International Journal of Otorhinolaryngology and Head and Neck Surgery | January-February 2019 | Vol 5 | Issue 1 Page 1
International Journal of Otorhinolaryngology and Head and Neck Surgery
Babu GR et al. Int J Otorhinolaryngol Head Neck Surg. 2019 Jan;5(1):xxx-xxx
http://www.ijorl.com
pISSN 2454-5929 | eISSN 2454-5937
Original Research Article
Correlation of anatomical variations in chronic sinusitis with
diagnostic nasal endoscopy and CT scan of paranasal sinuses:
an observational study
G. Ramesh Babu, G. Ravi Kumar*, V. Krishna Chaitanya
INTRODUCTION
Chronic sinusitis is the chronic inflammation of mucous
membrane of nose and one or more of paranasal sinuses.
In the early life during fetal development, the paranasal
sinuses originate as invagination of the nasal mucosa into
the lateral nasal wall, frontal, ethmoid, maxilla and the
sphenoid bones. This unique development explains the
enormous amount of anatomical variation.
1
Drainage and
ventilation of paranasal sinuses are important for the
normal function which in turn depends on effective
mucociliary clearance.
2
Patency of the pathways through
which the sinuses drain is crucial of adequate mucociliary
function and subsequent sinus drainage. Osteomeatal
complex obstruction may lead to fluid accumulation and
stagnation, creating a moist, hypoxemic environment
ideal for growth of pathogens.
3
ABSTRACT
Background: Drainage and ventilation of paranasal sinuses are important for normal function which depends on
effective mucociliary clearance. In present study we tried to emphasize variations in lateral wall of nose and clinical
features leading to nose and paranasal sinus disease using diagnostic nasal endoscopy and variations in CT scan of
paranasal sinuses. The objectives of the study are to observe various anatomical variations in nose and paranasal
sinuses and their clinical presentation using diagnostic nasal endoscopy and CT scan of paranasal sinuses and to
compare various anatomical variations in nose and paranasal sinuses.
Methods: Present study included 54 patients presenting in Department of ENT, Head and Neck Surgery, during
February 2015 to February 2017.
Results: Diagnostic nasal endoscopy findings reveal that most common finding was polypoidal changes in nasal
mucosa in 36 (66.67%) of patients, followed by mucopurulent discharge in 26 (48.14%), postnasal discharge in
20(37.03%) and 4 (7.40%) patients showed prominent agger nasi cell. CT scan of paranasal sinuses revealed multiple
sinus involvement in 41 (75.92%) of patients with partial involvement of sinuses. Complete sinus opacification with
pan sinusitis was observed in 9 (16.67%), blockade at osteomeatal complex was observed in 46 (85.18%), paradoxical
middle turbinate was observed in 5 (9.25%), Concha bullosa was observed in 12 (22.23%) of patients.
Conclusions: Each variation have an anatomic and surgical significance, hence each and every case should be
individually studied in detail before undergoing functional endoscopic sinus surgery to maximize patient benefit and
to prevent unnecessary complications. Diagnostic nasal endoscopic examination is clinical guide to evaluate disease.
Keywords: Paranasal sinus diseases, CT scan para nasal sinus, Endoscopic sinus surgery
Department of ENT, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
Received: 16 October 2018
Revised: 31 October 2018
Accepted: 02 November 2018
*Correspondence:
Dr. G. Ravi Kumar,
E-mail: drvkc17@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20184723