| dc.description.abstract | Introduction: Knowledge of anatomical variation of the paranasal sinus is of paramount importance to the ENT surgeon as it reduces the surgical complication rates during functional endoscopic sinus surgery (FESS), helps explain recurrence of disease and allows the surgeon to change the operative technique
Objective: To determine paranasal sinus anatomical variations in patients with rhinosinusitis undergoing cranial CT-scan evaluation in two health facilities in Kampala – Uganda
Methods: This was a cross sectional study of paranasal sinus CT scan images of adult patients between November 2021 to april 2022. Multiplanar reconstruction of 3mm images acquired in supine position using appropriate factors were done in 1 mm thin slices with 0.5 mm interval in all planes. Continuous data were summarized using median and interquartile range, while categorical data was summarized using proportions and frequencies. Pearson’s chi square test and Fisher’s exact test were used to compare categorical variables. A p-value < 0.05 was consider significant in the comparison.
Results: Head CT scan images of 278 patients were evaluated. Median age was 35.5 years IQR (26- 53). Male patients, 177(63.7%) were more than female in a ratio of 1.8:1. At least one anatomical variant was noted in 77.3% of the images evaluated. The most prevalent anatomical variants were; Agger Nasi cells in ethmoid sinus-45.3%(126), maxillary sinus hypoplasia in maxillary sinus -(47)16.9
%, post sellar pneumatization in sphenoid sinus-55.8%(155), absent frontal sinus - 9.4 % (26), concha bullosa in nasal turbinate-23.0%(64), and nasal septum deviation- 45.3 %(126) and Keros type- 2- 66.9
%(186) as common olfactory fossa variation were prevalent bone variations.
Sinusitis feature were more common in the maxillary sinus than in other sinuses. The maxillary sinus had the highest frequency of sinusitis features with bilateral mucosal thickening (34/278), bilateral opacification with air fluid levels (14/278). A statistically significant relationship between the Concha bullosa anatomical variation and the presence of maxillary sinusitis was noted, p-0.019.
About 79.5% of patients who had at least one anatomical variation in their sinuses, turbinate or bone also had evidence of sinusitis feature on their head CT scan images. Similarly, 73.1% of patients who had no anatomical variations in their sinuses, nasal turbinates or bone also had evidence of sinusitis feature in their head CT scans.
Conclusion and recommendations: Due to high prevalence of anatomical variations in this study setting, precise knowledge of anatomic variations of the paranasal sinuses is vital for carrying out good surgical therapy intra operatively to prevent possible complications, there is need of consistent reporting of paranasal sinus anatomical variations in PNS reports | en_US |
