Article Sidebar

Submitted
November 11, 2024
Accepted
November 11, 2024
Published
November 11, 2024
Download
PDF
Statistic
Read Counter : 482 Download : 399

Main Article Content

Abstract

Background: Paranasal sinus diseases are increasingly common worldwide. Early diagnosis and timely
therapy are vital to avoid prolonged issues. The variable anatomy of these sinuses can significantly impact
subsequent pathology.
Objective: To determine the prevalence of sinonasal anatomical variants (SNAVs) in a sample population
in Duhok city, assess their correlation with sex, and evaluate the association of these variants with sinonasal
inflammatory changes using computed tomography.
Patients and Methods: This retrospective cross-sectional study enrolled 100 patients from specialized
imaging centers in Duhok city over 6months (February to July2024). Multiple CT coronal, axial, and
sagittal sections were analyzed to evaluate the prevalence of sinonasal variants, affected sinuses, and their
association with sinonasal inflammatory changes.
Results: The study included 100 patients aged 12 to 69 years, with an equal gender distribution. The
frequency of SNAVs was 1097 (average 10.97 variants per case). SNAVs were more prevalent in females
(52.4%) compared to males (47.58%). Ethmoid air cells were the most common (46.7%), followed by
sphenoid sinus variation (27.5%). While SNAVs occurred in both genders at varying rates, significant
gender-based differences were found only for ethmoidal air cells and frontal sinus variants. The study found
no significant differences in sinusitis prevalence for most SNAVs by gender, except for ethmoidal air cells
elongation, where females showed an increased prevalence of sinusitis.
Conclusion: Understanding SNAVs and their impact on sinus surgery and disease is crucial. Gender
influences the prevalence of certain SNAVs and their association with sinusitis, indicating the need for a
tailored approach in clinical management.

