Role of CT scan in paranasal sinus pathology

Authors : Mohit Srivastava, Mohit Srivastava, Himani Singh, Himani Singh, Waseem Ahmed, Waseem Ahmed, Sachin Agarwal, Sachin Agarwal

DOI : 10.18231/j.ijashnb.2019.013

Volume : 5

Issue : 2

Year : 2019

Page No : 51-54

CT Scans use a narrow X-Ray beam that circles around the part of body to be scanned. The data is transmitted to a computer, which build up 3D cross sectional picture. Although CT Scans cannot distinguish between inflammation and infection, they correlate with extent of disease. CT Scans have been very useful in assessing severity of the disease or response to treatment in chronic Rhinosinusitis. It is also the most reliable radiological examination to identify a fungus ball. The latest CT machines allow a complete set of axial slices to be made within a few seconds. The CT scan proved to be an excellent imaging tool as it can accurately diagnose & differentiate benign & malignant lesions, can describe the masses in terms of their origin, nature, extension, & involvement. Computerized tomography (CT) is considered the gold standard for preoperative evaluation of PNS diseases for appropriate patient selection for functional endoscopic sinus surgery (FESS). CT has some medico-legal importance as well. This is a prospective study conducted on 30 patients (from September 2018 to May 2019). Both male and female patients of different age groups with clinically suspected PNS diseases were enrolled for the study. Both axial and coronal images were acquired using multi-detector CT unit. The paranal sinuses were evaluated for: mucosal thickening, wall of sinus, fluid level, soft tissue extension, hyperdensities and masses, blockage of osteomeatal complex, and pattern of bony involvement. There was a male predominance of 54% as compared to females 46%. The chief presenting complaint was of nasal obstruction (49%), followed by a headache (40.8%), nasal discharge (30.5%), facial pain (20%), and others (37.7%). The most common CT diagnosis was chronic sinusitis (13/30) followed by polyp (7/30) and fungal sinusitis (5/30). In this study, maxillary sinus (83.5%) was the most commonly involved sinus followed by ethmoid sinus (74.7%), sphenoid sinus (43.9%), and frontal sinus (54.9%). CT was able to characterize the PNS diseases along with their extension. It could also delineate the bony involvement of PNS diseases. CT may be used as gold standard imaging modality for evaluating the Paranasal Sinus diseases.

Keywords: Paranasal sinus pathology, Chronic sinusitis, Headache, Computed tomography.


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