Evaluation of paranasal sinus and nasal cavity variation with computed tomography

Evaluating paranasal sinus computed tomography (CT) scans using multiplanar imaging provides a better understanding of the complex anatomy of this region and its many anatomical variations. It is important for radiologists to recognize these anatomical variations and be aware of the critical clinical implications. Communication between the radiologist and surgeon improves the overall quality of assessments and provides better surgical outcomes (1). This study aims to identify and detect the variations that may be especially dangerous before surgery and to prevent possible complications related to these variations. In our study, paranasal sinus CTs of 402 (177 female, 225 male) cases aged between 18 and 84 who underwent paranasal sinus CT at the Radiology outpatient clinic of Gaziantep University Faculty of Medicine between January 2020 and December 2021 were retrospectively analyzed. Cases with a history of sinus surgery, younger than 18 years of age, sinonasal massive polyposis, severe sinus inflammatory disease, congenital major anomaly, fibroosseous lesion, and sinus malignancy were not included in the study. The most common anatomic variation detected in our study was the agger nasi cell with 77.6% (n=312). The least detected anatomical variations were pneumatized inferior turbinate and Uncinat process (UP) agenesis with 0% (n=0). In addition, bifid inferior turbinate, bifid UP, inferior turbinate hypoplasia, and anterior ethmoid artery canal and lamina papyracea dehiscence, which are rarely reported and studied in the literature, have been examined and we think that we will contribute to the literature. In our study, it was emphasized once again that multiplanar evaluation is indisputably a very valuable imaging method in the evaluation of variation. Keywords: paranasal sinus, anatomical variation, computed tomography, sphenoid sinus, functional endoscopic sinus surgery