“Deciphering The Enigma Of Nasal & Paranasal Anatomy Through Computed Tomography (CT) Imaging”

Introduction: the paranasal sinuses are mucosa-lined structures physically contiguous with the nasal cavity that aid in insulation, reducing cranial weight, heating & humidifying the air, imparting resonance to the voice, providing airway defense and simply to replace functionless bone. Sinusitis is rarely life threatening, but the complex anatomy of the facial planes, the associated venous and lymphatic spread and the close location to the central nervous system can lead on to serious complications. It is, therefore, important to understand the normal anatomy of the paranasal sinuses in order to understand the pathogenesis of sinus disease. Hence, the aim of the present study was deciphering the role of ct as the investigation of choice for the preoperative evaluation of the nose & paranasal sinuses and for delineation of obstructive inflammatory sinus disease to aid in the diagnosis and management of recurrent & chronic disease and to define the bony anatomy before surgery. Materials and methods: prospective cross-sectional study was conducted on 100 asymptomatic patients who were getting investigated by computed tomography for non-sinus indications in whom the paranasal sinus region could be included in the field of study referred to department of radio-diagnosis and imaging from indoor and outdoor departments of jan sewa hospital of dr. S. S. Tantia medical college, sri ganganagar. Results: the majority of patients were in the age group of 21-40 years (42.3%) with 70% being male. Patients in the age group equaling or more than 61 years & with diabetes had the most number of incidental findings (68.2 %) agger nasi was the commonest anatomical paranasal sinus variant (82.9 %) followed by concha bullosa (39.3 %), deviation of the nasal septum (35.4 %), onodi cells ( 12.2 %) & haller cells ( 11.8 %). Incidental paranasal sinus abnormality in the form of mucosal thickening, sinus secretions or polyps were detected in 51.9 % patients, mucosal thickening being most common (40.1 %) followed by secretions (31.9 %) and mucosal polyps ( 3.0 %). Incidental paranasal abnormalities were most commonly noted in the ethmoid sinuses (36.7 %) followed by the maxillary sinuses, sphenoid sinuses and then frontal sinuses in descending order of involvement. Conclusion: computed tomography (ct) provides a “road map” for diagnosis and management of recurrent & chronic paranasal sinus disease and to delineate the bony anatomy before sinus surgery and to get an insight into anatomical variants apropos of their clinical relevance & impact on sinus disease.