Mehdi ABBASİ, Mohammad Ebrahim YARMOHAMMADİ, Poopak IZADİ

Computed Tomographic Findings in the Nasal and Paranasal Sinuses of Patients Scheduled for Rhinoplasty at Mostafa Khomeini Hospital between 2011-13

Objective: Rhinoplasty is done to improve the morphology of the nose whilst also restoring its physiological function. Currently it is possible to perform rhinoplasty and endoscopic sinus surgery simultaneously. The need has therefore arisen to evaluate anatomical variation within the nose and paranasal sinuses in symptom-free patients who are scheduled for rhinoplasty. Coronal computed tomography (CT) is the standard method used to evaluate the nose and paranasal sinuses. We aimed to evaluate the frequency of anatomical variation noted within the nose and paranasal sinuses on coronal CT in patients scheduled for rhinoplasty. Methods: This is a descriptive, cross-sectional, retrospective study of CT findings in 84 patients who underwent rhinoplasty at Mostafa Khomeini Hospital, Shahed University, Tehran between 2011-13. The CT findings were evaluated in three different predefined categories: nasal septal, nasal turbinate, and paranasal sinuses abnormalities. Results: The study involved 84 individuals, consisting of 26 men and 58 women. The most frequent findings in the nasal septum category were nasal septal deviation (69.04%) and nasal septal spur (33.33%), whereas concha bullosa (45.23%) and inferior turbinate hypertrophy were the most frequent abnormality in the nasal turbinates category. Mucosal thickening of the sinuses (45.23%) and partial opacification of the sinuses (21.42%) were the most common findings in the paranasal sinuses. Conclusion: The high frequency of anatomical variation, inflammatory and congenital abnormal findings in CT images of the paranasal sinuses in patients scheduled for rhinoplasty indicates that preoperative CT examination may be useful in avoiding multiple surgical operations and in reducing costs.

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1. Hammad MS, Gomaa MA. Role of some anatomical nasal abnormalities in rhinogenic headache. Egypt J Ear Nose Throat All Sci 2012;13:31-5.

2. Hafezi F, Kouchakzadeh K, Naghibzadeh B. History and status of nose surgery. Iranian Journal of Surgery 2009;17:88-94.

3. Bradoo R. Anatomical Principles of Endoscopic Sinus Surgery: A Step by Step Approach. In: Pitman KT, editor. Book reviews. Head Neck 2007;29:302.

4. Muhammad IA, Rahman NU. Complications of the surgery for deviated nasal septum. J Coll Physicians Surg Pak 2003;13:565-8

5. Flint PW, Haughey BH, Lund VJ, et al. Cummings Otolaryngology Head and Neck Surgery. 6th ed. Philadelphia, PA: Mosby/Elsevier; 2015. p. 1565-9.

6. Haaga JR, Boll D. CT and MRI of the Whole Body. 6th ed. Philadelphia, PA: Mosby/Elsevier; 2017. p.1553-7.

7. Mendiratta V, Baisakhiya N, Singh D, Datta G, Mittal A, Mendiratta P. Sinonasal anatomical variants: CT and endoscopy study and its correlation with extent of disease. Indian J Otolaryngol Head Neck Surg 2016;68:352-8.

8. Andrades P, Cuevas P, Danilla S, et al. The accuracy of different methods for diagnosing seotal deviation in patients undergoing septorhinoplasty: A prospective study. J Plast Reconstr Aesthet Surg 2016;69:848-55.

9. Bolger WE, Parsons DS, Butzin CA. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 1991;101:56-64.

10. Nikakhlagh S, Saki N, Tahmasbi M, Jouhari H. Anatomic variations of the bone in sinonasal CT scan: A report of 279 cases. Jundishapur Sci Med J 2008;6:476-82.

11. Talaiepour AR, Sazgar AA, Bagheri A. Anatomic variations of the paranasal sinuses on ct scan images. J Dentistr Tehran Univ Med Sci 2005;2:142-6.

12.SadrS,AhmadinejadM,SaediB,RazaghianF,RafieeM.Anatomical variations in sinus imaging in sinusitis: a case control study. B-ENT 2012;8:185-9.

13. Pérez-Piñas I, Sabaté J, Carmona A, Catalina-Herrera CJ, Jiménez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat 2000;197:221-7.

14. Sam A, Deshmukh P, Patil C, Jain S, Patil R. Nasal Septal Deviation and External Nasal Deformity: A Correlative Study of 100 Cases. Indian J Otolaryngol Head Neck Surg 2012;64:312-8.

15. Varshney H, Varshney J, Biswas S, Ghosh SK. Importance of CT scan of paranasalsinusesintheevaluationoftheanatomicalfindingsinpatients suffering from sinonasal polyposis. Indian J Otolaryngol Head Neck Surg 2016;68:167-72.

16. Abdi R, Majidi H, Kasiri AM, Barzin M, Madani SA. Evaluation of prevalence of the anatomical variation in paranasal sinuses in CT scan of the patients referred to Bina medical imaging center of Sari. J Mazand Univ Med Sci 2004;14:45-51.

17. Elsherif AAMH, Elsherif AMH. Some anatomic variations of the para nasal sinuses in patients with chronic sinusitis: A correlative CT study to age and sex. AAMJ 2006;4:1-15.

18. Riello APFL, Boasquevisque EM. Anatomical variants of the osteomeatalcomplex:Tomographicfindingsin200patients.RadiolBras 2008;41:149-54.

19. Lerdlum S, Vachiranubhap B. Prevalence of anatomic variation demonstrated on screening sinus computed tomography and clinical correlation. J Med Assoc Thai 2005;88:110-5.

20. Flint PW, Haughey BH, Lund VJ, et al. Cummings Otolaryngology Head and Neck Surgery. 6th ed. Philadelphia, PA: Mosby/Elsevier; 2015. p. 1570-5.

21. Huang BY, Lloyd KM, Delgaudio JM, Jablonowski E, Hudgins PA. Failedendoscopicsinussurgery:SpectrumofCTfindingsinthefrontal recess. Radiographics 2009;29:177-95.

22.NaderpourM,LotfiA,AyatE,EbrahimAA,BasiriF.Incidenceofanatomic variants in patients with chronic sinusitis. Med J Tabriz Univ Sci 2009;31:67-70.

23. Zinreich SJ. Imaging of chronic sinusitis in adults: X-ray, computed tomography, and magnetic resonance imaging. J Allergy Clin Immunol 1992;90:445-51.

24. Gupta AK, Gupta B, Gupta N, Tripathi N. Computerized tomography of paranasal sinuses: A roadmap to endoscopic surgery. Clin Rhinol Int J 2012;5:1-10.

25. Stammberger H. Endoscopic endonasal surgery-concepts in treatment of recurring rhinosinusitis. Part II. Surgical technique. Otolaryngol Head Neck Surg 1986;94:147-56.

26.KrzeskiA,TomaszewskaE,JakubczykI,Galewicz-ZielińskaA.Anatomic variations of the lateral nasal wall in the computed tomography scans of patients with chronic rhinosinusitis. Am J Rhinol 2001;15:3715.

27. Meyer TK, Kocak M, Smith MM, Smith TL. Coronal computed tomography analysis of frontal cells. Am J Rhinol 2003;17:163-8.

28. Han D, Zhang L, Ge W, Tao J, Xian J, Zhou B. Multiplanar computed tomographic analysis of the frontal recess region in Chinese subjects without frontal sinus disease symptoms. ORL J Otorhinolaryngol Relat Spec 2008;70:104-12.