COMPARATIVE STUDY OF COMPUTED TOMOGRAPHIC SCAN AND INTRAOPERATIVE ENDOSCOPIC FINDINGS OF ANATOMICAL VARIATIONS OF OSTEOMEATAL COMPLEX IN PATIENTS WITH CHRONIC RHINOSINUSITIS
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Keywords
Anatomical Variants of Nose and Osteomeatal Complex, Chronic Sinusitis
Abstract
Background: Anatomical abnormalities around the osteomeatal complex may have a negative impact on frontal, maxillary, and anterior ethmoidal air cell drainage and ventilation, leading to chronic sinusitis. The capacity to precisely treat even very small abnormalities in the osteomeatal complex that obstruct the frontal, ethmoid, and maxillary sinuses' mucociliary clearance is the cornerstone of functional endoscopic sinus surgery. In addition to being effective diagnostic tools for sinus disease, CT and nasal endoscopy may precisely reach this region to look for signs of a specific illness or any anatomical abnormality that would impair mucociliary clearance and breathing. The purpose of these investigations is to determine the mucosal abnormalities and bony anatomic variations of the paranasal sinus and assess the possible pathogenicity of these findings in patients undergoing evaluation for sinusitis.
Methods: This was a prospective study carried out between November 2016 and November 2018 among 55 patients 15-70 years of age who were diagnosed with chronic rhino sinusitis on the basis of a detailed history and physical examination and did not respond to three weeks of medical treatment. A direct endoscopy and computed tomography scan were done for these patients. Intraoperative endoscopic surgery findings were compared with pre-operative CT scan findings.
Results: Deviated nasal septum was the most common variation observed, most commonly in the 41-50 year age group with a female preponderance. The agreement between the CT scan and endoscopic operative findings was very good for concha bullosa, paradoxical middle turbinate and medialised uncinate. Good agreement was observed for deviated nasal septum, Agger nasi and Haller cells, while there was a moderate agreement for mucosal thickening in OMC.
Conclusion: Concha bullosa, Haller cells, Agger nasi, and deviated nasal septum were the most prevalent structural variations of the nose and PNS that predispose to sinusitis in order of frequency. The results of the CT scan and the endoscopic surgical discoveries of different anatomical variances
agreed rather well. Therefore, in order to perform a safe and successful endoscopic sinus surgery, the current study reiterates the need for an accurate radiological assessment of each patient.
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Dr Shruti Satish
Shri Atal Bihari Vajpayee medical college and research Center, Senior resident, Department of ENT, , 9500527503
Dr. Aishwarya M
Assistant Professor, Dr. Chandramma Dayananda Sagar Institute of Medical Education and Research, Harohalli, Karnataka, Ph: 8105067515
Abhishek S
HCG hospitals, Fellow in head and neck oncology, 9611165338
, Dr P Krishna Prasad
National cancer institute, Consultant oncosurgeon, 7680824199