Computed Tomographic Findings of Nasal and Paranasal Sinuses in Patients Scheduled for Rhinoplasty in Shahid Mostafa Khomeini Hospital during 2011-13

Abstract

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. 

Keywords

• Rhinoplasty,computed tomography,nasal septum,nasal concha,paranasal sinuses

Kaynakça

1. 1. Hammad MS, Gomaa MA. Role of some anatomical nasal abnormalities in rhinogenic headache. Egyptian Journal of ENT and Allied Sciences. 2012;13:31-5
2. 2. Hafezi F, Kochakzadeh K, Naghibzadeh B. History and status of nose surgery.The Iranian Journal of surgery. 2009;17:88-94
3. 3. Marcus B, Patel Z, Busquets J, Hwang PH, Cook TA. The utility of concurrent rhinoplasty and sinus surgery. A 2-team approach. Arch Facial Plast Surg. 2006;8:260-2
4. 4. Bradoo R. anatomical principles of endoscopic sinus surgery:a step by step approach.Pitman KT editors. Book reviews. 1st ed. tayler & francis; 2005.p.302
5. 5. Muhammad IA, Rahman NU. Complications of the surgery for deviated nasal septum. J Coll Physicians Surg Pak. 2003;13:565-8
6. 6. Alrumaih RA, Ashoor MM, Obidan AA, Al-khater KM, Al-jubran SA. Radiological sino-nasal anatomy: exploring the Saudi Population. Saudi J Health Sci. 2010;44:290-7
7. 7. Flint PW, Haughey BH, Lund VJ, Niparko JK, Robbins K, Regan J, et al. Cumming’s otolaryngology head and neck surgery. 6th ed. philadelphia: Elsevier mosby; 2015.p.1565-9
8. 8. Haaga JR, Boll D. Computed tomography & magnetic resonance imaging of the whole body.6th ed. Elsevier; 2008.P.1553-7

9. 9. 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
10. 10. Andrades P, Cuevas P, Danilla S, Bernales J, Longton C, Borel C, 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
11. 11. Bolger WE, Parsons DS, Butzin CA. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. The Laryngoscope. 1991;101:56-64
12. 12. Nikakhlagh S, Saki N, Tahmasebi M, Jouhari H. Anatomic variations of the bone in sinonasal CT scan: A report of 79 cases. Jundishapur scientific medical journal. 2008;6:476-82
13. 13. Talaiepour AR, Sazgar AA, Bagheri A. Anatomic variations of the paranasal sinuses on ct scan images. J Dent (Tehran). 2005;2:142-6
14. 14. Sadr S, Ahmadinejad M, Saedi B, Razaghian F, Rafiee M. Anatomical variations in sinus imaging in sinusitis: A case control study. Acta Otorhinolaryngol Belg. 2011;8:185-9
15. 15. Perez-Pinas I, Sabate J, Carmona A, Catalina-Herrera C, Jimenez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000;197:221-7
16. 16. 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
17. 17. Varshney H, Varshney J, Biswas S, Ghosh SK. Importance of CT scan of paranasal sinuses in the evaluation of the anatomical findings in patients suffering from sinonasal polyposis. Indian J Otolaryngol Head Neck Surg. 2016;68:167-72
18. 18. Abdi R, Majidi H, Kasiri A, Barzin M, Madani SA. Assesment of paranasal sinus anatomical variations in CT scan of patients’ reffered to Bina radiology center in Sari. Journal of Mazandaran University of Medical Science. 2004;14:45-51
19. 19. Elsherif A-AMH, Elsherif AM. Some anatomic variations of the paranasal sinuses in patients with chronic sinusitis: A correlative ct study to age and sex. Al-Azhar medical journal. 2006;4:1-15
20. 20. Riello APFL, Boasqueviscue EM. Anatomical variants of the osteomeatal complex: Tomographic findings in 200 patients. Radiol Bras. 2008;41:149-54
21. 21. 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
22. 22. Flint PW, Haughey BH, Lund VJ, Niparko JK, Thomas Robbins K, Regan Thomas J, et al. Cumming’s otolaryngology head and neck surgery. 6 ed. philadelphia: Elsevier mosby; 2015. P. 1570-5
23. 23. Huang BY, Lloyd KM, Delgaudio JM, Jablonowski E, Hudgins PA. Failed endoscopic sinus surgery: Spectrum of CT findings in the frontal recess. Radiographics. 2009;29:177–95
24. 24. Naderpoor M, Lotfi A, Ayat E, Edhami A, Basiri F. Incidence of anatomic variants in patients with chronic sinusitis. Medical journal of Tabriz University of medical sciences. 2009;31:67-70
25. 25. Zinreich SJ. Imaging of chronic sinusitis in adults: X-ray,computer tomography and magnetic resonance imaging. J Allergy Clin Immunol. 1992;90:445–51
26. 26. Gupta AK, Gupta B, Gupta N, Tripathi N. Computerized tomography of paranasal sinuses: A roadmap to endoscopic surgery. Clin Otolaryngol. 2012;5:1–10
27. 27. Stammberger H. Endoscopic endonasal surgery—concepts in treatment of recurring rhinosinusitis. Part II. Surgical technique. Otolaryngol Head Neck Surg. 1986;94:147-56
28. 28. Krzeski A, Tomaszewska E, Jakubczyc I, Galewicz-Zielinsca A. Anatomic variations of the lateral nasal wall in the computed tomography scans of patients with chronic rhinosinusitis. Am J Rhinol. 2001;15:371-5
29. 29. Meyer TK, Kocak M, Smith MM, Smith TL. Coronal computed tomography analysis of frontal cells. Am J Rhinol. 2003;17:163-8
30. 30. 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
31. 31. Ameri A, Eslambolchi A, Bakhshandeh H. Anatomic variants of paranasal sinuses and chronic sinusitis. Iran J Radiol. 2005;2:121-4