Correlation Between the Opacification Degree of Paranasal Sinuses on CT, Clinical Symptoms and Anatomical Variations of the Nose and Paranasal Sinuses in Patients with Chronic Rhinosinusitis

Mahdi Niknami; Elham Emami; Abdolhosein Mozaffari; Hashem Sharifian; Sanaz Safari

doi:10.18502/fid.v18i33.7337

Mahdi Niknami Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
Elham Emami Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abdolhosein Mozaffari Private Practice, Tehran, Iran
Hashem Sharifian Department of Radiology, Amir Aalam Hospital, Tehran University of Medical Sciences, Tehran, Iran
Sanaz Safari Department of Oral and Maxillofacial Radiology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/fid.v18i33.7337

Keywords: Sinusitis; Tomography, X-Ray Computed; Signs and Symptoms; Anatomical Variation

Abstract

Objectives: This study aimed to evaluate the correlation between the opacification degree of the paranasal sinuses on computed tomography (CT) with clinical symptoms, and anatomical variations of the nose and paranasal sinuses in patients with chronic rhinosinusitis (CRS).

Materials and Methods: This descriptive prospective study evaluated 100 patients (60 males and 40 females), who were diagnosed with CRS by ENT specialists according to the clinical findings, and were scheduled for a CT scan. The patients were requested to express the severity of their symptoms using a visual analog scale. The CT scans of the paranasal sinuses were assessed for the presence of anatomical variations and scored using the modified Lund-Mackay scoring system for the opacification degree of each sinus. The correlations between the anatomical variations and sinusitis, and also between the severity of symptoms/disease severity and CT scores were statistically analyzed. P<0.05 was considered statistically significant.

Results: The most common symptoms were purulent (discolored) nasal drainage and nasal obstruction. Septal deviation was the most common anatomical variation. The maxillary and anterior ethmoid sinuses were the most commonly involved areas. The Spearman’s correlation coefficient showed a significant correlation between the sinus involvement and some of the evaluated symptoms, as well as certain types of anatomical variations (P<0.05).

Conclusion: Some specific anatomical variations of the paranasal sinuses may predispose them to sinusitis. The CT scan score can predict the severity of many symptoms such as purulent (discolored) nasal drainage, nasal obstruction, hyposmia/anosmia, halitosis, cough, and fatigue, among the other symptoms of CRS.