Evaluation of the Frequency of Anatomic Variations of the Paranasal Sinus Region by Using Multidetector Computed Tomography: A Hospital-Based Cross-Sectional Study

Abstract

Background and Aims

The sinus anatomy should be well-understood by the sinus surgeons to carry out functional endoscopic sinus surgery carefully. That's why CT scans are vital to provide essential clarity and accuracy for comprehensive presurgical planning with minimal risks. The aim of this study was to evaluate the frequency of anatomic variations of the paranasal sinus region by using multidetector computed tomography.

Methods

A cross-sectional study of one hundred and fifty-three patients of all age groups was carried out in the radiology department of Shalamar Hospital Lahore from 20 January, 2024 to 10 April, 2024 to evaluate anatomical variations presented to the facility by using multidetector CT. Data were collected using a standardized data collection sheet and analyzed using SPSS version 25.0.

Results

The study included 94 males and 59 females with a median age of 43.9 years. Among the study population, 4.6% had aplasia of the frontal sinus, 84.3% had bilateral frontal sinus, but 13.7% had unilateral, 42.5% had more than 2 chambers of frontal sinus, and 9.8% had hypoplasia with persistent metopic suture. Four patterns of sphenoid sinus pneumatization were recognized: the conchal, the presellar, the sellar, and the post-sellar, with prevalence rates of 2.0%, 11.1%, 28.1%, and 56.9%, respectively. 0.7% had hypoplasia of maxillary sinus, 9.2% had exostoses, 13.7% had extension of teeth roots to maxillary sinus, and 3.3% had maxillary sinus septations. Ethmoidal bulla, Agger nasi cells, and Haller cells had frequencies of 49%, 32.7%, and 30.7%, respectively.

Conclusions

The most common anatomical variations are bilateral frontal sinus, post-sellar pneumatization of sphenoid sinus, ethmoidal bulla in ethmoid sinus, and extension of teeth roots to maxillary sinus. Such characteristics and findings are to be evaluated for the management of pathologies associated with these variations and consequent surgical interventions.