DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20173032

A CT and DNE study of osteomeatal complex variations and their correlation in chronic rhinosinusitis patients

Parul Sachdeva, Kuldeep S. Sachdeva, Baldev Singh, Manjit Singh, Manpreet Kaur, Isha Goyal, Gaurav Kataria

Abstract


Background: CRS is a global burden reducing the productivity at work. This study was done to evaluate the occurrence of anatomical variations of osteomeatal complex (OMC) and to assess its relation in causation of chronic rhinosinusitis in the study population.

Methods: A 100 patients diagnosed with CRS in the outdoor of Dept. Of ENT between November 2012 – November 2015 were subjected to CT Imaging and DNE and the frequency of anatomical variations and involvement of paranasal sinuses were evaluated. The correlation between them was established using chi-square test.  

Results: Agger nasi cells were the most common variant seen in 73 (73%) patients with 12% being unilateral and 61% bilateral. Other variants seen were: deviated nasal septum in 68%, uncinate process variations in 58%, concha bullosa in 30%, enlarged bulla ethmoidalis in 25%, paradoxical middle turbinate in 18%, haller’s cells in 6% and accessory maxillary ostia in 2%. We could establish a correlation between a few of these variants and the affected sinuses.

Conclusions: The importance of CT and nasal endoscopy is emphasized in patients with persistent symptoms to identify the anatomical variations that may contribute to the development of chronic sinus mucosal disease.


Keywords


Chronic rhinosinusits, Osteomeatal complex, Anatomical variations, CT scan, DNE

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References


Deepthi NV, Menon UK, Madhumita K. Chronic Rhinosinusitis – An Overview. Amrita J Med. 2012:8(1):1-44.

Schlosser RJ, Woodworth BA. Chronic Rhinosinusitis and Polyposis. In: Snow B, Wackym PA, editors. Ballenger’s Otorhinolaryngology. 17th ed. USA: Pmph; 2008: 573-583.

Thiagarajan B, Basith Y. Role of Anatomical Obstruction in the Pathogenesis of Chronic Sinusitis. Online J Otolaryngol. 2012:2(3):7-15.

Freitas AP, Boasquevisque EM. Anatomical variants of the ostiomeatal complex: tomographic findings in 200 patients. Radiol Bras J. 2008:41(3):149-54.

Zinreich SJ, Kennedy DW, Rosenbaum AE, Gayler BW, Kumar AJ, Stammberger H. Paranasal sinuses: CT imaging requirements for endoscopic surgery. Radiol. 1987:163:769-75.

Wani AA, Kanotra S, Lateef M, Ahmad R, Qazi SM, Ahmad S. CT scan evaluation of the anatomical variations of the ostiomeatal complex. Indian J Otolaryngol Head Neck Surg. 2009:61:163-8.

Stammberger H. Anatomic and Pathophysiologic Considerations. Endoscopic endonasal surgery. Concepts in treatment of recurring rhinosinusitis. Otolaryngol Head and Neck Surg. 1986:94:143-6.

Zinreich SJ, Kennedy DW. Paranasal sinuses. CT imaging requirements for endoscopic surgery. Radiol. 1987:163:769-74.

Lee KJ. Textbook of otolaryngology and head and neck surgery. New York: Elsevier; 1989: 222-223.

Sheetal D, Devan PP, Manjunath P, Martin P, Satish Kumar K, Sreekantha et al. CT PNS—Do We Really Require before FESS? J Clin Diagnostic Res. 2011:5(2):179-81.

Gupta AK, Gupta B, Gupta N, Tripathi N. Computerized Tomography of Paranasal Sinuses: A Roadmap to Endoscopic Surgery. Clin Rhinol Int J. 2012:5(1):1-10.

Stoney P, Probst L, Shankar L. CT scanning for functional endoscopic sinus surgery: analysis of 200 cases with reporting scheme. J Otolaryngol. 1993:2272-8.

Dua K, Chopra H, KhuranaAS, Munjal M. CT scan variations in chronic sinusitis. Ind J Radiol Imag. 2005:15(3):315-20.

Midilli R, Aladag G, Erginoz E, Karci B, Savas R. Anatomic variations of the paranasal sinuses detected by computed tomography and the relationship between variations and sex. Kulak BurunIhtis Der. 2005:14(3):49-56.

Leunig A, Betz CS, Sommer B, Sommer F. Anatomical variations of the sinuses: multiplanar CT-analysis in 641 patients. Laryngorhinootologie. 2008:87(7):482-9.

Kaygusuz A, Haksever M, Akduman D, Aslan S, Sayar Z. Sinonasal anatomical variations: their relationship with chronic rhinosinusitis and effect on the severity of disease-a computerized tomography assisted anatomical and clinical study. Indian J Otolaryngol Head Neck Surg. 2014:66(3):260-6.

Cagici CA, Yilmaz I, Erkan AN, Yilmazer C, Ozluoglu L. Coexistence of the anatomic variations of the paranasal sinuses and thickening of the sinus mucosa. Turkish Arch Otolaryngol. 2006:44(4):211-7.

Mamatha H, Shamasundar NM, Bharathi MB, Prasanna L. Variations of ostiomeatal complex and its applied anatomy: a CT study. Indian J Sci Tech. 2010:3(8):904-7.

Biswas J, Patil CY, Deshmukh PT, Kharat R, Nahata V. Tomographic Evaluation of Structural Variations of Nasal Cavity in Various Nasal Pathologies. Int J Otolaryngol Head and Neck Surg. 2013:2:129-34.

Fadda GL, Rosso S, Aversa S, Petrelli A, Ondolo C, Succo G. Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis. Acta Otorhinolaryngol Ital. 2012:32:244-51.

Krzeski A, Tomaszewska E, Jakubczyk I, Zielinska AG. Anatomic Variations of the Lateral Nasal Wall in the Computed Tomography Scans of patients with Chronic Rhinosinusitis. Am J Rhinol. 2001:15(6):371-5.

Arslan H, Avdinlioglu A, Bozkurt M, Egeli E. Anatomical variations of the paranasal sinuses: CT examination for endoscopic sinus surgery. Auris Nasus Larynx. 1999:26(1):39-48.

Al-Quadah MA. Anatomical Variations in Sino-Nasal Region: A Computer Tomography (CT) Study. J Med J. 2010:44(3):290-7.

Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991:101;56-64.

Madani SA, Hashemi SA, Kianejad AH, Heidari S. Association Between Anatomical Variations of the Sinonasal Region and Chronic Rhinosinusitis: A Prospective Case Series Study. Scientific J Faculty Med. 2013:30(2):73-7.