Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature

Abstract

Background Chronic rhinosinusitis (CRS) refers to a group of disorders characterized by inflammation of the mucosa of the paranasal sinuses. Nasal endoscopy and computed tomography (CT) scans are successfully used as diagnostic modalities of nose and paranasal sinus diseases. There have been many studies regarding the anatomic variations leading to pathogenesis of paranasal sinus diseases. Considerable progress has been made in the medical and surgical control of these conditions; however, a large number of questions relating to the diagnosis, evaluation, and treatment of the diseases remain unanswered. Materials and methods The study included 82 clinically diagnosed cases of CRS who underwent CT scan and were advised to undergo diagnostic endoscopy. The anatomical findings of the nose were compared to see correlation between nasal endoscopy and CT scan. Results The mean age (±standard error of the mean) of presentation was 34.11 (±1.42) years, while most patients were from the age group of 18 to 30 years. Males were predominating the study group with 62.2%, while 37.8% were females. The most common anatomic variation was deviated nasal septum with 92.68% CT reported patients. This was followed by inferior turbinate hypertrophy, septal spur, concha bullosa, and agger nasi cells. Conclusion Computed tomography scan is considered the gold standard for sinonasal imaging. Diagnostic endoscopy and CT scan are a must prior to any functional endoscopic sinus surgery. They help in assessing the extent of sinus disease and to know the variations and vital relations of the paranasal sinuses. Computed tomography scan assists the surgeon as a “road map” during endoscopic sinus surgery. How to cite this article Chakraborty P, Jain RK, Joshi P, Kumari R, Pradhan S. Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature. Clin Rhinol An Int J 2016;9(1):13-17.

Assessment of Sinonasal Anatomical Variants using 128-Slice MDCT in Patients with Chronic Rhinosinusitis

“…CT depicts excellent anatomical soft tissue and bony details and helps in the diagnosis, and gives detailed sinonasal anatomy for surgery. 12 CT help in evaluating the extent of sinus disease and helps in knowing the anatomical variations and its vital relations with the paranasal sinuses. CT scan assists the surgeon as a "road map" during functional endoscopic sinus surgery.…”

“…Computed tomography (CT) scans are the gold standard diagnostic modality of nose and paranasal sinus diseases. [9][10][11][12][13][14] There are many studies regarding the anatomic variations leading to pathogenesis of chronic rhinosinusitis. Some of the anatomic variants have been reported to be associated with chronic rhinosinusitis, possibly leading to inflammation by obstructing drainage pathways from the sinuses and nasal cavity.…”

Frequency and intensity of symptoms in patients with chronic rhinosinusitis

“…Two or several symptoms are clinically diagnosed, one of which has to be nasal obstruction, or nasal discharge, while the remaining symptoms are facial pain/pressure and reduction or loss of smell; in children cough is recorded instead of reduction or loss of smell [1]. Along with the mentioned symptoms, these patients can experience fatigue, headache, cough in adults, earache and toothache, halitosis and other [2]. The final diagnosis of CRS is done endoscopically and/or by computer tomography (CT) [3].…”