Multi Detector Computed Tomographical Assessment of Anatomical Variants of Paranasal Sinuses

Author(s):  
P. K. Roopa Rajavarthini ◽  
I. Venkatraman

Multi detector computed tomography (MDCT) scan of paranasal sinuses has become mandatory for all patients undergoing functional endoscopic sinus surgery. It depicts the anatomical variations in much simpler way and acts as a roadmap for endoscopic sinus surgery. In this study the maximum of participants were in the age group of 41- 50 years (32 %). The mean age of the study participants was observed to be 43.8 ± 15.6 years. HRCT PNS results shows nasal septum was found to be the most common anatomical variant (DNS- 94%). Concha Bullosa in right side were seen in 37.5% and left side were 21.9% (total unilateral cases- 59.4%) and bilateral Concha Bullosa were seen in 40.6% of the cases. Agger nasi were found to be present in 58% of the CRS cases among which right AN was 41%, left side was 30.8%, and bilateral AN were seen in 28.2% of the cases and Paradoxical Middle Turbinate were seen in 42% of cases in our study. Medialised uncinate was seen in 22% of the cases.

2021 ◽  
Vol 10 (38) ◽  
pp. 3351-3355
Author(s):  
Ganesh Manohar Vihapure ◽  
Akshay Sorade ◽  
Kaenat Ahmed ◽  
Lakshmi Sravya Yarlagadda ◽  
Khaleel Basha Munnaru

BACKGROUND The paranasal sinuses (PNS) have various anatomical difference. Computed tomography (CT) is an excellent means of providing anatomical information of this region, disease extent, assisting endoscopic evaluation and guiding treatment. Functional endoscopic sinus surgery (FESS) has become an increasingly popular treatment for chronic sinus diseases. CT of the paranasal sinuses has become a roadmap for FESS. The present study focuses on the assessment of the efficacy, safety and benefits of functional endoscopic sinus surgery in cases of maxillary pathologies and also study the anatomical variations in maxillary sinus in computed tomography and its usefulness in planning and management of chronic sinonasal diseases. METHODS It was a prospective study and a total of 80 patients were included in this study from July 2019 to June 2020 in the Otolaryngology Department, KIMS, Karad. Standard surgical steps were applied in each case according to the extent of disease. All patients underwent standard post-operative care. All findings were recorded and studied. RESULTS Total number of patients were 80. Of which, 31 (38.75 %) patients were operated for ethmoidal polyp, 24 (30 %) for chronic rhinosinusitis, 10 (12.5 %) for antrochoanal polyp, 9 (11.25 %) for rhinosporidiosis and 6 (7.5 %) for inverted papilloma. Postoperative complications were periorbital echymoses (13 %), synechiae (2.5 %), epiphora (2.5 %), infection (2.5 %), hemorrhage (4 %). Complete relief of symptoms were noted in 81.67 % cases. CONCLUSIONS Successful outcome and patient satisfaction post treatment can be obtained by careful evaluation and patient selection by history, examination and most importantly, proper imaging of the sinuses. KEY WORDS Maxillary Sinus, Sinusitis, Nasal Polyp, Paranasal Sinus Disease, Computed Tomography (CT)


Author(s):  
Abhijit Pawar ◽  
Santosh Konde ◽  
Priya Bhole

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">To evaluate the olfactory fossae depth according to the Keros' classification on pre functional endoscopic sinus surgery (pre-FESS) and determine the incidence and degree of asymmetry in the height of the ethmoid roof in the population of western Maharashtra</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">Retrospective analysis of 200 multidetector CT studies (400 sides) of paranasal sinuses performed in between January to August, 2017</span><span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">According to the Keros’ classification, the incidence of different types of olfactory fossae was as follows: type I: 18.5%, type II: 74.5% and type III: 7%. Asymmetry in the ethmoid roof height was found in 11.5% of cases</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">Keros’ type II was the commonest followed by type I and type III. There was asymmetry in the depth of the olfactory fossae in 11.5% cases. There was no significant gender predilection as far as type and asymmetry were considered</span><span lang="EN-IN">.</span></p>


1999 ◽  
Vol 113 (8) ◽  
pp. 754-755 ◽  
Author(s):  
J. C. Lim ◽  
P. J. Hadfield ◽  
S. Ghiacy ◽  
N. R. Bleach

AbstractWe report the case of a 57-year-old patient with a presumed developmental anomaly of the medial orbital wall. The resultant protrusion of orbital contents into the ethmoidal complex was clearly demonstrated on coronal computed tomography (CT) scans of the paranasal sinuses. This anomaly presents a high risk of iatrogenic injury to the medial rectus and orbit during functional endoscopic sinus surgery and has not previously been described.


