Preoperative computed tomography evaluation of the paranasal sinuses: what should the physician know? - pictorial essay

Abstract The introduction of functional endoscopic sinus surgery in the 1980s brought about a drastic change in the treatment of patients with rhinosinusitis, improving quality of life through the removal of pathological processes or anatomical variations that obstruct the drainage pathways of the paranasal sinuses. However, despite the routine use of computed tomography in the anatomical evaluation of the paranasal sinuses, most radiological reports still do not provide sufficient information to guide the surgical planning. The objective of this pictorial essay was to demonstrate, through computed tomography, the main anatomical variations of the paranasal sinuses, the recognition of which is fundamental for preoperative planning, in order to avoid treatment failure and iatrogenic complications.

摘要 20世纪80年代功能性鼻内镜鼻窦手术（functional endoscopic sinus surgery）的首次临床应用，使鼻-鼻窦炎（rhinosinusitis）患者的治疗迎来了颠覆性变革：通过清除阻塞鼻旁窦（paranasal sinuses）引流通路的病理改变与解剖变异，显著提升了患者的生活质量。然而，尽管计算机断层扫描（computed tomography，CT）已常规用于鼻旁窦的解剖学评估，但多数放射学报告仍无法提供足够信息以指导手术规划。本影像专题旨在通过计算机断层扫描图像，展示鼻旁窦的主要解剖变异，对该类变异的精准识别是术前规划的核心前提，可有效避免治疗失败与医源性并发症。