DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20192717

Association of nasal blockage and prevalence of anatomical variants on CT scan of nose and paranasal sinuses

Shruti Venugopalan, Paresh J. Khavadu, Payal S. Chavada, Yash D. Lavana, Manish R. Mehta, Sejal N. Mistry

Abstract


Background: Nasal blockage is the most common nasal symptom with which patients present in ENT OPD. Sometimes, it is associated with headache and facial pain. The symptoms are secondary to mucosal contact points in the nasal cavity without any observable nasal mass, nasal discharge or turbinate hypertrophy, hence, known as rhinogenic headache or facial pain syndrome.

Methods: This is a prospective study done in the department of otorhinolaryngology, at P.D.U. Medical College and Hospital, Rajkot, for a period of twenty months from May 2017 to December 2018. A total number of 100 CT scans of patients aged above 5 years of both genders who presented with complaints of nasal blockage at department of otorhinolaryngology, P.D.U. Hospital, Rajkot.  

Results: Out of 100 patients above 5 years with symptoms of nasal blockage and CT scan showing anatomical variants, 78 patients had deviated nasal septum as the most common anatomical variant presenting with nasal blockage. Males (62%) were more commonly affected with different anatomical variants; 25-45 year old age group (48%) was the most common affected age group. The other anatomical variants: concha bullosa (13%), paradoxically curved middle turbinate (4%), Onodi cell (2%), Haller cell (2%) and unilateral choanal atresia (1%).

Conclusions: Nasal blockage is more common in 25-45 year old males and deviated nasal septum is the most common anatomical variant.


Keywords


Nasal blockage, Deviated nasal septum

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References


Stammberger H, Lund V. Anatomy of the nose and paranasal sinuses. In: Scott Brown’s Otorhinolaryngology, Head and Neck Surgery. Chapter 104. 7th edition, Taylor and Francis group; 2017: 1334-1335.

Bradoo R. Radiological Anatomy; Chapter 5. In: Anatomical Principles Of Endoscopic Sinus Surgery: A Step By Step Approach by Renuka Bradoo: 1st edition. Mumbai: Jaypee; 2012: 73-86.

Nandita A, Basavaraju SM, Pachipulusu B, Pravin GU. Assessment of anatomical variations of paranasal sinus region: a computed tomography study. Int J Oral Care Res. 2017;5(2):97-101.

Chong VFH, Fan YF, Sethi DS. Pictorial review-functional endoscopic sinus surgery (FESS). Clin Radiol. 1998;53(9);650-8.

Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101:56-64.

Zinreich SJ, Matox DE, Kennedy DW, Chisholm HL, Diffley DM, Rosenbaum AE. Concha Bullosa: CT evaluation. J Comput Assist Tomogr. 1988;12:778-84.

Ebrahim ZI, Lockhat ZI. Paranasal sinus variants. S Afr J Radiol. 2012;16(1):a232.

Scuderi AJ, Harnsberger HR, Boyer RS. Pneumatization of the paranasal sinuses: normal features of importance to the accurate interpretation of CT scans and MR images. Am J Roentgenol. 1993;160:1101-4.

Ritter FN. The paranasal sinuses anatomy and surgical technique. St. Louis: C.v. Mosby Co; 1973.

Zinreich SJ, Kennedy DW, Gayler BW. CT of nasal cavity, paranasal sinuses: an evaluation of anatomy in endoscopic sinus surgery. Clear images. 1988;2:2-10.

Lloyd GAS, Lund VJ, Scadding GK. Computerised tomography in the pre-operative evaluation of functional endoscopic sinus surgery. J Laryngol Otol.1991;105:181-5.

Dahnert W. Radiology review manual. 5th edition. Philadelphia, USA: Lippincott Williams and Wilkins, 2003: W656.

Weissleder R, Wittenberg J. Mukesh GH, et al. Sinuses and Nasal Cavity, Head and Neck Imaging. Chapter 7. In: Primer of Diagnostic Imaging. Philadelphia, USA: Mosby Elsevier; 2011: 445-449.

Diament MJ, Senac MO, Gilsanz V, Baker S, Gillespie T, Larsson S. Prevalence of incidental paranasal sinuses opacification in paediatric patients: a CT study. J Comput Assist Tomogr. 1987;11:426-31.

Warwick R, Williams Pl (eds). Gray’s anatomy. 35th edition. London: Longman; 1973: 299-300.

Negus JR. The comparative anatomy and physiology of the nose and paranasal sinuses. Edinburgh: E.S. Livingstone; 1958: 286-327.

Moore WJ. The nasal region. In: The mammalian skull. Cambridge: Cambridge University press; 1981: 240-279.

Pirsig W. Septoplasty in children: influence on nasal growth. Rhinology. 1977;15:193-204.

Verwoed CDA, Urbanus NAM, Nijdam DC. The effects of septal surgery on the growth of the nose and maxilla. Rhinology. 1979;27:53-63.

Rhys Evans P. The paranasal sinuses and other enigmas: an aquatic evolutionary theory. J Laryngol Otol. 1992;106:214-25.

Lang J. Clinical anatomy of the nose, nasal cavity and paranasal sinuses. Stuttgart: Georg Thieme Verlag; 1989: 7-37.

Gupta S, Gurjar N, Mishra HK. Computed tomographic evaluation of anatomical valuations of paranasal sinus region. Int J Res Med Sci. 2016;4:2909-13.

Adeel M, Rajput MS, Akhter S, Ikram M, Arain A, Khattak YJ. Anatomical variations of nose and para-nasal sinuses; CT scan review. J Pak Med Assoc. 2013;63(3):317-9.

Kumar P, Rakesh BS, Prasad R. Anatomical variations of sinonasal region, a coronal CT scan study. Int J Contemp Med Res. 2016;3(9):2601-4.