Keywords

Anatomic variants CT scan Inflammation Para nasal sinuses

Article Details

License

Copyright (c) 2024 University of Thi-Qar Journal Of Medicine

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Paranasal Sinuses: A Systematic Review. Cureus. 2021;13(1). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883520/
  2. Yousef M, Sulieman A, Hassan H, Ayad C, Bushara L, Saeed A, Gamerddin M,
  3. Ahmed B. Computed Tomography Evaluation of Paranasal Sinuses Lesions. Sudan Med
  4. Monit. 2014;9(3):123–126. https://www.researchgate.net/publication/271325257_Computed_tomography_evaluation _of_paranasal_sinuses_lesions
  5. AJR. CT of Anatomic Variants of the Paranasal Sinuses and Nasal Cavity: Poor
  6. Correlation With Radiologically Significant Rhinosinusitis but Importance in Surgical
  7. Planning. Am J Roentgenol. https://pubmed.ncbi.nlm.nih.gov/26001236/
  8. 2014;202(6):1255–1260. Tomovic I. High-Resolution Computed Tomography Analysis of the Prevalence of Onodi Cells. Laryngoscope. https://pubmed.ncbi.nlm.nih.gov/22685058/
  9. 2012;122(11):1180–1184. Alkire S. An Assessment of Sinonasal Anatomic Variants Potentially Associated with Recurrent Acute Rhinosinusitis. Laryngoscope. 2010;120(8):1645–1651. https://pubmed.ncbi.nlm.nih.gov/20131360/
  10. Smith KD, Edwards PC, Saini TS, Norton NS. The Prevalence of Concha Bullosa
  11. and Nasal Septal Deviation and Their Relationship to Maxillary Sinusitis by Volumetric
  12. Tomography. Int J Dent. 2010;2010. https://pubmed.ncbi.nlm.nih.gov/20862205/
  13. .Busaba NY, Sin HJ, Salman SD. Impact of Gender on Clinical Presentation of
  14. Chronic Rhinosinusitis with and without Polyposis. J Laryngol Otol. 2008;122(11):1180
  15. https://pubmed.ncbi.nlm.nih.gov/18184447/
  16. Roman RA, Hedeşiu M, Gersak M, Fidan F, Băciut G, Băciut M. Assessing the
  17. Prevalence of Paranasal Sinuses Anatomical Variants in Patients with Sinusitis Using Cone Beam Computer Tomography. Clujul Med.
  18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990440/
  19. 2016;89(3):423–429. Badia L, Lund V, Wei W, Ho WK. Ethnic Variation in Sinonasal Anatomy on CTScanning. Rhinology. 2005;43:210–214. https://pubmed.ncbi.nlm.nih.gov/16218515/
  20. Cornelius RS, Martin J, Wippold FJ, Aiken AH, Angtuaco EJ, Berger KL, et al.
  21. ACR Appropriateness Criteria Sinonasal Disease. J Am Coll Radiol. 2013;10(4):241–246.
  22. https://pubmed.ncbi.nlm.nih.gov/23420025/
  23. Kroll KE, Camacho MA, Gautam S, Levenson RB, Edlow JA. Findings of Chronic
  24. Sinusitis on Brain Computed Tomography Are Not Associated with Acute Headaches. J
  25. Emerg Med. 2014;46(6):753–759. https://pubmed.ncbi.nlm.nih.gov/24750900/
  26. Jagannathan D, Kathirvelu G, Hithaya F. Prevalence of Variant Anatomy of Paranasal Sinuses in Computed Tomography and Its Correlation to Sinusitis. IOSR JDMS. 2017;16(03):01–07. https://www.iosrjournals.org/iosr-jdms/papers/Vol16-issue3/Version
  27. /A1603130107.pdf
  28. Dasar U, Gokce E. Evaluation of Variations in Sinonasal Region with Computed
  29. Tomography. World J Radiol. 2016;8(1):98–108. https://tinyurl.com/kzbksccv
  30. Bora A, Koç M, Durmuş K, Altuntas EE. Evaluating the Frequency of Anatomical
  31. Variations of the Sinonasal Region in Pediatric and Adult Age Groups According to
  32. Gender: Computed Tomography Findings of 1532 Cases. Egypt J Otolaryngol.
  33. ;37(1):58. https://ejo.springeropen.com/articles/10.1186/s43163-021-00122-9
  34. Al-Abri R, Bhargava D, Al-Bassam W, Al-Badaai Y, Sawhney S. Clinically
  35. Significant Anatomical Variants of the Paranasal Sinuses. Oman Med J. 2014;29(2):110
  36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976721/
  37. Roman RA, Hedeşiu M, Gersak M, Fidan F, Băciut G, Băciut M. Assessing the
  38. Prevalence of Paranasal Sinuses Anatomical Variants in Patients with Sinusitis Using Cone
  39. Beam Computer Tomography. Clujul Med. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990440/
  40. 2016;89(3):423–429. Choby G, Thamboo A, Won TB, Kim J, Shih LC, Hwang PH. Computed
  41. Tomography Analysis of Frontal Cell Prevalence According to the International Frontal
  42. Sinus Anatomy Classification. Int Forum Allergy Rhinol. 2018;8(7):825–830. https://pubmed.ncbi.nlm.nih.gov/29457874/
  43. Hung K, Montalvao C, Yeung AWK, Li G, Bornstein MM. Frequency, Location, and Morphology of Accessory Maxillary Sinus Ostia: A Retrospective Study Using Cone Beam Computed Tomography (CBCT). Surg Radiol Anat. 2020;42(2):219–228. https://pubmed.ncbi.nlm.nih.gov/31456002/
