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      Preoperative computed tomography evaluation of the paranasal sinuses: what should the physician know? - pictorial essay Translated title: Avaliação pré-operatória das cavidades paranasais por tomografia computadorizada: o que o médico deve saber? - ensaio iconográfico

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          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.

          Translated abstract

          A introdução da cirurgia endoscópica sinusal funcional na década de 80 proporcionou uma mudança drástica no tratamento de pacientes com rinossinusite, melhorando a qualidade de vida mediante a retirada de processos patológicos ou variações anatômicas que provocam obstrução nas vias de drenagem dos seios paranasais. Porém, apesar do uso rotineiro da tomografia computadorizada na avaliação anatômica dos seios paranasais, a maioria dos laudos radiológicos ainda carece de informações que orientem o planejamento cirúrgico. O objetivo deste ensaio iconográfico é demonstrar, por meio de tomografia computadorizada, as principais variações anatômicas dos seios paranasais, cujo reconhecimento é fundamental para o planejamento pré-operatório, a fim de evitar falhas terapêuticas e iatrogenias.

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          Most cited references17

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          Determinants of outcomes of sinus surgery: a multi-institutional prospective cohort study.

          1) To measure the proportion of patients with chronic rhinosinusitis (CRS) who experience clinically significant improvement after endoscopic sinus surgery (ESS) in a prospective, multi-institutional fashion. 2) To identify preoperative characteristics that predict clinically significant improvement in quality of life (QOL) after ESS.
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            Complications of primary and revision functional endoscopic sinus surgery for chronic rhinosinusitis.

            The goal of this study was to determine the incidence of major complications following primary and revision functional endoscopic sinus surgery (FESS). In addition, this study aimed to determine factors associated with the occurrence of complications including patient and provider characteristics and the use of image guidance system (IGS) technology.
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              The Preoperative Sinus CT: Avoiding a "CLOSE" Call with Surgical Complications.

              Although functional endoscopic sinus surgery is an effective means of treating patients with recurrent and refractory sinusitis, the procedure is not without risk of serious surgical complications. Preoperative computed tomography (CT) affords radiologists the opportunity to prospectively identify anatomic variants that predispose patients to major surgical complications; however, these critical variants are not consistently evaluated or documented on preoperative imaging reports. The purpose of this review is to illustrate important anatomic variants and landmarks on the preoperative sinus CT with a focus on those that predispose patients to surgical complications. These critical variants and landmarks can be quickly recalled and incorporated into the preoperative imaging report through the use of the mnemonic "CLOSE": Cribriform plate, Lamina papyracea, Onodi cell, Sphenoid sinus pneumatization, and (anterior) Ethmoidal artery. This approach will greatly enhance the value of the preoperative imaging report for referring otolaryngologists and help reduce the risk of surgical complications. (©) RSNA, 2016 Online supplemental material is available for this article.
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                Author and article information

                Journal
                Radiol Bras
                Radiol Bras
                rb
                Radiologia Brasileira
                Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
                0100-3984
                1678-7099
                Mar-Apr 2019
                Mar-Apr 2019
                : 52
                : 2
                : 117-122
                Affiliations
                [1 ] Instituto Estadual do Cérebro Paulo Niemeyer - Departamento de Radiologia, Rio de Janeiro, RJ, Brazil.
                [2 ] Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
                Author notes
                Correspondence: Dr. Bruno Niemeyer de Freitas Ribeiro. Instituto Estadual do Cérebro Paulo Niemeyer - Departamento de Radiologia. Rua do Resende, 156, Centro. Rio de Janeiro, RJ, Brazil, 20231-092. E-mail: bruno.niemeyer@ 123456hotmail.com .
                Author information
                https://orcid.org/0000-0002-1936-3026
                https://orcid.org/0000-0003-1483-2759
                https://orcid.org/0000-0001-8797-7380
                Article
                10.1590/0100-3984.2017.0082
                6472854
                ca4a06f6-a7df-4096-8088-a6249da19097

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 18 May 2017
                : 01 June 2017
                Categories
                Pictorial Essay

                tomography, x-ray computed,paranasal sinuses,rhinitis,sinusitis,tomografia computadorizada,seios paranasais,rinite,sinusite

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