Author(s):  
Sumit Prinja ◽  
Jailal Davessar ◽  
Gurbax Singh ◽  
Simmi Jindal ◽  
Alisha Bali

<p class="abstract">Anatomic variations of the paranasal sinuses can lead to various diseases per se. The paranasal sinus anatomy should be carefully examined prior to performing endoscopic sinus surgery in terms of both existent pathologies and anatomic variations. The anatomy of the paranasal sinuses and its variations have gained importance, along with advances in coronal paranasal sinus computed tomography and extensive use of endoscopic sinus surgery. Rhinolith is a mass resulting from calcification of an endogenous or exogenous nidus within the nasal cavity. It is an uncommon disease that may present asymptomatically or cause symptoms like headache and nasal obstruction. A 24 year old woman was admitted in ENT department of GGS Medical College and Hospital, Faridkot with complaints of nasal obstruction, anosmia and headache persisting for 5 years. Right sided rhinolith was detected on anterior rhinoscopy. Bilateral concha bullosa with right sided rhinolith was reported on preoperative paranasal computed tomography scan. It is known that the paranasal sinuses have a number of anatomical variations. Sometimes severe anatomic variations predispose to rhinosinusitis. Herein we report a rare case, along with a review of the literature, to emphasize that severe anatomical variations should not be ignored.</p>


1997 ◽  
Vol 11 (3) ◽  
pp. 203-210 ◽  
Author(s):  
Javier Medina ◽  
Hector Hernandez ◽  
Lawrence W.C. Tom ◽  
Larissa Bilaniuk

The development of computed tomography and functional endoscopic sinus surgery has improved diagnosis and management of sinusitis. It has also renewed interest in the developmental anatomy of the paranasal sinuses. There are significant differences between adult and pediatric sinus anatomy, and to safely perform functional endoscopic sinus surgery in children, the surgeon must be aware of these differences. To define the developmental anatomy of the paranasal sinuses, we analyzed 145 computed tomograms from patients under 18 years of age. The study emphasized landmarks at the level of the maxillary sinus ostium. In addition, distances and angles from the nasal spine to various points in the sinuses were determined. The structures were identified and traced on a digitizing tablet. Means and standard deviations were calculated for each measure as a function of age. This study can aid a better understanding of sinus development in children and provide guidance to the endoscopic sinus surgeon.


2020 ◽  
Vol 7 (43) ◽  
pp. 2442-2447
Author(s):  
Shahul Hameed A ◽  
Abdul Salam R.T ◽  
Dilna Dilna

BACKGROUND In recent times, due to advancement in sinus endoscopes and sinus surgery instruments and the acquirement of skills, the variety of sinonasal diseases being treated and the indications for transnasal endoscopic approaches have increased dramatically. They include chronic rhinosinusitis and sinonasal polyposis to sinonasal tumours, skull base and orbital pathology. We wanted to study the role and outcome of endoscopic sinus surgery in the management of sinonasal disease. METHODS A cross sectional study was conducted among 200 patients attending the Department of ENT, Govt. Medical College, Kozhikode, over a period 2 years with sinonasal diseases. Demographic details, ENT examination, CT scan Paranasal Sinuses (PNS) and endoscopic examination of the nasal cavity were performed in all patients. Clinical signs were recorded and classified according to their pathologies. All the patients were subjected to functional endoscopic sinus surgery. Operative methods and results were recorded. RESULTS Among the 200 patients, 144 (72 %) were males and 56 (28 %) were female patients in the present study. Among the 200 patients, 126 (63 %) were in the age group of 21 to 50 years. 40 / 200 (20 %) patients belonged to the age group of 0 to 20 Years. 34 / 200 (17 %) patients belonged to the age group of 51 to 70 years. CONCLUSIONS The diseases of the nose and paranasal sinuses ranged from inflammatory aetiology to neoplasms. Use of conventional tools for diagnosis and management of such a variety of diseases had their own limitations and demerits. Whereas endoscopic view of the disease sites was exceptionally clear and well-illuminated, giving an added edge to the ability to inspect the recesses with angled distal endoscopes. Definition of micro anatomical sites was well defined by the CT scan especially around osteo-meatal complex, and its anatomical variants. Functional endoscopic sinus surgery was an excellent and safe procedure. The prognosis in surgically treating sinonasal pathologies with FESS was good in terms of lesser morbidity and minimal chances of recurrence. KEYWORDS Sinusitis, Endoscopic Sinus Surgery, CT Scan PNS, Skull Base Surgery, Sinonasal Tumours


2002 ◽  
Vol 127 (6) ◽  
pp. 549-557 ◽  
Author(s):  
Ivica Klapan ◽  
Ljubimko Šimičić ◽  
Ranko Rišavi ◽  
Nada Bešenski ◽  
Karlo Pasarić ◽  
...  

One of the main objectives of our 3-dimensional (3D) computer-assisted functional endoscopic sinus surgery was to design a computer-assisted 3D approach to the presurgical planning, intraoperative guidance, and postoperative analysis of the anatomic regions of the nose and paranasal sinuses. Such an extremely powerful approach should allow better insight into the operating field, thereby significantly increasing the safety of the procedure. The last step to implementing the technology in the operating room was to connect the computer workstations and video equipment to remote locations by using a high-speed, wide-bandwidth computer network. During patient preparation, the surgeon in the operating room consulted remote experienced and skillful surgeons by viewing CT images and 3D models on computer workstations. The surgeon and consultants used software for CT image previews and 3D model manipulations on top of collaboration tools to define the pathosis, produce an optimal path to the pathosis, and decide how to perform the real surgical procedure. With tele-flythrough or tele-virtual endoscopy rendered through the use of 3D models, both surgeons can preview all the characteristics of the region (ie, anatomy, pathosis) and so predict and determine the next steps of the operation. This ensures greater safety thanks to the operation guidance and reduces the possibility of intraoperative error. The duration of the teleconsultation is thus shortened, which may prove the greatest benefit of tele-3D computer-assisted surgery. If this method were used, clinical institutions would spend less money for telesurgical consultation.


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