  44. Keast A, Sofie Y, Dawes P, Lyons B. Anatomical Variations of the Paranasal
  45. Sinuses in Polynesian and New Zealand European Computed Tomography Scans. Otolaryngol Head Neck https://pubmed.ncbi.nlm.nih.gov/18656718/
  46. Surg. 2008;139(2):216–221. Dasar U, Gokce E. Evaluation of Variations in Sinonasal Region with Computed
  47. Tomography. World J Radiol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4731353/
  48. 2016;8(1):98–108. Shpilberg KA, Daniel SC, Doshi AH, Lawson W, Som PM. CT of Anatomic Variants of the Paranasal Sinuses and Nasal Cavity: Poor Correlation With Radiologically Significant Rhinosinusitis but Importance in Surgical Planning. Am J Roentgenol.
  49. ;204(6):1255–1260. https://pubmed.ncbi.nlm.nih.gov/26001236/
  50. Rasul S, Abdullah K, Ali T. Frequency of Anatomical Variations of Nose and
  51. Paranasal Sinuses in Clinically Suspected Rhinosinusitis Patients by Computerized
  52. Tomography. J Sul Med Coll. 2018;8(3):139–148. https://jsmc.univsul.edu.iq/index.php/jsmc/article/view/jsmc-10161
  53. Dawood SN. Normal Anatomic Variants of Paranasal Sinus Region Studied by
  54. Computed Tomography. Zanco J Med https://zjms.hmu.edu.krd/index.php/zjms/article/view/770
  55. 12]. Sci. 2020;24(2):187–196. Nair S, Bhat S, Nambiar S. The Role of Onodi Cells in Sphenoiditis: Results of
  56. Multiplanar Reconstruction of Computed Tomography Scanning. [Internet]. [cited 2024 Mar Available from: https://pubmed.ncbi.nlm.nih.gov/27161189/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9444771/
  57. Cellina M, Gibelli D, Cappella A, Martinenghi C, Belloni E, Oliva G. Nasal Cavities
  58. and the Nasal Septum: Anatomical Variants and Assessment of Features with Computed Tomography. Neuroradiol J. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7416352/
  59. 2020;33(4):340–347. Sethi KS, Choudhary S, Ganesan PK, Sood N, Ramalingum WBS, Basil R, et al.
  60. Sphenoid Sinus Anatomical Variants and Pathologies: Pictorial Essay. Neuroradiology.
  61. ;65(8):1187–1203. https://link.springer.com/article/10.1007/s00234-023-03163-4
  62. Bora A, Koç M, Durmuş K, Altuntas EE. Evaluating the Frequency of Anatomical
  63. Variations of the Sinonasal Region in Pediatric and Adult Age Groups According to
  64. Gender: Computed Tomography Findings of 1532 Cases. Egypt J Otolaryngol.
  65. ;37(1):58. https://ejo.springeropen.com/articles/10.1186/s43163-021-00122-9
  66. Roman RA, Hedeşiu M, Gersak M, Fidan F, Băciut G, Băciut M. Assessing the
  67. Prevalence of Paranasal Sinuses Anatomical Variants in Patients with Sinusitis Using Cone Beam Computer Tomography. Clujul Med. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4990440/
  68. 2016;89(3):423–429. Kulich M, Long R, Reyes Orozco F, Yi AH, Hao A, Han JS, et al. Racial, Ethnic, and Gender Variations in Sinonasal Anatomy. Ann Otol Rhinol Laryngol. 2023;132(9):996–1004. https://pubmed.ncbi.nlm.nih.gov/36200783/
  69. Marino MJ, Riley CA, Wu EL, Weinstein JE, Emerson N, McCoul ED. Variability of Paranasal Sinus Pneumatization in the Absence of Sinus Disease. Ochsner J. 2020;20(2):170-176. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310164/
  70. Sunyecz I, Hunt C, Ramadan HH, Makary CA. Role of Sinonasal Anatomic Variants in Recurrent Acute Rhinosinusitis. Laryngoscope. 2024;134(3):572–580. https://pubmed.ncbi.nlm.nih.gov/38451036/
  71. Papadopoulou AM, Bakogiannis N, Skrapari I, Bakoyiannis C. Anatomical Variations of the Sinonasal Area and Their Clinical Impact on Sinus Pathology: A Systematic Review. Int Arch Otorhinolaryngol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282972/
  72. 2022;26(3)–e498. Ference EH, Tan BK, Hulse KE, Chandra RK, Smith SB, Kern RC, et al. Commentary on Gender Differences in Prevalence, Treatment, and Quality of Life of Patients with Chronic Rhinosinusitis. Allergy Rhinol (Providence). 2015;6(2)2015.6.0120.
  73. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541639/
  74. Qureshi MF, Usmani A. A CT-Scan Review of Anatomical Variants of Sinonasal Region and Its Correlation with Symptoms of Sinusitis (Nasal Obstruction, Facial Pain and Rhinorrhea). Pak J Med Sci. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794148/ 2020;37(1):139–148.

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)