scholarly journals Computer Tomographic study of Anatomic Variations of Paranasal Sinuses in Libyan Population and their Clinical Correlation

2020 ◽  
pp. 1-8
Author(s):  
Hawa M R Hawla ◽  
Keyword(s):  
Paranasal Sinus ◽  
Endoscopic Surgery ◽  
Paranasal Sinuses ◽  
Nasal Septum ◽  
Intraoperative Complications ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Anatomical Variants ◽  
Precise Knowledge ◽  
Anatomic Variants

Introduction: In the era of Functional Endoscopic Sinus Surgery, precise knowledge of paranasal sinus anatomy and variations are essential for the surgeon. The multi-slice computed tomography is the imaging modality of choice provides accurate evictions of the anatomy, the anatomical variants and the extent of the disease in paranasal sinuses, such a method allowing their accurate identification with high anatomical details. Some of these variants may predispose to sinus diseases or become of high risk for injuries and complication during surgical procedure, therefore, the study of anatomic variants of paranasal sinuses is important in the preoperative endoscopic surgery. Objectives: The purpose of this study is to assess the frequency of anatomic variants and their clinical importance. Materials and methods: This retrospective study was conducted at the Department of Radiology, Benghazi Medical Center, Benghazi, Libya. Data comprised the paranasal sinus computed images of 112 patients (46 males and 66 females) analyzed for the presence of anatomic variants and associated sinus pathology. Results: Our results showed that the most common anatomical variants was deviated nasal septum (60.7%) with slight higher incidence on left side, followed by concha bullosa (22.3%), other variants found were absent frontal sinus (18.8%), Nasal spur (14.3%) , Agger nasi cell (16.1%), Haller cell (5.4%), Onodi cell (2.7%), accessory ostia of maxillary sinuses (10.7%), accessory middle nasal concha (1.8%), paradoxical middle turbinate (1.8%), nasal septum pneumatization (5.4%), Crista galli pneumatization (2.7%), pneumatization of hard palate (1.8%) and pneumatization of clinoid process (6.3%). (53.6%) patients suffered from sinusitis, the results showed that the most common sinus involved was maxillary sinus. Conclusion: Anatomical variations of PNS are quite common. Analysis of every paranasal CT scan obtained for sinusitis for the presence of different anatomic variants is of questionable value unless endoscopic surgery is planned to reduce the risk of intraoperative complications.

scholarly journals A radiological study of anatomical variations in ostiomeatal complex in patients with chronic rhinosinusitis

2017 ◽  
Vol 3 (3) ◽  
pp. 528
Author(s):  
Rajneesh . ◽  
Rahul S.
Keyword(s):  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Intraoperative Complications ◽  
Preoperative Evaluation ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Leonardo Da Vinci ◽  
Type I ◽  
Anatomical Variants ◽  
Increased Risk

<p class="abstract"><strong>Background:</strong> In ancient times the paranasal sinuses, without any anatomical differentiation, were thought to be a system of hollow spaces through which mucus produced by the brain was drained. Leonardo da Vinci in Milano in 1489 was the first to prepare and draw anatomical specimens of the paranasal sinuses; the drawings, however, only became accessible to scientific evaluation as late as 1901.</p><p class="abstract"><strong>Methods:</strong> All adult patients (more than 20 years of age) attending the Outpatient department at ENT, diagnosed to have chronic rhinosinusitis, willing to undergoing Computed Tomographic evaluation were included in this study. Sample of 50 was selected using purposive sampling technique. All CT scans were obtained with GE Brightspeed scanner (16 slice MDCT scanner). Coronal sections were performed with the patients in prone position, with extended neck and the plane perpendicular to the infraorbitomeatal line.</p><p class="abstract"><strong>Results:</strong> Agger nasi was the most common variation seen in 72% cases followed by dwviated nasal septum in 66% patients. Other variations found were lateral attachment of uncinate process in 54%, uncinate attachment to skull base in 33%, concha bullosa in 32%, overpneumatized bulla ethmoidalis in 21%, medial attachment of unicinate process to middle turbinate in 13%, paradoxical bent middle turbinate in 11%, haller cell seen in 6%. 56% had type I frontoethmoidal cells, 29% had type II, and 15% had type III frontoethmoidal air cells.</p><p><strong>Conclusions:</strong> The presence of anatomical variants does not indicate a predisposition to sinus pathology but these variations may predispose patients to increased risk of intraoperative complications. The surgeon must pay close attention to anatomical variants in the preoperative evaluation avoid possible complications and improve success of management strategies. </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.

