Anatomical variations of Nose and Paranasal Sinuses in Chronic Rhinosinusitis

The aim of this study was to (a) detect the prevalence of anatomical variations of nose and paranasal sinuses in Chronic Rhinosinusitis (CRS) on ‘Nasal Endoscopy’,and‘Computed Tomography’, (b) correlate between the two investigation modalities and (c) study association of anatomical variations of nose and paranasal sinuses in Chronic Rhinosinusitis. This Cross sectional study was carried out at Tertiary Rural Health Institute ‘NKP Salve Institute of Medical Sciences and Research Centre’ Nagpur, during November 2011 to October 2013. Diagnostic Nasal Endoscopy and Computed Tomography of nose and Paranasal Sinuses of 122 patients of chronic rhinosinusitis were studied and results were statistically analysed using z-test and chi-square test. Mean age of the study population was 35.48 years (SD=16.15) with male predominance. Maxillary sinus (68.03%) was the most commonly affected sinus due to chronic sinusitis followed by anterior ethmiod sinusitis (60.66%). Deviated Nasal Septum was the most common anatomical variation, which was detected in 59(48.30%) patients on Diagnostic Nasal Endoscopy and in 62(50.81%) patients on Computed Tomography. Aggernasii cells, medialised uncinated process and concha bullosa were diagnosed both by Diagnostic Nasal Endoscopy and Computed Tomographic scan with good agreement between the two. Anatomical variations like deviated nasal septum, aggernasii cells, medialised uncinated process, large concha bullosa were statistically significantly associated with chronic rhinosinusitis. Diagnostic nasal endoscopy and CT scan are complimentary in diagnosis of anatomical variations of nose and paranasal sinuses. Some anatomical variations of osteomeatal complex play important role in pathogenesis of chronic rhinosinusitis.