it should be considered as a differential diagnosis in case of unilateral nasal mass with epistaxis. Definitive diagnosis of schwannoma can be considered only after final histopathological reporting of the surgical specimen.

scholarly journals Role of CT Nose Paranasal Sinuses and Nasal Endoscopy for Decision Making in a Case of Deviated Nasal Septum

2019 ◽  
Vol 27 (3) ◽  
pp. 235-239
Author(s):  
Sayan Hazra ◽  
Ankit Choudhary ◽  
Swapan Kumar Ghosh ◽  
Subhradev Biswas ◽  
Kaustuv Das Biswas
Keyword(s):  
Ct Scan ◽  
Nasal Obstruction ◽  
Paranasal Sinuses ◽  
Nasal Septum ◽  
Pathological Condition ◽  
Middle Turbinate ◽  
Inferior Turbinate ◽  
Nasal Endoscopy ◽  
Deviated Nasal Septum ◽  
Pathological Conditions

Introduction Deviated nasal septum (DNS) can be asymptomatic in an individual or may cause nasal obstruction. The condition is generally diagnosed clinically and based on clinical diagnosis it is managed Surgically by large without much heed to diagnostic procedure. Thus, often underlying other causes of Obstruction is missed. Thus, it becomes essential to evaluate every patient presenting with history of Nasal obstruction and clinically Deviated septum, with aid of Nasal Endoscopy and CT scan Nose Paranasal Sinuses (PNS) to rule out/diagnose other coexisting conditions. Methods and Methodology 100 patients who presented with nasal obstruction and clinically diagnosed to have Deviated Nasal Septum were then subjected to Nasal Endoscopy and CT scan Nose and PNS and findings were noted for analysis. Results and Analysis Of these 100 patients, 48 patients were found to have coexisting pathological conditions/anatomical variants. Various anatomical and pathological Conditions were found to coexist together. Inferior turbinate hypertrophy in 34% is the most common pathological condition found to be associated with DNS followed by of sinusitis in 25% patients apart from polyp, concha bullosa and paradoxical middle turbinate. Discussion Studies done so far shows there is a definite link of deviated nasal septum to various anatomical and pathological conditions of the nose.  CT Scan Nose PNS and Nasal Endoscopy plays a vital role in diagnosing such anomalies. Conclusion Most of the patients, presenting with nasal obstruction and having Deviated Nasal Septum, undergo management without proper analysis and returns with recurrence of symptoms which could be analyzed properly if Nasal endoscopy and CT scan is employed during diagnosis of the condition, reducing risk of treatment failure.

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 Radiological significance of the sinonasal anatomical variants in recurrent acute rhinosinusitis patients

2017 ◽  
Vol 5 (6) ◽  
pp. 2379
Author(s):  
Niranjan Sahu ◽  
Satya Sundar G. Mohapatra ◽  
Siba N. Rath ◽  
Rabindra N. Padhy
Keyword(s):  
Nasal Septum ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Sinus Surgery ◽  
Concha Bullosa ◽  
Deviated Nasal Septum ◽  
Anatomical Variants ◽  
Acute Rhinosinusitis ◽  
Computed Tomography Images ◽  
Osteomeatal Complex

Background: Recurrent acute rhinosinusitis (RARS), a low form chronic rhinosinusitis is frequently under evaluated. The significance of sinonasal anatomical variants of osteomeatal complex (OMC) and spheno-ethmoidal (SE) recess regions in patients of RARS is assessed.Methods: Retrospective analysis of coronal sinonasal computed tomography images of 120 RARS patients presented with sinonasal anatomical variants during November 2013 to October 2016 was carried out. Patients with acute and expansile sinonasal lesions are excluded.Results: Sinonasal anatomical variants in the regions of OMC and SE recess are responsible for obstruction of normal mucociliary drainage of corresponding paranasal sinuses in presence of inflammation predisposing to RARS. Anatomical variants of nasal septum were, deviated nasal septum (DNS) in 86 (72%) and septal spur in 58 (48%) patients. Anatomical variants in OMC region were, pneumatized middle turbinate (concha bullosa) in 50 (48%), paradoxical middle turbinate in 38 (28%), giant ethmoid bulla in 35 (32%), agger nasi cell in 29 (38%), Haller cell in 23 (15%), pneumatised uncinate process in 20 (18%), medialized uncinate process in 18 (22%) and septated maxillary sinus in 5 (4%) patients. Anatomical variants in SE recess were superior concha bullosa in 14 (12%) and septal bullosa in 11 (9%) patients.Conclusions: OMC pattern of recurrent rhinosinusitis is often prevalent in patients of RARS due to abundance of anatomical variants in the OMC region. DNS or ethmoid bulla when gets associated with concha bullosa increased the incidence of RARS. Present analysis would help surgeons to evaluate RARS patients for selective endoscopic sinus surgery.

