Evaluation of paranasal sinus pathologies by cone beam computed tomography

Air-filled and bony surrounded structures around the nasal cavity, called sinus frontalis, sinus ethmoidalis, sinus sphenoidalis, and sinus maxillaris, are defined as paranasal sinuses and are effective in the development of facial structures, jaws and airway. Although these structures are separated from each other by thin bone lamina, they are connected via ostiums. In addition, paranasal sinuses are associated with many important anatomical structures such as internal carotid artery, orbit, cavernous sinus, optic nerve. Knowing of the anatomy and variations of the paranasal sinuses is very important in terms of applications such as functional endoscopic sinus surgery, implant surgery involving posterior maxilla and complications that may occur. In our study, 180 cone beam computed tomography images containing all of the paranasal sinuses were evaluated retrospectively in terms of anatomical variation and pathology. The most common anatomic variations in our study were agger nazi cell (80.6%), concha bullosa (65.6%) and septum pneumatization (60.3%), while the least observed variations were sphenomaxillary plate (2.1%), second middle turbinate (1.8%) and concha bullosa of the inferior turbinate. (1.7%). The most common pathological finding in our study was the maxillary sinus mucosal thickening (25%). In 3-dimensional radiological examination of the paranasal sinuses, cone beam computed tomography stands out as a good option due to its lower radiation dose and less cost compared to gold standard computed tomography.