ROLE OF MULTI-DETECTPR CT FOR ANATOMICAL VARIATIONS OF PARANASAL SINUSES IN SINUSITIS IN COMPARISON WITH PLAIN X-RAY PNS

Abstract

Objectives
The present study aimed to evaluate the role of Multi-Detector Computed Tomography (MDCT) in identifying anatomical variations of the paranasal sinuses (PNS) in patients with sinusitis and to compare its diagnostic effectiveness with plain X-ray PNS.

Methodology
This comparative cross-sectional study was conducted in the radiology department of a tertiary care hospital, Rawalpindi. A total of 60 patients presenting with clinical symptoms of sinusitis, including nasal obstruction, facial pain, headache, nasal discharge, and reduced sense of smell, were included in the study. All patients underwent both plain X-ray PNS and MDCT scanning of the paranasal sinuses. Plain radiographs were obtained using standard Water’s and Caldwell views, while MDCT was performed using a multi-slice CT scanner with axial images reconstructed into coronal and sagittal planes. Qualitative variables included anatomical variations such as deviated nasal septum, concha bullosa, agger nasi cells, Haller cells, Onodi cells, paradoxical middle turbinate, and septal spurs, as well as sinusitis features like mucosal thickening, air-fluid levels, and sinus opacification. Quantitative variables included patient age, frequency of anatomical variations, and distribution of sinus involvement. Data were analyzed using descriptive statistical methods.

Results
The mean age of the patients was 34.6 ± 11.2 years, with 58.3% males and 41.7% females. MDCT demonstrated a significantly higher detection rate of anatomical variations and sinus pathologies compared with plain X-ray PNS. Variations such as deviated nasal septum, concha bullosa, agger nasi cells, Haller cells, and Onodi cells were more accurately identified on MDCT. The maxillary sinus was the most commonly affected sinus, followed by the ethmoid sinus. Findings including mucosal thickening, air-fluid levels, and sinus opacification were better visualized with MDCT.

Conclusion
MDCT is a more accurate and reliable imaging modality than plain X-ray PNS for evaluating anatomical variations and sinus involvement in patients with sinusitis. It provides detailed visualization of sinus anatomy and pathology and plays a crucial role in accurate diagnosis and preoperative planning.