Paranasal Sinus CT Scan Findings in Patients with Chronic Sinonasal Symptoms

Background: In the last few years some ana¬tomical CT variations and pathological find¬ings were supposed as a possible element which favors development of sinus pathol¬ogy and symptoms usually connected with sinusitis. Frontal cell types (Bent) and con¬tact points between the nasal turbinates and the nasal septum (pearson, Wagner-Novak) can be trigger zones for tension type vascu¬lar headaches. Our aim was to analyze the frequency of anatomical variation in group of patients having sinonasal symptoms and signs. Methods: In a five-year retrospective study 460 patients were included, who have visited rhinologic outpatientʹs clinic because of nasal complaints. Data collected included age, sex, duration of the symptoms, asthma and smoking, presence and type of postnasal drip, type and localization of headache, impaired nasal breathing and CT scan finding. On CT scans were analyzed frontal cell type, contact points between both middle and superior nasal turbinate and nasal septum, mucosal thickening in the in the ostiomeatal complex (OMC) and adjacent sinuses, Haller cell and conha bullo¬sa. CT staging was done according with Lund CT staging score. Results: Headache was present in 360 (78.3%) patients and posterior nasal discharge in 250 (54.3%) patients. Impaired nasal breathing was bilateral in 123 patients (26.7%). Contact between superior nasal turbinate and nasal septum was present in 193 (42.0%) patients. pneumatization of the middle turbinate (conha bullosa + intra-llamelar cell) was present in 280 (60.9%) of the patients. Mean Lund staging score was 2.2 (from 0.0 to 21.0). Conclusion: We have to pay attention during evaluation of CT scans of nose and paranasal sinuses, on contact points between nasal septum and superior nasal turbinates and on types of frontal cells (suspected narrowing of frontal recess). Technological improvement of CT scan and use of 3d software reconstruction perhaps will lighten this matter.