Frequency of Clinical Symptoms Associated With Incidental Paranasal Sinus Anomalies on MRI Brain in Patients Reporting to a Tertiary Healthcare Centre in Pakistan

Background: Magnetic resonance imaging (MRI) of the brain is an increasingly advised investigation in clinical settings for various indications. There is a concurrent and proportionate rise in the incidence of various paranasal abnormalities, reported on this modality. Objective: The objective of this study was to report the frequency of clinical symptoms in incidental paranasal sinus anomalies in patients undergoing MRI of the brain in a tertiary care hospital. Methodology: This prospective observational study was conducted at a tertiary healthcare setup in Pakistan from January 16 to July 16, 2024, with a total of 214 individuals who underwent brain MRI. The images were examined for the presence of any incidental paranasal sinus abnormalities. Any symptomologies reported by respective individuals having these structural anomalies on MRI brain were then recorded. Results: Of the total 214 patients included in the study, 61.2% (n=131) were male, with a mean age of 47.47±10.60 years, and 38.8% (n=83) were female, with a mean age of 48.08±10.16 years. Of the 214 patients, 35.5% (n=76) were found to have one incidental finding on their paranasal sinuses, while 12.6% patients (n=27) showed two or more incidental abnormalities. The remaining 111 patients (51.8%) had no paranasal sinus anomalies on their brain MRIs. Of the 103 patients with incidental paranasal sinus anomalies on MRI brain, 41% (n=43) had at least one symptom. The presence of mucosal thickening of >2mm and >4mm was more likely to be associated with symptoms like nasal blockage, headache, and allergic rhinitis, with a significant p-value of 0.04 and 0.02, respectively. Male patients are more likely to have symptomatic ethmoid sinus mucosal thickening than their female counterparts. Conclusion: The paranasal sinuses anomalies may frequently be encountered on MRI brain imaging. The patients having a mucosal thickening of more than equal or more than 2 mm on MRI brain are more likely to have corresponding symptoms. Other structural abnormalities may not result in any significant symptoms.