CT evaluation of anatomical variations of osteomeatal complex:Indian Journal of Otolaryngology &HNS

The main article in July-September 2009 issue Indian Journal of Otolaryngology &HNS
Authors :AA Wani Sohit Kanotra M Latif et al
GMC Srinagar
A total of 150 patients of chronic rhino sinusitis (medical treatment failure ) who were subjected to FESS were CT scanned pre operatively to find any anatomic variation and extent of mucosal disease
Concha Bullosa was commonest anatomical variation and was seen in 45 (30%)patients. The others variations included :paradoxical middle turbinate in 9.33 %patients ,uncinate process variation in 25 % patients, agar nasi cell in 9.33 %,Haller cell in 8.66 % and posterior septal deviation in 25.33 % patients
The mucosal disease was most commonly seen in anterior ethmoids (87.33%),followed by maxillary sinus ostial area (70 %),posterior ethmoid disease (38%),frontal sinus disease (15 %)and sphenoid mucosal disease (8.66%) patients .
The authors have tabulated the prevalence of anatomical variation of other few studies ,each showing different percentages.
Another analysis has been done on involvement on one side or both sides. Where as most anatomic variations are predominantly unilateral but most mucosal disease is bilateral (except frontal and sphenoidal
The authors conclude that pre operative detection of various anatomical variations is essential as it significantly influence the selection of technique and also helps in avoiding complications .