CT Findings in Revision Endoscopic Sinus Surgery

Chung, Seung Kyu; Ha, Byung Suk; Dhong, Hun Jong

Abstract

BACKGROUND AND OBJECTIVES: When performing a revision endoscopic sinus surgery, operators should pay close attention due to the altered sinonasal anatomy or defects of anatomical landmarks. Careful preoperative evaluation of altered anatomy is important, however, little has been reported on its structural changes. We investigated status of anatomical structures and mucosal pathology by reviewing OMU CT in revision sinus surgeries.
MATERIALS AND METHODS
A total of 117 operated sides (right: 59, left: 58) from 62 patients who received revision endoscopic sinus surgeries were evaluated. They had history of previous sinus surgeries such as Caldwell-Luc operation, polypectomy, or endoscopic sinus surgery. We investigated the following 5 parameters by reviewing preoperative OMU CT; Sinus mucosal pathology, bony thickening, absence of superior or middle turbinate, structural changes of superior or middle turbinate, and defects of anatomical landmarks.
RESULTS
Sinus mucosal pathology was most commonly found in the maxillary sinuses, and was followed by the anterior ethmoid, the posterior ethmoid, the frontal, and the sphenoid sinuses. Out of 117 sides, 47 showed bony thickening and 7 showed absence of superior or middle turbinate. Eleven revealed structural changes in the superior or middle turbinate, and three showed defects in the lamina papyracea. However, there was no complete absence of the middle or superior turbinates, all of which were partially preserved.
CONCLUSION
Significant bony thickening, defects or changes of anatomical structures and associated mucosal pathology were frequently found in revision endoscopic sinus surgeries. Preoperative review of OMU CT, identification of structural changes, and close attention during surgery would be necessary.