Prevalence of Normal Anatomical Variations in the Region of Paranasal Sinuses in Patients with Chronic Rhinosinusitis

Abstract

Background: Knowledge of the anatomical relationships and the anatomical variations in paranasal sinus region is critical for surgeonsperforming endoscopic sinus surgery. It helps surgeons to avoid the potential complications of sinus surgery and to improve success ofmanagement strategies. Objective: The objective of this study was to show how prevalent are the anatomic variations in the region of theparanasal sinuses and nasal cavity in patients with chronic rhinosinusitis. Materials and Methods: A cross‑sectional study was conducted fromJanuary 2018 to July 2018 at Al‑Hilla general teaching hospital. We collected data of 75 patients (who have met the clinical criteria of chronicrhinosinusitis) subjected to computed tomography (CT) of the paranasal sinuses. CT was performed using SIEMENS SOMATOM DefinitionAS and Philips machines. Direct coronal scans (1 mm in thickness) were made, from the anterior wall of the frontal sinus to the posterior wallof the sphenoid sinus with axial and sagittal reconstruction images. Results: Anatomical variations found in 69 patients of a total 75 patientswith age range from 18 to 60 years with 92%. Among these, nasal septal deviation was the most common (seen in 54/75 patients = 72%)followed by the Agger nasi cells in 52 patients (69%), concha bullosa in 31 patients (41.3%), Haller cells in 28 patients (37%), and Onodi cellsin 18 patients (24%). Conclusion: Sinonasal anatomical variations are common findings in patients with chronic rhinosinusitis. Providinginformation on these anatomical variations will improve the success of endoscopic sinus surgery.