Abstract
Introduction
Functional endoscopic sinus surgery (FESS) has revolutionized the approach and treatment of chronic rhinosinusitis. Certain anatomical variations are thought to be predisposing factors for the development of sinus disease and it is necessary, for the surgeon to be aware of these variations, especially if the patient is a candidate for FESS.
Objective
The aim of the present study was to identify the various anatomical variations of the ostiomeatal complex in patients of chronic rhinosinusitis who underwent FESS.
Materials and methods
A total of 150 patients of chronic rhinosinusitis (medical treatment failures) who were subjected to FESS were CT scanned preoperatively to find any bony anatomic variation and the extent of mucosal disease.
Results
Concha bullosa was the commonest anatomic variation and was seen in 45 (30%) patients. The other anatomic variations noted included: paradoxical middle turbinate in 9.33% patients, uncinate process variations in 25% patients, agger nasi cells in 9.33%, Haller cells in 8.66% and posterior septal deviations in 25.33% patients. The mucosal disease was most commonly seen in anterior ethmoids (87.33% ), followed by maxillary sinus ostial area (70%), maxillary sinus disease (65.33%), posterior ethmoidal disease (38%), frontal sinus disease (15%) and sphenoid sinus mucosal disease (8.66%) patients.
Conclusion
A thorough preoperative CT evaluation of the patients undergoing FESS is necessary to detect various anatomical variations in the ostiomeatal complex.
Similar content being viewed by others
References
Zinreich S, Kennedy D, Rosenbaum A, et al. (1987) Paranasal sinuses: CT imaging requirements for endoscopic surgery. Radiology 163:769–775
Bolger WE, Butzin CA, Parsons DS (1991) Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 101(1 Pt 1):56–64
Zinreich S (1993) Imaging of inflammatory sinus disease. Otolaryngol Clin North Am 26:535–547
Levine HL (1990) FESS, evaluation of surgery and follow up of 250 patients. Laryngoscope 100:79–84
Stammberger H (1991) Results, Problems and complications. In: Stammberger H, Hawke. FESS: The Messerklinger Technique. Philadelphia B.C. Decker, pp 459–477
Kennedy DW (1992) Prognostic factors, outcomes and staging in ethmoid sinus surgery. Laryngoscope 102(12 Pt 2 Suppl 57):1–18
Weir DG et al. (1997) Infective rhinitis and sinusitis. In: IS Makay, TR Bull (ed.) Scott Brown Rhinology, Butterworth & Co. 6th Editiion.4/8/3–4/8/20
Stammberger H and Wolf G (1988) Headaches and sinus disease: the endoscopic approach. Ann Otol Rhinol Laryngol Suppl 134:3–23
Joe JK, Ho SY and Yanagisawa E (2000) Documentation of variations in sinonasal anatomy by intraoperative nasal endoscopy. Laryngoscope 110:223–229
Perez-Pinas I, Sabate J, Carmona A, et al. (2000) Anatomical variations in the human paranasal sinus regions studied by CT. J Anat 197:221–227
Lloyd GAS (1990) CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. J Laryngol Otol 104:477–481
Calhoun KH, Waggenspack GA, Simpson CB, et al. (1991) CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg 104:480–483
Laine F and Smoker W (1992) The ostiomeatal unit and endoscopic surgery: anatomy, variations, and imaging findings in inflammatory diseases. Am J Roentgenol 159:849–857
Stammberger H and Wolf G (1988) Headaches and sinus disease: the endoscopic approach. Ann Otol Rhinol Laryngol Suppl 134:323
Lloyd GA, Lund VJ and Scadding GK (1991) CT of the paranasal sinuses and functional endoscopic surgery: a critical analysis of 100 symptomatic patients. Laryngol Otol 105:181–185
Bolger W, Butzin C and Parsons D (1991) Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 101:56–64
Messerklinger W (1978) Endoscopy of the nose. Baltimore: Urban & Schwartzenberg
Tonai A and Baba S (1996) Anatomic variations of the bone in sinonasal CT. Acta Otolaryngol Suppl 525:9–13
Perez-Pinas I, Sabate J, Carmona A, et al. (2000) Anatomical variations in the human paranasal sinus regions studied by CT. J Anat 197:221–227
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wani, A.A., Kanotra, S., Lateef, M. et al. CT scan evaluation of the anatomical variations of the ostiomeatal complex. Indian J Otolaryngol Head Neck Surg 61, 163–168 (2009). https://doi.org/10.1007/s12070-009-0059-8
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-009-0059-8