Evaluation of paranasal sinus diseases by computed tomography: A tertiary care hospital based study

Background: Paranasal sinus (PNS) diseases affect a wide range of population and include a broad spectrum of diseases ranging from inflammatory conditions to neoplasms, both benign and malignant. The application of computed tomography (CT) in the paranasal sinuses study has allowed the detail assessment of inflammation, cysts, benign, and malignant conditions. CT has increased the accuracy of patient management with a consequent decrease in morbidity and mortality. Materials & Methods: This hospital based prospective study was carried out in Department of ENT and Radio diagnosis of a tertiary care teaching hospital, Haldia, West Bengal from January 2018 to March 2019. Institutional Ethical Approval was obtained for the study. A total of 44 patients fulfilling the inclusion criteria, were included in the present study. The CT was done using Philips 16 Slice BRILLIANCE 190P MDCT and images were acquired in both axial and coronal planes. Post contrast study was done in those who required further evaluation. Soft tissue window level and width (50/200) and bone window level and width (350/2500). Contrast agent Omnipaque 350 was used if indicated and consent was obtained from the patient. CT findings were evaluated in all the patients and characterisation of the various sinonasal lesions were done with the help of various CT parameters. Results: Our study included 30 males (68.18%) and 14 females (31.82%)) aged between 4 yrs and 78 years, as all the patients with suspected sinonasal pathologies presented during the specified period of study were included without taking age as criteria for exclusion. Most common sinonasal pathology in present study was chronic sinusitis (other than fungal) 19 (43.18%) followed by sinonasal polyps 11 (25%) and antrochoanal polyp 5 (11.36%). Only 2 cases out of 44 (4.54%) sinonasal pathologies diagnosed to be malignant lesions on CT findings. The chief presenting complaints were of a headache (70.45%) followed by nasal discharge (43.2%), nasal obstruction (47.73%), facial pain (38.64%), allergic symptoms (15.91%), hyposmia (11.36%), epitaxis (6.82%), and mouth breathing (20.45%). Conclusion: CT is considered the gold standard for preoperative evaluation of PNS diseases for appropriate patient selection for functional endoscopic sinus surgery. CT of the sinuses uses special x-ray equipment to evaluate the paranasal sinus cavities – hollow, air-filled spaces within the bones of the face surrounding the nasal cavity