Anatomical Variations of the Nose and Paranasal Sinuses Found on CT Scans Images of Adult Chronic Rhinosinusitis Patients

Abstract

Background: Anatomical variations of the nose and paranasal sinuses are one of the contributing factors in developing Chronic Rhinosinusitis (CRS) predisposing factor and complications during surgery complicating factors. CT Scan has an important role in diagnosing. One of the tools used to identify and detecting thesediagnose anatomical variations. in patients is CT scans. Objectives : To study theexamine prevalence of anatomical variations of the nose and paranasal sinuses found on CT Scanscans images of adult chronic rhinosinusitis patients. with CRS. Methods: The research conduct through aA retrospective descriptive studyresearch was conducted using CT scans images of 43 nose and paranasal sinuses CT Scans of the adult CRS patients who went tovisited the Allergy Rhinology Polyclinic at Dr. Hasan Sadikin hospital,Hospital in Bandung; on 1 between January-31 1 and December 31, 2019. Anatomical variations assessment of the nosewere assessed and paranasal sinuses divided into:categorized as CRS predisposing and surgery-complicating factors. CRS factors include septal deviation, Agger nasi, frontal bullae, concha hypertrophy, bullae ethmoid, pneumatized septum, concha bullosa, accessory ostium, bullous uncinate process; paradoxical, secondary, and sinus concha. While surgery complicating factors are depth of olfactory fossa, fronto ethmoid cells, inter frontal sinus septal cells, Haller cells, supraorbital cells, Onodi cells, intra maxillary sinus septum, and uncinate process attachment. Other include infraorbital nerve, anterior ethmoid artery, optic nerve, internal carotid artery, vidian canal dehiscence, atelectasis uncinate processus, intra sphenoid sinus septum, frontal, maxilla, and sphenoid sinus pneumatization. Results: The result showed that the most common CRS predisposing factors were septal deviation (90.8%), concha hypertrophy (72.2%), and Agger Nasi Cells (65.1%);%). Regarding surgery -complicating factors are, the most prevalent ones were Keros II (72.2%), sellar sphenoid sinus (69,.8%), and Kuhn I (58,.1%). Conclusion:SeptalIn conclusion, septal deviations, concha hypertrophy, and Agger Nasi cells asCells are the most common anatomical variations associated with CRS predisposing factors;predisposition. Additionally, Keros II, sellar sphenoid sinus sellar, and Kuhn I were identified as the most frequent complicating factors for surgery. These findings emphasize the importance of considering these anatomical variations in managing CRS.