بررسي تنوع آناتوميكي ديواره استخواني سينوسهاي پارانازال با استفاده از سي تي اسكن: گزارش 279 مورد بيمار

Anatomic variations of the bone in sinonasal CT scan: A report of 279 cases

Objectives: Anatomical variations of nasal cavity and paranasal sinuses are more important nowadays because endoscopic sinus surgery is performed more frequently by otorhinolaryngologist. While some anatomic variations such as Haller cell, concha bullosa, big agger nasi cell, pneumatized uncinate process may be a predisposition for chronic sinusitis or nasal polyposis. CT-scan is important as a preoperative evaluation for functional endoscopic sinus surgery. Coronal CT-scan can clearly visualize details of mucosal abnormalities, paranasal sinus involvement and anatomic variation of the bone. In this study we aimed to evaluate the frequency of occurrence of anatomical variations of paranasal sinuses and nasal cavity among patients scheduled for elective endoscopic sinus surgery using computed tomography. Subjects and Methods: The subjects of this study included 204 patients with sinus disease (sinus group) suffering from chronic sinusitis and sinonasal polyposis. A further 75 patients (non-sinus group) who were diagnosed for hypophysial tumour and recurrent dacryocystitis, ophthalmologic diseases and other for reasons were subjected to CT scanning. The results of CT scanning were analysed for their anatomical variations. Results: This study included 163 male, 116 female. Anatomic variations were detected as follows: 57.7% (septal deviation), 48.2% (Agger nasi cell), 28% (concha Bullosa) and 13.5% (large Bulla cell), 0.9% (Haller cell), uncinate process with medial bent (12.1%) or lateral bent (5.2%). Conclusion: The finding of this study showed that septal deviation is the most common and unicate process with lateral bent being least common types of the anatomical variation nasal cavity and paranasal sinuses of anatomical. Prudently, in order to prevent the development of complications during the surgery, this aspect need to be considered for each individual patient elected for endoscopic sinus surgery.