Analytical Study of Anatomical Variations of Nose And Pns in Ct Scan And Chronic Sinusitis

Back Ground: Sinusitis affects millions of people each year and is a major cause of concern worldwide. Chronic rhino-sinusitis is an inflammation of Nose and Paranasal sinuses and the aetiology of it is multifactorial. Anatomical variations of nose and paranasal sinuses are one of the most important aetiological factor for chronic sinusitis. The approach to patients with chronic rhinosinusitis is endoscopic surgery which aims at removing the obstruction of the main drainage pathway. The Osteomeatal complex based essentially on the concept that obstruction perpetuates the sinus disease. This in turn requires the surgeon to have detailed knowledge of the anatomy of the lateral Nasal wall, Paranasal sinuses and surrounding vital structures and of the large number of anatomical variants in the region. CT Scan of Para Nasal Sinuses has become mandatory for all patients undergoing Functional Endoscopic Sinus Surgery. It depicts the anatomical complexities of Osteomeatal complex in a simpler way and acts as a road map for endoscopic sinus surgery. Aim: the Aim of the study was to 1. Detect prevalence of anatomical variations of Nose and PNS in Chronic Rhino Sinusitis in Computed Tomography. 2. Study the association of anatomical variations of Nose and PNS in Chronic Rhino-Sinusitis. Materials And Methods: Descriptive cross sectional studies in which 144 consecutive cases of chronic rhinosinusitis patients attending ENT Out –patient department, who had chronic sinusitis for more than 3 months duration not responding to the medical line of treatment and who were willing to undergo functional endoscopic sinus surgery satisfying the inclusion criteria were studied. The results were expressed in percentage and proportions. The retrospective study was conducted in patients at the Government ENT Hospital, Andhra Medical College, Visakhapatnam, who had presented between October 2012 – September 2015. Results: In our study it was observed that 1 or more types of anatomical variants were observed in 112 cases out of 144 cases. The most frequent being the Deviated Nasal Septum (73.2%) and the choncha bullosa (45.5%), and the other less common anatomical variants observed were paradoxical middle turbinate, Aggar Nasi cells, Haller cell, Onodi cell and Septal Cell. Conclusion: Prevalence of multiple anatomical variations are more in our study in comparision to single anatomical variation. Deviated Nasal Septum was the most common anatomical variation encountered in our study followed by Choncha Bullosa.