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مصاحبة الاختلافات التشريحية للجيوب الانفية مع امراض الجيوب الانفية في المفراس الحلزوني متعدد المقاطع == Co - existence of anatomical variations of paranasal sinuses and sinonasal abnormalities on multislice computed tomography

Author name: ميثاق محي عبد الله
Supervisor name: عبد اللطيف علي اصغر | محمد ضياء احمد
General topic: Medicine
Specific topic: Diagnostic Radiology
Degree: Higher Diploma
University: University of Baghdad - Faculty Of Medicine
Language: English
University location: Baghdad
First pages: 19T1340 - p.pdf
Abstract: Background : Certain anatomic variations ( as concha bullosa and nasal septal deviation) are common in general population and are often predispose the patients to inflammatory diseases because they may obstruct the infundibulum or any part of the osteomeatal complex resulting in interference of air flow or mucociliary clearance. Computed tomography is the imaging modality of choice since the advent of functional endoscopic sinus surgery. It is now mandatory and a medicolegal requirement to evaluate the paranasal sinuses as this provide a road map with excellent details regarding anatomy, anatomical variants with type and extension of the pathology.Objectives : to identify the incidence of different types of paranasal sinus variants and their coexistence with sinonasal abnormalities by using multislice computed tomography.Patients and methods : This is a cross sectional study was done on 87 patients referred for computed tomography scan of the paranasal sinuses in Al - shaheed Ghazi Al.Hariri Teaching Hospital in medical city - Baghdad, from January 2013 to June 2013, patients were clinically suspected to have sinonasal diseases. The sample of this study was consist of 52 males and 35 females. The age of patients ranged from 12 - 60 years. All patients were examined by computed tomography scan of paranasal sinus protocol in axial sections with coronal reformat.Results : From 87 patients in our study, 76 patients were have diseased sinuses, we reported 5 mucosal abnormalities; mucosal thickening, opacification, air fluid level, mucosal polyp and cyst. The most commonly involved sinus was the maxillary (62 patients) followed by anterior ethmoid, and the commonest abnormality was mucosal thickening. Types of variations were seen in this study; nasal septal deviation(52.4%), concha bullosa(49%), enlarged ethmoidal bullae (15.9%), large Aggar nasi (15.9%), Haller cells(19.1%), bent uncinate process(11.4%),Onodi cells(11.4%), paradoxical middle turbinate(9.1%), maxillary sinus hypoplasia(7.9%), pneumatized crista galli(6.8%), and both pneumatized nasal septum and asymmetrical ethmoid roof were of (3.4%). the total number of patients having anatomical variants but with no associated sinonasal mucosal abnormalities were (17.1%), while (82.9%) of patients were associated with sinonasal abnormalities.Conclusion : by using multislice computed tomography we find correlation between certain anatomical variations and specific inflammatory sinonasal mucosal abnormalities due to defect in the drainage of the sinus secretions and secondary infection. Also there was another group of variants which may lead to intraoperative complications if surgery indicated.
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