Volumetric Analysis of the Paranasal Sinuses Using CT Among Chronic Sinusitis Patients

Abstract

Volumetric of air sinuses contributes in diagnosis of sinus pathologies, and applied in forensic field. The aim of the study was to estimate the volumes of paranasal sinuses in Saudi Arabia Qassim region relative to right, left, gender and age in normal patients and to compare paranasal sinus volumes of chronic rhinosinusitis (CRS) patients to unaffected controls. This study is retrospective based on CT images for a sample consisted of 50 normal controls (24 males, 26 females) and101 patients with chronic sinusitis (47 males, 54 females) ranging from 1 to 83 years. The volumes obtained by axial manual segmentation of the air sinuses using 3D Slicer Program. Normal sample group divided into six age groups; 1-5; 6-10; 11-15; 16-20; 20-25 and more than 25 years old. The results showed that: the volume of the maxillary air sinus was the largest and the sphenoid and frontal air sinuses were the smallest, and the mean volumes of maxillary, ethmoid, frontal and sphenoid were 13.1, 4.6, 3.4 and 3.4 cm respectively. When we compared the growth of the air sinuses with age groups, the results showed that; the air sinuses have significant proportional correlation with aging and the data revealed that; the maximum volume reached by maxillary, ethmoid, frontal and sphenoid were at age groups 21-25,16-20,16-20 and 21-25 years respectively. While the growth of ethmoid and sphenoid sinuses decreased after reaching the maximum volume; the maxillary and frontal sinuses followed by a plateau thereafter. The data revealed that the growth rates of the two sides were symmetrical for all sinuses except for the frontal air sinuses in which the left air sinus appears to grow at a faster rate than the right side in the period from16 to 20 years old. Male sinuses volumes were greater than female in different age groups for all sinuses except both sphenoid sinuses. Chronic sinusitis group divided into two age groups: more than 20years old (n=82) and less than 20 years (n=19) to compare with normal unaffected group; more than 20years (n=26) and less than20 years (n=24). The results showed that; the commonly involved gender with sinuses pathologies was the female, with a 53.5% relative to male. The chronic sinusitis infected older ages (more than 20years old) with a percent of 81.18% more than the younger one (less than 20 years old) with a percent of 18.81%.The study revealed that the common involved sinuses were the maxillary sinuses followed by ethmoid sinuses , the mean of bilateral maxillary and ethmoid sinus volumes in the chronic sinusitis patients were smaller than that in the normal or control group, the mean bilateral frontal and sphenoid sinus volumes in the chronic sinusitis patients were similar to the normal or control group.