Importance of CT scan of Para nasal Sinus

Sino nasal polyps are nothing but lesions which mainly arise from the mucosa of our nasal cavity. More than one Para nasal sinus may grow at the outflow tract of the sinuses. Treating this sinus may differ and no effective treatment in particular has been found yet.

Around 4% of the population is affected by Para nasal sinuses. But this prevalence has been found to be as high as 32% in the cadaveric study. Mostly the patients older than 20 years of age are affected and the adults are affected pre dominantly. Children under the age of 10 are less affected by this or may be present as cystic fibrosis. Most of the people suffering from Para nasal sinus have been reported to already have asthma and polyps are present in 7% patients having asthma. Cost of CT PNS scan differs from one hospital to another.

Causes

A polyp is known to be the consequence of chronic inflammation. Thus, chronic inflammation in our nasal cavity can often lead to nasal polyps. Anatomic factors are also known to play a major role in the etiology of SNP as nasal polyps are mainly located in the middle meatus and mainly originate from our mucous membrane of the outlets leading from the Para nasal sinuses. The major reason for SNP is mostly unknown, but below are some of the possible causes of SNP:

• If we touch our mucous membranes in the narrow ostiomeatal complex, then this will result in the release of pro inflammatory cytokines from the epithelial cells, and this will in turn affect the integrity of the Sodium channels. This mainly causes the tissue edema to produce polyp in the due course of time.
• A SNP can also be the influence of a special airflow or air current and even a pressure in the upper part of our nose.
• If the nerve endings near the borderline between our nose and the Para nasal sinuses are thin and then it may easily get damaged by cytotoxic proteins, which are released by eosinophil and this loss of autonomic innervations will lead to the induction of abnormal vascular permeability which in turn will lead to tissue edema.

Diagnosis

The diagnosis of Para nasal sinus is made by rhinoscopy which is of two types mainly.

• Anterior
• Posterior

 The diagnosis of Para nasal sinus often gets easier if only a small probe is used for gentle palpation. The polyps are usually insensitive and are also mobile in nature as a fact on their pedicles. A normal radiograph of the Para nasal sinus is usually of no value for the diagnosis of the nasal polyps. But the chances of pacification of the sinuses may arise.

Another way treating this Para nasal sinus is a computed tomography which is a very fast, effective and at the same time it is also readily accessible imaging technique to be performed on the patient suffering from Para nasal sinus. This examination or this way of diagnosis is well tolerated by the patients and therefore elderly or infirm patients and the children, people with claustrophobia, or patients who are critically ill as well is able to cope with this method quite well. A CT PNS scan Chennai also shows the several anatomical variations. It also shows the extent of the disease as to how much it has spread. It is also essential to know if any surgical treatment is to be implemented or whether it suggested by the doctor. Surgery may not be or to be very clear it should not be referred to as the primary step in the diagnosis of this condition. In case a condition arises where there are unilateral signs and symptoms present or any other sinister features arises in any way, then surgical diagnosis may become a necessary or even the only way of treating this Para nasal sinus.

 Any kind of intravenous contrast medium injection will not be needed. It can be required only if a tumour, vascular lesion, or acute complication is suspected by the doctor through a CT scan.

Treating Para nasal sinus helps in relieving nasal obstruction, restoring olfaction and also helps in improving sinus drainage and for treating any kind of rhinitic symptoms. Corticosteroids are known to be the only medical therapy to have a proven and a really good effect on the symptoms and signs of nasal polyps and can be used either topically or systemically. If at any time an intranasal corticosteroid is introduced to the patient then the sensory attributes and immediate efficacy may decide the preference and adherence of the patient to the therapy and thereby it will automatically reflect on the outcome of the treatment. In one of the study it was shown that, although the immediate efficacy and tolerability among the patients were quite comparable, but then again most of the patient preferred fluticasone propionate formulation instead of ciclesonide.

So, CT scans in patients having Para nasal sinus is important mainly to know the variations in the anatomical structure as an etiology of Sino nasal polyp. It also helps to diagnose the presence of fungal etiology of the patient having nasal polyp. It also show the extent of polyposis and anatomical distinctions and thus helps to prevent any kind of unwanted complications during the navigation of sinus surgery.

No single surgical technique in particular is known to have helped entirely in treating the patients and thus often they have to undergo repeated number of procedures and so they receive a long-term medical treatment. This Para nasal sinus can reoccur at any time which is very common and between 5 and 10 % of patients may have this experience. The surgical method of nasal polyps has changed over the last two decades with the advancement of FESS. The major role of pre-operative CT scan is done to see the anatomic variations and this should be kept in mind when FESS is performed to prevent further complications. Based on the CT scan of Para nasal sinus, the most common is maxillary sinus.