Anatomical variations of the paranasal sinuses and the nasal cavity

KK Shrestha; R Acharya; RR Joshi; S Maharjan; D Adhikari

KK Shrestha Department of Otolaryngology Nepal Medical College
R Acharya 2 Department of Radiology, Nepal Medical College Teaching Hospital, Kathmandu, Nepal
RR Joshi Department of Otolaryngology Nepal Medical College Teaching Hospital, Kathmandu, Nepal
S Maharjan Department of Otolaryngology Nepal Medical College Teaching Hospital, Kathmandu, Nepal
D Adhikari Department of Otolaryngology Nepal Medical College Teaching Hospital, Kathmandu, Nepal

Abstract

Computed tomography (CT) of the para-nasal sinuses (PNS) has nowadays become the investigationof choice for the diagnosis of sinonasal diseases. Numerous sinonasal anatomic variants exist and arefrequently seen on CT scans. A sound knowledge of these variations is important not only for diagnosisbut also for planning surgery in order to avoid complications. The aim of this study is to investigate thefrequency of these variations in patients with sinonasal symptoms and also to determine their relation tosinonasal disease if any. A total of 76 patients were included in the study from August 2017 to July 2018 ofwhich 43 (56.6%) were males and while 33 (43.4%) were females with male to female ratio of 1.3:1. The agesof patients ranged from 14 to 72 years with a mean age of 33.2±14.2 years. Out of 76 patients, 68 (89.5%)had at least one type of anatomical variation while 8 (10.5%) had no variation. Only one variation wasseen in 39 (51.3%) patients while 29 (38.2%) had two or more variations. The most common variant wasdeviated nasal septum (DNS), occurring in 49 (64.5%) patients followed by concha bullosa (CB) and aggernasi cell (AN) seen in 15 (19.7%) and 14 (18.4%) patients respectively. Genderwise, anatomical variationswere seen more in males but the difference was not statistically significant. Some variations were seenmore on the right sidewhile others on the left. Some variations were present bilaterally. The differencewas not statistically significant. The presence of DNS was statistically significant in the study population (pvalue 0.012 in nonparametric chi square test). The age group 14 to 30 years showed maximum variationsthough not significant statistically. Therefore, during management of patients with sinonasal symptoms,these variations need to be addressed, if required, surgically. Proper knowledge of both common anduncommon sinonasal variations in our community could help in better surgical planning and overallmanagement of sinonasal disorders

Keywords : Anatomical variations, computedtomography (CT) scan, paranasalsinuses