BONY ANATOMIC VARIANTS SEEN ON SCREENING SINUS CT

Abstract

Screening sinus CT (SSCT) has emerged as the standard imaging modality in the investigation of inflammatory disease of the sinuses. Its ability to demonstrate detailed anatomy of the sino-nasal complex makes it an invaluable tool in functional endoscopic sinus surgery (FESS). In addition to exquisite demonstration of the anatomy and pathology of the sinonasal complex, anatomic variants which are identified can be predisposing factors to inflamma- tory sinus diseases. They are important operative considerations during the planning of FESS. The aim of this study is to document the prevalence of major anatomic variants seen on SSCT in our local population and to illustrate some of these variants as identifica- tion of these anomalies may have crucial operative implications. In view of the heteroge- neous make up of our study population, an analysis of the prevalences of the variants amongst the different races is also made.
Screening sinus CT of 302 consecutive patients referred for sinonasal symptoms were studied. Anatomic variations were identified and recorded. These included pneumatized middle turbinate (concha bullosa), paradoxical middle turbinate (PMT), Haller's cells, septal deviation and uncinate process pneumatization. Overall bony anatomic variations were seen in 216 (71.5%) patients. A total of 134 (44.4%) patients had concha bullosa, 18 (6.0%) had paradoxical middle turbinate while 24 (7.9%) patients showed the presence of Haller's cells. There was significant lower prevalence of paradoxical middle turbinate noted in the Chinese group when compared with the Non-Chinese. There were only 4 patients (1.3%) with pneumatization of the uncinate process and these were only seen in the Non-Chinese group. Comparison is made between our study population and that of other similar published studies.