Septal Deviation and Chronic Sinus Disease

2000 ◽  
Vol 14 (3) ◽  
pp. 175-180 ◽  
Author(s):  
Mohammed M Elahi ◽  
Saul Frenkiel
Keyword(s):  
Paranasal Sinus ◽  
Computerized Tomography ◽  
Nasal Septum ◽  
Middle Turbinate ◽  
Septal Deviation ◽  
Lateral Nasal Wall ◽  
Sinus Disease ◽  
Ostiomeatal Complex ◽  
Anatomic Variants ◽  
Paranasal Sinus Disease

The introduction of computerized tomography in the identification of sinonasal pathology and associated anatomic variants has contributed to a greater understanding of the factors leading to ostiomeatal complex (OMC) obstruction and chronic sinus disease. The OMC and paranasal sinus regions were prospectively evaluated in 150 consecutive patients as a function of the degree of nasal septal deviation and compared with matched controls. These data were correlated with paranasal sinus disease, lateral nasal wall findings, and middle turbinate abnormalities. An increased incidence and severity of bilateral chronic sinus disease was present with increasing septal deviations (p < 0.05). Similarly, patients with increasing nasal septum deviations were noted to have a higher incidence of OMC obstruction (p < 0.05). Ostiomeatal complex obstruction in the direction of septal angulation was associated with nasal septal deformity; however, contralateral OMC obstruction was associated with middle turbinate and lateral nasal wall abnormalities (p < 0.05). The evaluation of the degree of septal angulation has helped better understand the factors contributing to chronic sinus disease and OMC obstruction.

CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery

1990 ◽  
Vol 104 (6) ◽  
pp. 477-481 ◽  
Author(s):  
G. A. S. Lloyd
Keyword(s):  
Paranasal Sinuses ◽  
Adult Population ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Control Group ◽  
Middle Meatus ◽  
Large Reservoir ◽  
Control Series ◽  
Anatomical Variants ◽  
Sinus Infection

AbstractA control series of biplane CT scans of the paranasal sinuses, derived from patients examined for orbital tumours, is described. The scans were assessed for the presence of anatomical variants in the middle meatus, said to contribute to meatal stenosis, and for signs of asymptomatic infection revealed by the presence of clouding or mucosal thickening in the sinuses.Of the anatomical variants, only concha bullosa (pneumatisation of the middle turbinate) was associated with a high incidence of infection in the sinuses (85 per cent). Evidence of asymptomatic sinus infection was as high as 39 per cent overall, the highest incidence occurring in the ethmoid cells (28 per cent). Isolated ethmoid clouding on CT was observed in 15 per cent and is likely to be found in as many as one in seven of the adult population in the UK. It is concluded that in the majority of patients clouding confined to a few ethmoid cells shown on CT is without clinical significance.The evidence from the control series did not support the concept that most sinus infection starts in the middle meatus. The presence of a large reservoir of quiescent or chronic sinus infection in the control group suggests that in most instances sinusitis derives from a recrudescence of this pre-existing infection.

Fungus ball paranasal sinuses: pattern of histopathology and culture characteristics

2019 ◽  
Vol 49 (20) ◽  
Author(s):  
Nugroho Suharsono
Keyword(s):  
Aspergillus Niger ◽  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Histopathological Examination ◽  
Morphological Characteristics ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
Fungus Ball ◽  
Methenamine Silver ◽  
Fungus Balls

