Anatomical Variations in Chronic Rhinosinusitis : A Clinical Study

Background: Evaluation of a patient with chronic rhinosinusitis also requires proper radiological examination apart from otolaryngological examination and diagnostic nasal endoscopy. Various anatomical variations can be seen on CT Scan of nose and paranasal sinuses. Methods: This was a prospective cross sectional study carried out in department of ENT at Government Medical College &Dr. Susheela Tiwari government hospital, Haldwani during the period of October 2014 to October 2015. 30 adults patients of Chronic rhinosinusitis diagnosed clinically by revised task force criteria were included in the study. Acute rhinosinusitis, benign and malignant nasal and paranasal disease, previously operated for sinonasal pathology and facio-maxillary trauma were excluded from the study. After clinical diagnosis all patient underwent non contrast CT scan of nose and paranasal sinuses. The study reviewed coronal, sagittal and axial view in bony windows of all CT scan films. Anatomical variations were noted and their correlation with chronic rhinosinusitis was discussed. Results: Of the 30 patients of the study group, 28 (93.33 %) with DNS, 10 (33.33%) with concha bullosa, 8 (26.66%) with enlarged bulla, 6 (20%) with agger nasi, 2 (6.66%) with onodi cell were found. Conclusion: Anatomical variations are common in the osteomeatal complex. Deviated nasal septum was the most common anatomical variation encountered in our study followed by concha bullosa and enlarged ethmoidal bulla.