scholarly journals Diagnosis of chronic rhinosinusitis: can nasal endoscopy be the new gold standard in developing countries?

2016 ◽  
Vol 2 (1) ◽  
pp. 30
Author(s):  
Sushant Tyagi ◽  
Mohit Srivastava ◽  
Vandana Singh
Keyword(s):  
Developing Countries ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Diagnostic Value ◽  
Uncinate Process ◽  
Nasal Endoscopy ◽  
Deviated Nasal Septum ◽  
Diagnostic Modality

<p class="abstract"><strong>Background:</strong> Objective of the study was to study the role of diagnostic value of nasal endoscopy in diseases involving nasal cavity and paranasal sinuses particularly chronic rhinosinusitis in developing countries.</p><p class="abstract"><strong>Methods:</strong> A total of 200 Patients with clinical evidence of sinonasal diseases were evaluated. All patients were subjected to thorough ENT examination with special emphasis on anterior and posterior rhinoscopy. Nasal Endoscopy was done using Hopkins rod endoscopes ( 0º, 30º, 45º, 70º and 90º) - diameter 2.7 mm/ 4 mm, length 18 cm after administering a spray puff of Xylocaine with adrenaline (10 drops of adrenaline to 2 ml of Xylocaine). Computed tomography of paranasal sinuses was done in 100 patients whose symptoms, examination and clinical picture were sufficient to warrant the procedure.  </p><p><strong>Results: </strong>The most common anatomical variations detected on nasal endoscopy were deviated nasal septum (83.5%) followed by paradoxical middle turbinate (42.5), and concha bullosa (26.5%). Accessory middle turbinate was seen in 7 out of 200 cases (3.5%). The most common pathological abnormality detected on nasal endoscopy was mucopus in middle meatus (69%) and next were hypertrophied (45 and 35% inferior and middle turbinate respectively) and congested turbinates (44.5%), followed by polypoidal changes (28%) and oedematous/congested uncinate process (27.5%).</p><strong>Conclusion: </strong>Diagnostic nasal endoscopy can prove to be a better diagnostic modality compared to CT scan when conditions like middle meatal secretions, condition of mucosa, polyps are looked for. It can detect early polypoidal and other pathological changes missed on CT which can aid in early diagnosis and medical management of sinonasal diseases thereby preventing patient from unnecessary surgical exposure. Also being easily available and cost effective, patients can be spared from unnecessary cost and radiation exposure by performing diagnostic nasal endoscopy prior to CT.

scholarly journals Prospective evaluation of chronic rhinosinusitis with reference to anatomical variation