Background: Fungal infection of the nose and paranasal sinuses is an uncommon condition which is now being increasingly recognized. The clinical presentation is not specific with various symptoms such as nasal obstruction, purulent nasal discharge, facial pain, and chronic cough. Only unilaterality may alert the clinician. Purpose: To find the morphological characteristics of the fungus in patients with paranasal sinus fungus ball. Methods: A retrospective study of 13 paranasal sinus fungus balls cases which underwent endoscopic sinus surgery at Department of Otorhinolaryngology Head and Neck Surgery St. Vincentius A Paulo Hospital Surabaya from March, 2012 until December, 2013. Age, sex, histopathology and fungal cultur were analysed. Histopathologic sections of all the patients were stained with hematoxylin and eosin (H&E), and Gomori methenamine silver (GMS). The specimens were then cultured on Sabouraud dextrose agar plates and incubated at 30°C for 1 month. At the end of the incubation period, the samples were evaluated microscopically to detect fungi and identify their species. Results: The age reported of the 13 patients, was ranging from 36 to 63 years old. There was a significant female predominance, 10 female patients (76.92%) and 3 male patients (23.08%). Histopathological examination showed that most causative agents were Aspergillus species 92.31% (12/13). Culture test was positive for 69.23% (9/13). Aspergillus niger (61.54%, 8/13) is the most frequent fungus reported to cause fungus balls. Conclusion: Pattern of histopathologic on HE and GMS is very helpful and sensitive to identify fungi. The most common isolated mould in our study was Aspergillus niger.Keywords: fungus ball, histopathology and culture, Aspergillus nigerABSTRAK Latar Belakang: Infeksi jamur di hidung dan sinus paranasal merupakan kondisi yang jarang terjadi, namun kini lebih sering ditemukan. Gejala klinisnya tidak spesifik dapat berupa obstruksi hidung, sekret dari hidung, nyeri wajah, dan batuk kronis. Bila terjadi unilateral, patut diwaspadai oleh para klinisi. Tujuan: Untuk mengetahui karakteristik morfologi fungus yang didapati pada pasien sinusitis jamur yang kami teliti. Metode: Dilakukan penelitian retrospektif pada 13 pasien sinusitis jamur yang menjalani bedah sinus endoskopi di Departemen Otorinolaringologi-Kepala Leher Rumah Sakit St. Vincentius A Paulo Surabaya dari bulan Maret 2012 sampai dengan Desember 2013. Dilakukan analisis usia, jenis kelamin, histopatologi dan kultur jamur. Pewarnaan preparat histopatologi menggunakan Hematoxylin dan eosin (H&E) dan Gomori Methenamine Silver (GMS). Kemudian spesimen diletakkan pada piring agar Sabouraud dextrose, dan dilakukan inkubasi pada suhu 30°C selama satu bulan. Pada akhir masa inkubasi, sampel dievaluasi dengan mikroskop untuk mendeteksi jamur dan spesiesnya. Hasil: Didapati usia 13 penderita berkisar dari 36-63 tahun. Wanita lebih dominan sebanyak 10 penderita (76,92 %) dan 3 penderita laki-laki (23,08%). Hasil pemeriksaan histopatologi menunjukkan spesies Aspergillus sebagai penyebab utama (92,31%) pada 12 penderita (12/13).Tes kultur positif pada 69,23% (9/13). Jamur yang paling sering menyebabkan bola jamur pada sinus adalah Aspergillus niger (61,54%, 8/13). Kesimpulan: Pewarnaan preparat histopatologi menggunakan Hematoxylin dan eosin (H&E) dan Gomori Methenamine Silver (GMS) sangat berguna dan sensitif dalam mendeteksi adanya jamur. Jenis jamur yang paling banyak ditemukan pada penelitian kami adalah Aspergillus niger.

Development of the Paranasal Sinuses in Children: Implications for Paranasal Sinus Surgery

1993 ◽  
Vol 102 (9) ◽  
pp. 705-711 ◽  
Author(s):  
Gerald Wolf ◽  
Wolfgang Anderhuber ◽  
Frederick Kuhn
Keyword(s):  
Nasal Cavity ◽  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Age Groups ◽  
Clinical Importance ◽  
Sinus Surgery ◽  
Clinical Anatomy ◽  
Surgical Interventions ◽  
Stage Of Development ◽  
Paranasal Sinus Surgery

The pediatric nasal cavity and paranasal sinuses, when compared to those in adults, differ not only in size but also in proportion. Knowledge of the unique anatomy and pneumatization of children's sinuses is an important prerequisite to understanding the pathogenesis of sinusitis and its complications. It is also important in evaluation of radiographs and in planning surgical interventions. In order to study the development of the paranasal sinuses in children and relate clinical anatomy to sinus surgery, the sinuses in 102 pediatric skulls and cadaver heads were measured. The results were classified by stage of development into 4 different age groups: newborn and 1 to 4, 4 to 8, and 8 to 12 years. The characteristics of each group and their clinical importance for paranasal sinus surgery are described.

