Computed tomographic evaluation of anatomical variations of paranasal sinus region

Background: With the advent of multidetector computed tomography (MDCT), imaging of paranasal sinuses prior to functional endoscopic sinus surgery (FESS) has become mandatory. CT of PNS depicts anatomical complexities of osteomeatal complex and its variations that are often found.Methods: In the present retrospective and prospective study, we have studied anatomical variants of PNS in 200 Indian subjects with clinical suspicion of sinusitis between January 2011 to March 2016, using CT in the coronal plane complemented by axial views.Results: In majority of patients, anatomical variations were noted with mucosal changes (78.80%). Deviation of nasal septum were the most common anatomical variation followed by Paradoxical middle turbinate, Middle concha bullosa. Other common variants included superior concha bullosa, prominent agger nasi cells, Haller's cells, bony spurs, aerated crista galli and hypoplastic frontal sinus.Conclusions: Anatomical variations studied on CT scan are found to block the OMC and cause rhinosinusitis. Thus, knowledge of various anatomical variants is necessary for both surgeon & radiologist to avoid possible complications and improve success of management strategies