Anatomical variations of maxillary and ethmoid sinus in chronic rhinosinusitis

Authors

  • Karthika Rajeev Department of Otorhinolaryngology Head and Neck Surgery, KVG Medical College, Sullia, Karnataka, India
  • Ravishankara S. Department of Otorhinolaryngology Head and Neck Surgery, KVG Medical College, Sullia, Karnataka, India
  • Chethana C. S. Department of Otorhinolaryngology Head and Neck Surgery, KVG Medical College, Sullia, Karnataka, India
  • Supreetha B. Shenoy Department of Otorhinolaryngology Head and Neck Surgery, KVG Medical College, Sullia, Karnataka, India
  • Jyoti . Department of Otorhinolaryngology Head and Neck Surgery, KVG Medical College, Sullia, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20182703

Keywords:

Anatomical variations, Computed tomography, Diagnostic nasal endoscopy

Abstract

Background: The objectives of the study were to compare the anatomical variants of maxillary and ethmoid sinus in CT PNS and diagnostic nasal endoscopy, to determine the incidence of variations of maxillary and ethmoid sinus and to determine the association of anatomical variations with extent of the disease.

Methods: Patients with chronic rhinosinusitis attending the outpatient department of otorhinolaryngology, head and neck surgery (ENT-HNS) of KVG Medical College for a period of 12 months from December 2016 to November 2017. 100 consecutive patients with history of CRS subjected for nasal endoscopy and CT-PNS.  

Results: The majority of patients were females. Male to female ratio was 1:1.46. Headache and postnasal drip were the main symptoms (76%). Concha bullosa (42.4%) was most common anatomical variation, which was detected in 59(42.4%) patients on CT PNS and DNE. There was statistically significant correlation between right septal deviation and right maxillary sinusitis (p<0.01), left septal deviation and left maxillary sinusitis (p=0.001) and left deviation and left ethmoid sinusitis (p=0.017). We also found correlation between left Haller cells and left ethmoid sinusitis (p=0.003).

Conclusions: By using diagnostic nasal endoscopy and CT PNS, anatomic variations can be easily identified and aid as a guide map during functional endoscopic sinus surgeries. 

References

Deosthale NV, Khadakkar SP, Singh B, Harkare VV, Dhoke PR, Dhote KS. Anatomical variations of Nose and Paranasal Sinuses in Chronic Rhinosinusitis. PJSR. 2014;7(2):1-7.

Zinreich S, Kennedy D, Rosenbaum A, Gayler BW, Kumar AJ, Stammberger H. Paranasal sinuses: CT imaging requirements for endoscopic surgery. Radiology. 1987;163:769–75.

Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101(1):56–64.

Zinreich S. Imaging of infl ammatory sinus disease. Otolaryngol Clin North Am. 1993;26:535–47.

Brown S. Anatomy of nose and paranasal sinuses. In: Lund VJ, Stammberger H, eds. Scott Brown Otolaryngology, Basic Sciences. Volume 5. Oxford: Butterworth-Heinemann; 7th ed. 2008: 13-18.

Levine HL. FESS, evaluation of surgery and follow up of 250 patients. Laryngoscope. 1990;100:79–84.

Kirtane MV. Functional endoscopic sinus surgery (A preliminary study). Indian J Otolaryngol. 1991;43:126-9.

Gandotra SC, Matvani G, Kapoor R, Choudhary M. Functional Endoscopic Sinus Surgery results in 69 patients. Indian J Otolaryngol Head Neck Surg. 2000;52:5-8.

Berrettini S, Carabelli A, Sellari- Franceschini S, Bruschini L, Quartieri F. Perennial allergic rhinitis and chronic rhinosinusitis: correlation with rhinologic risk factors. Allergy. 1999;54(3):242-8.

Nouraei SA, Elisay AR, Dimarco A, Abdi R, Majidi H, et al. Variations in paranasal sinuses anatomy: implication for the pathophysiology of Chronic Rhinosinusitis and safety of endoscopic sinus surgery. J Otolaryngol Head Neck Surg. 2009;38:32-7.

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(3):163-8.

Downloads

Published

2018-06-23

Issue

Section

Original Research Articles