Paranasal Sinus Mucoceles in Cystic Fibrosis

1993 ◽  
Vol 7 (1) ◽  
pp. 31-35 ◽  
Author(s):  
William E. Davis ◽  
Giulio J. Barbero ◽  
William R. LaMear ◽  
Jerry W. Templer ◽  
Peter Konig
Keyword(s):  
Cystic Fibrosis ◽  
Paranasal Sinus ◽  
Computerized Tomography ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
The Other ◽  
Sinus Surgery ◽  
Lateral Nasal Wall ◽  
Osteomeatal Complex

Six patients between the ages of 6 and 22 years old with cystic fibrosis were found to have mucoceles of the paranasal sinuses. Four were male and two were female. They experienced nasal obstruction, purulent rhinorrhea, and anosmia, but none had fever or pain. Nasal endoscopy and coronal computerized tomography scans revealed the lateral nasal wall to be displaced medially against the septum. Functional endoscopic sinus surgery revealed large cystic spaces filled with thick yellow-green mucus. Postoperatively most patients are able to smell and breathe through their noses. The mucocele probably begins as an obstructed anterior ethmoid cell, which then enlarges and obstructs the osteomeatal complex, which further impairs drainage of the other sinuses into this area.

ʺStomatologyʺ in functional endoscopic sinus surgery – 2 case reports

2018 ◽  
Vol 7 (2) ◽  
pp. 43-47
Author(s):  
Paulina Kołodziejczyk ◽  
Tomasz Gotlib
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Surgery ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Case Reports ◽  
Functional Endoscopic Sinus Surgery ◽  
The Body ◽  
Sinus Surgery ◽  
Facial Region ◽  
Rare Phenomenon

Functional endoscopic sinus surgery (FESS) is most commonly used in chronic rhinosinusitis treatment. This method is also applicable to other diseases, including the treatment of symptomatic ectopic teeth. Ectopic teeth are a quite rare phenomenon. They may appear within the facial region, as well as in other parts of the body. The article describes two cases of ectopic teeth appearing within the nose area and paranasal sinuses, there endoscopic surgery has been used in the extraction, which resulted in the remission of symptoms.

Anatomic Site of Origin of Nasal Polyps: Endoscopic Nasal and Paranasal Sinus Surgery as a Screening Method for Nasal Polyps in an Autopsy Material

1996 ◽  
Vol 10 (4) ◽  
pp. 211-216 ◽  
Author(s):  
P. L. Larsen ◽  
M. Tos
Keyword(s):  
Paranasal Sinuses ◽  
Nasal Polyps ◽  
Screening Method ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Anatomic Site ◽  
Endoscopic Endonasal ◽  
Paranasal Sinus Surgery ◽  
History Of ◽  
Place Of Origin

Systematic examination of the paranasal sinuses and nasal cavity followed by endoscopic endonasal surgery was performed in 31 cadavers, polyps being found in 13. In all, a total of 27 polyps was found. Only four patients had a case history of allergy or sinusitis. The polyps and their place of origin were documented photographically. A total of 70% of the polyps originated in the ostia, clefts, or recesses. In three patients, polyps originated on the middle turbinate, and in one the agger nasi area, indicating that polyp formation in the ethmoidal sinuses and other paranasal sinuses is secondary to the formation of polyps in the sinus ostia, clefts, and recesses.

Applied Anatomy of the Paranasal Sinuses with Emphasis on Endoscopic Surgery

1994 ◽  
Vol 103 (4_suppl) ◽  
pp. 3-32 ◽  
Author(s):  
Stephen P. Becker
Keyword(s):  
Endoscopic Surgery ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Structural Changes ◽  
Chronic Sinusitis ◽  
Sinus Surgery ◽  
Serial Sections ◽  
Anatomic Landmarks ◽  
Applied Anatomy

Serial sections of frozen cadaver heads were obtained in the axial, coronal, and sagittal planes. These were analyzed with specific attention to the anatomy of the paranasal sinuses as it pertains to endoscopic sinus surgery. Important anatomic landmarks are pointed out. The use of these landmarks to guide the surgeon through the dissection and to avoid complications is discussed. The resolution of chronic sinusitis is often brought about by the structural changes secondary to endoscopic sinus surgery, and the reasons for this outcome are reviewed.

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