2020 ◽  
Vol 6 (2) ◽  
pp. 326
Author(s):  
Sindhura . ◽  
Mamatha Devi Kandipilli ◽  
Ali Shaik ◽  
Venkata Ramana
Keyword(s):  
Chronic Rhinosinusitis ◽  
Anatomical Variation ◽  
Medical Science ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Final Diagnosis ◽  
Sinus Surgery ◽  
Nasal Endoscopy ◽  
Deviated Nasal Septum ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Rhinosinusitis is one of the commonest sinonasal condition with chronic Rhinosinusitis affecting 10% of population worldwide. Although the diagnosis of chronic rhinosinusitis is clinical, the final diagnosis should be confirmed by objective measures like radiography and nasal endoscopy. Though anatomical variations in sinonasal region are rare, they have significant impact in the causation of sinonasal diseases and pose difficulties during surgery.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study conducted on 60 patients who attended to the Department of ENT and HNS, Konaseema Institute of Medical Science, Amalapuram between December 2017 to July 2019. By considering AAO-HNS criteria patients were selected and subjected to high resolution computerized tomography para nasal sinuses and diagnostic nasal endoscopy.  </p><p class="abstract"><strong>Results:</strong> As per study, 60% patients are having deviated nasal septum, followed by aggar nasi in 58.3%, concha bullosa in 26.8%, Haller cells in 11.7%, paradoxical middle turbinate in 11.7%, uncinate pneumatisation in 5%, and onodi cells in 5% of cases.</p><p class="abstract"><strong>Conclusions:</strong> Anatomical variations in sinonasal cavity predispose to chronic rhinosinusitis and hence require correction. Also, detecting these variations preoperatively by computed tomography of paranasal sinus helps in avoiding complications during functional endoscopic sinus surgery.</p>

scholarly journals A PROSPECTIVE STUDY ON ASSOCIATION BETWEEN DEVIATED NASAL SEPTUM AND SINUSITIS AT ENT DEPARTMENT OF SKMCH, MUZAFFARPUR, BIHAR

2020 ◽  
pp. 21-22
Author(s):  
Kameshwar Prasad Singh ◽  
Debarshi Jana
Keyword(s):  
Nasal Septum ◽  
Chronic Sinusitis ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
World Population ◽  
Deviated Nasal Septum ◽  
Turbinate Hypertrophy ◽  
Group I

Background: Chronic sinusitis (CS) is an extremely prevalent disorder. It affects up to two percent of the world population. It has a significant impact on the quality of life of people. Basically, the word “sinusitis‟ refers to a group of disorders characterized by inflammation of mucosa of nose and paranasal sinuses. Deviated Nasal septum is one of the most common disorder that presents up to 62% of the population. Its role in the pathogenesis of chronic sinusitis remains uncertain. Methods: Two groups were included in this study.Each group had 30 cases with Midline nasal septum & Deviated nasal septum. This study conducted in the Department. of ENT, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. The duration of the study was over a period of six months from August 2019 to January 2020. Results: We were studied two groups, 30 cases involved in group I of Midline nasal septum and in group II 30 cases involved with Deviated nasal septum. In this study we showed symptom & sign of rhinoscopy. In the group I, 14 cases had congested nasal mucosa followed by 10 cases of nasal discharge, 4 cases of inferior turbinate hypertrophy & 2 cases of Middle turbinate hypertrophy. Conclusions: that management of chronic maxillary sinusitis should include simultaneous treatment of any anatomical variation. For treating chronic sinusitis along with deviated nasal septum, nowadays treatment of choice is Septoplasty along with Functional Endoscopic Sinus Surgery (FESS). FESS technique is used for managing sinus infection and ostial obstruction.

Unilateral agenesis of middle nasal turbinate

2009 ◽  
Vol 124 (4) ◽  
pp. 447-449 ◽  
Author(s):  
U Aydil ◽  
T Özçelik
Keyword(s):  
World Literature ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Anatomical Variations ◽  
Lateral Nasal Wall ◽  
Nasal Turbinate ◽  
Computed Tomography Images ◽  
Complex Anatomy ◽  
Left Middle ◽  
Sinonasal Symptoms

AbstractObjective:We present the first report of agenesis of the middle nasal turbinate.Method:We present a case report and briefly discuss the world literature.Results:A 57-year-old man presenting with sinonasal symptoms was evaluated clinically and radiologically. Agenesis of the patient's left middle turbinate was detected. Coronal computed tomography images showed a septal spur replacing the absent left middle turbinate.Conclusion:The lateral nasal wall has complex anatomy, and several anatomical variations have been reported. The most common anatomical variation of the middle nasal turbinate is concha bullosa. Unilateral agenesis of the middle nasal turbinate has not previously been reported; the presented patient represents the first reported case.

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