Abstract
Chronic Rhinosinusitis is a common, persistent inflammation of the paranasal sinuses often associated with anatomical variations that hinder normal sinus drainage and airflow. Computed Tomography is the gold standard for identifying these structural changes, providing essential information for accurate diagnosis and effective treatment planning, especially when surgery like Functional Endoscopic Sinus Surgery is considered. Recognizing and understanding these variations is key to improving patient outcomes and guiding optimal clinical management. In a study of 350 patients (54.9% male, mean age 48.35 years), CRS severity was categorized as no disease (13.1%), mild (31.7%), moderate (32.0%), and severe (23.1%). Higher Chronic Rhinosinusitis severity was significantly linked to increased sinus Opacification and osteomeatal complex obstruction (p < 0.001), especially in the anterior and posterior ethmoid sinuses. Common findings in mild and moderate cases included deviated nasal septum, compensatory hypertrophy, concha bullosa, mucosal thickening, and bony spurs, while severe cases often showed Sino nasal polyposis, osteomeatal complex occlusion, and soft tissue changes. Rare anatomical variations like Onodi and Haller cells were observed only in CRS patients. This study highlights the high prevalence of anatomical variations such as deviated nasal septum, concha bullosa, Agger nasi cells, Haller cells, and Onodi cells in patients with chronic Rhinosinusitis. These variations can impair sinus drainage and ventilation, potentially contributing to disease persistence and complicating surgical treatment.
Keywords
Computed tomography, Paranasal sinuses, Anatomical variations, Chronic rhino sinusitis
Introduction
The ability of computed tomography (CT) to create detailed, high-resolution images to support the development of treatment plans makes it a definitive diagnostic and management tool for patients with sinus disease. Clinical experts can assess the severity of the disease by distinguishing between various inflammatory, benign and malignant sinus disorders and using CT scans to identify clear changes in the contours of the sinus bone. To maximize the follow-up plan, detailed high-resolution images created by CT scans are extremely important to determine the type of treatment approach a patient need [1]. CT scans are usually used to assess the pathology of CRS and are considered essential for clear decisions related to manipulation of conditions [2]. Computed tomography, commonly known as CT scanning, (as shown in Fig 1) is widely recognized in the medical community as the gold standard when it comes to accurately diagnosing various sinus conditions and aiding in the meticulous planning of surgical interventions based on detailed and comprehensive imaging results [3]. Sinus scans allow for clear visualization and examination of most anatomical nasal structures, such as sinus cells, haller cells, and tumor cells, according to successful diagnostic imaging, and conditions such as nasal septal cells and Concha Bullosa [4]. The recent advancement of Functional Endoscopic Sinus Surgery (FESS) has significantly transformed sinus surgical procedures by introducing a significant dependence on nasal endoscopes [5].
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Mohit Sharma
Corresponding author
Saraswati Group of Colleges (SGC)
Saurav Singh Gusain
Co-author
Saraswati Group of Colleges (SGC)
Amisha Kharola
Co-author
Saraswati Group of Colleges (SGC)
Arushi Thakur
Co-author
Saraswati Group of Colleges (SGC)
Mohit Sharma*, Aayushi, Saurav Singh Gusain, Amisha Kharola, Arushi Thakur, Assessing the Anatomical Variations in Route CT Scan of Paranasal Sinuses in Patients with Chronic Rhinosinusitis, Int. J. Sci. R. Tech., 2026, 3 (1), 291-304. https://doi.org/10.5281/zenodo.18341555
10.5281/zenodo.18341555
