Publication:

Computed tomography of paranasal sinuses for early and proper diagnosis of nasal and sinus pathology

Background Pathological lesions of the paranasal sinuses include a wide spectrum of conditions ranging from inflammation to neoplasms both benign and malignant. Most patient of common cold present with symptoms of nasal discharge, nasal obstruction, headache and nasal allergy etc. The patient of paranasal mass usually present with facial deformity, swelling or repeated episodes of epistaxis. The aim of the study was to establish the role of CT in evaluation of pathologies and their proper early diagnosis.

Methods It is a prospective study. A total of 100 patients who were referred to our department with clinical suspicion of PNS disease underwent CT evaluation of PNS using 64 multi slice CT scanner from December 2012 to October 2015.

Results Out of 100 cases 51 (51%) cases were males and rest 49 (49%) patients were females. The majority of the cases were of age group 16-30 which were 37case (37%) The most common symptoms were nasal obstruction (50%), followed by nasal discharge (49%), headache in 20% cases. Most common anatomical variations seen was deviated nasal septum (49%) more commonly on right side next common was agger nasi in 48% of cases. Maxillary sinuses are most commonly involved in the study (82 cases), followed by the ethmoid sinuses (ant. group 77 cases, post group 40 case) and frontal sinus 55 cases. The most common pathology seen was masses in 30% cases followed by DNS in 21% cases. The most common form of mucosal thickening noted is circumferential type seen in 7% cases. The most common pathology involving the sinuses was sinusitis (30%) followed by polyp (25%).

Conclusions Most of the patients with PNS pathology were from 2nd and 3rd decade. Slight male preponderance was noted. Majority of the patients presented with nasal obstruction. Most common anatomical variant seen was DNS. Most common sinus involved was maxillary. Sinonasal pathologies were the most common followed by pure nasal or pure sinosal. The most common pathology was inflammatory (74%). The most common benign pathologies were polyps with 92% accuracy. 15% of cases had malignancy with diagnostic accuracy of 90%.