ROLE OF COMPUTED TOMOGRAPHY IN ASSESSING PARANASAL SINUS DISEASE: CORRELATION WITH CLINICAL FINDING AND ANATOMICAL VARIATIONS
DOI:
https://doi.org/10.71000/pkctwx48Keywords:
Computed Tomography, Agger Nasi Cells, Anatomical Variation, Paranasal Sinuses, Radiology, Sinusitis, Structural AbnormalitiesAbstract
Background: Paranasal sinus diseases are frequently underdiagnosed or misdiagnosed due to overlapping clinical presentations. Anatomical variations in the sinonasal region significantly contribute to disease onset and persistence. Accurate imaging is essential to distinguish between inflammatory processes and structural abnormalities. Computed tomography (CT) offers high-resolution, multiplanar visualization of sinonasal anatomy, making it the preferred modality for diagnosing paranasal sinus pathologies and planning appropriate treatment strategies.
Objective: To analyze the role of computed tomography in assessing paranasal sinus diseases and its correlation with clinical findings and anatomical variations.
Methods: This cross-sectional study was conducted over three months at Tehsil Headquarters (THQ) Hospital, Sadiqabad. A total of 60 patients aged 18–60 years of both genders were enrolled using a non-probability convenient sampling technique. Patients with recent sinus surgery, facial trauma, or pregnancy were excluded. All participants underwent paranasal sinus CT scans using a Toshiba Canon Aquilion 16-slice machine. Data on clinical symptoms, anatomical variations, and radiological findings were collected and analyzed. Chi-square tests were used to evaluate associations between anatomical structures and sinus pathology.
Results: Among the 60 patients, sinusitis was identified in 38.3% (n=23), nasal polyps in 31.7% (n=19), mucosal thickening in 11.7% (n=7), and chronic sinusitis in 10.0% (n=6). Only 6.7% (n=4) showed normal CT findings. Deviated nasal septum was the most common anatomical variation (35.0%), followed by bone remodeling (26.7%) and agger nasi cells (20.0%). A statistically significant correlation was found between anatomical variations and paranasal sinus disease (p = 0.000).
Conclusion: Computed tomography is an essential diagnostic modality for paranasal sinus diseases, offering precise visualization of anatomical variations. Its use significantly enhances diagnostic accuracy and guides effective treatment planning.
References
Papadopoulou A, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical variations of the nasal cavities and paranasal sinuses: a systematic review. Cureus. 2021 Jan 15;13(1).
Iturralde-Garrote A, Sanz J, Forner L, Melo M, Puig-Herreros C. Volumetric changes of the paranasal sinuses with age: a systematic review. Journal of Clinical Medicine. 2023 May 9;12(10):3355.
Cappello Z, Minutello K, Dublin A. Anatomy, head and neck, nose para nasal sinuses. Treasure Island (FL): StatPearls Publishing; 2023.
Fahrioglu S, VanKampen N, Andaloro C. Anatomy, head and neck, sinus function and development. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
Ahilasamy N, Narendrakumar V, Kumar R, Rajasekaran S, Niharika R, Lavanya M. “Fizz Sign” in Acute Sinusitis–A CT Scan Finding. Indian Journal of Otolaryngology and Head & Neck Surgery. 2022 Dec;74(Suppl 3):4734–7.
Gala Z, Bai D, Halsey J, Ayyala H, Riddle K, Hohenleitner J, et al. Head computed tomography versus maxillofacial computed tomography: an evaluation of the efficacy of facial imaging in the detection of facial fractures. Eplasty. 2022 Jun 20;22: e22.
Spinnato P, Patel D, Di Carlo M, Bartoloni A, Cevolani L, Matcuk G, et al. Imaging of musculoskeletal soft-tissue infections in clinical practice: a comprehensive updated review. Microorganisms. 2022 Nov 25;10(12):2329.
Chmielewski P. Clinical anatomy of the paranasal sinuses and its terminology. Anatomical Science International. 2024 Sep;99(4):454–60.
Yamakawa K, Nishijima H, Koizumi M, Kondo K. Assessing volume growth of paranasal sinuses and nasal cavity in children using three-dimensional imaging software. Auris Nasus Larynx. 2024 Dec 1;51(6):917–21.
Bagewadi A, Lagali-Jirge V, S L, Panwar A, Keluskar V. Reliability of gender determination from paranasal sinuses and its application in forensic identification—a systematic review and meta-analysis. Forensic Science, Medicine and Pathology. 2023 Sep;19(3):409–39.
Yaprak F, Coban I, Sarıoğlu O, Özer M, Govsa F. Computed Tomography Based Evaluation of the Anterior Group of the Paranasal Sinuses. European Journal of Therapeutics. 2023 Jun 13;29(3):341–51.
Gülbeş M, Aksoy S, Orhan K. Evaluation of Paranasal Sinus Septa Types, Orientations, and Angles Using Cone Beam Computed Tomography. European Annals of Dental Sciences. 2023;50(Suppl 1):23–6.
Qureshi M, Usmani A, Mehwish A, Rehman F, Ahmed R. Use of Computed Tomography for Nasal and Paranasal Anatomic Variants. Pakistan Journal of Medicine and Dentistry. 2023;12(3).
de Mendonça D, Ribeiro E, de Barros Silva P, Rodrigues A, Kurita L, de Aguiar A, et al. Diagnostic accuracy of paranasal sinus measurements on multislice computed tomography for sex estimation: A systematic review, meta‐analysis, and meta‐regression. Journal of Forensic Sciences. 2022 Nov;67(6):2151–64.
Grunz J, Petritsch B, Luetkens K, Kunz A, Lennartz S, Ergün S, et al. Ultra-low-dose photon-counting CT imaging of the paranasal sinus with tin prefiltration: how low can we go? Investigative Radiology. 2022 Nov 1;57(11):728–33.
Usmani T, Fatima E, Raj V, Aggarwal K. Prospective study to evaluate the role of multidetector computed tomography in evaluation of paranasal sinus pathologies. Cureus. 2022 Apr 10;14(4).
Turgut N, Bahar S, Kılınçer A. CT and cross-sectional anatomy of the paranasal sinuses in the Holstein cow. Vet Radiol Ultrasound. 2023;64(2):211-23.
Shih MC, Edwards TS, Snyder J, Germroth M, Nguyen SA, Schlosser RJ. Impact of Nasal Cavity CT Opacification Upon Sinonasal Quality of Life. Ann Otol Rhinol Laryngol. 2023;132(12):1590-9.
Ahmed ANA, Elsharnouby MM, Elbegermy MM. Nasal sinuses cholesteatoma: case series and review of the English literature. Eur Arch Otorhinolaryngol. 2023;280(2):743-56.
Goldman-Yassen AE, Meda K, Kadom N. Paranasal sinus development and implications for imaging. Pediatr Radiol. 2021;51(7):1134-48.
Dai J, Huai D, Xu M, Cai J, Wang H. Revision endoscopic frontal sinus surgery for refractory chronic rhinosinusitis via modified agger nasi approach. J Int Med Res. 2021;49(4):300060521995273.
Vaid S, Vaid N. Sinonasal Anatomy. Neuroimaging Clin N Am. 2022;32(4):713-34.
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Copyright (c) 2025 Aiman Batool, Kiran Muhammad baksh, Hafza Sadiq, Muqadas Maryam, Fozia Amin, Muqadas Maryam (Author)
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