Identification of Significant Anatomical Variations in the Nose and Anterior Skull Base Using Computed Tomography: A Cross-Sectional Study

Anatomy and Variations of Onodi Cells and Haller Cells: A HRCT Cum Clinical Analysis in Sinonasal Disease and Polyposis

The Onodi cell is defined as the posterior-most ethmoid cell. Haller cells are defined as infraorbital ethmoid cells. HRCT scanning provides excellent bone detail and accurate soft tissue mapping. The aim of this study is to know the prevalence of Haller cells and Onodi cells and to find variations in them on HRCT. Also to find co-relation between HRCT findings and Intra operative findings. A Hospital based prospective and cross-sectional study which included 30 patients above 15 years of age coming to ENT OPD with complaints related to sinonasal disease and polyposis;willing for HRCT followed by operative procedures. A total of 30 patients are included in the study. The mean age was found to be 38.70 ± 14.37. Prevalence of haller cells and onodi cells was 30% and 33.3% respectively. Statistical significance was found between association of haller cells with sinusitis. Intra-operative findings corresponded to 8 out of 9 HRCT findings (p-value = 0.001). We conclude that the actual prevalence of haller cell and onodi cell is best noted on HRCT-PNS and this holds a significant role in imparting thorough knowledge of the anatomical variations of PNS and hence preventing intraoperative complications due to presence of these variant cells.

A CT-Scan review of anatomical variants of sinonasal region and its correlation with symptoms of sinusitis (nasal obstruction, facial pain and rhinorrhea)

Objective:

To determine the incidence of anatomical variants of sinonasal region and its correlation with symptoms of sinusitis.

Methods:

The study was conducted from January-June 2020 at Radiology Department of PNS Shifa Hospital, Karachi. The study involved 50 symptomatic subjects of sinusitis with age ranges from 18-60 years which were prepared for computed tomography of paranasal sinuses. The scans were reviewed for nasal-septum, turbinates, uncinate process, ethmoid air-cells along with other anatomical variants and were correlated with symptoms of sinusitis.

Results:

Out of 50 subjects, 34 were males and 16 were females with mean age of 42.68±18.22 years. Most common anatomical variants observed were agger nasi cells (64%), deviated nasal septum (56%), and concha-bullosa (46%). Statistically significant correlation existed between bilateral agger nasi cells and nasal obstruction (p=0.017, ρ= -0.336).

Conclusion:

The anatomy of sinonasal region is highly complex. However, anatomical variants can disturb the sinus mucociliary drainage pathway resulting in patient suffering. Therefore, considering the variable anatomy of sinonasal region, CT-PNS is recommended for every subject in order to avoid surgical hazards.