Anatomical variations may predispose to repeated sinus infections

1. Anatomical Variations In Nose &
Paranasal Sinuses
Dr Shrikant Phatak
Head of ENT Department
Choithram Hospital & Research Center
Indore

2. Anatomical Variations In Nose &
Paranasal Sinuses
• The nose & PNS have a lot of anatomical
variations which the surgeon should be aware
of so as to prevent complications and also for
complete & successful FESS.
• Even the two sides of the nose may not be the
mirror image.

3. Concha DNS
Pneumatised middle turbinate narrows ipsilateral middle meatus &also
narrows the opposite side by deviating septum

4. Spur Paradoxical MT
Spur can cause friction with turbinate & cause facial pain also narrowing of
ipsilateral middle meats due to paradoxical concha that may lead to sinusitis

5. Left Concha Bullosa

6. Concha Bilateral ,Infected

7. Paradoxical MT

8. Large Agar ,Infected Frontal
Big Agar can narrow ipsilateral frontal recess or opposite recess by
deviating bony septum to the opposite side

9. Large Agar
CT & Endoscopic view of Big Agar

11. Pneumatised Medially Bent Uncinate

12. Haller Cell Thick Mediatized UP

13. Big Pneumatised Uncinate
Pneumatised Uncinate narrows the meatus on same side or can narrow opposite
middle meatus by deviating the septum

14. Big Bulla Haller Cell

15. Low Anterior Ethmoidal Artery

16. Pneumatised SupTurbinate Accessory Ostia

17. Keros Type 1 & 2

18. Keros3 AsymmetricRoof

19. Agenesis Antrum

20. Agenesis of Sinuses

21. Turbinectomy Antrostomy

22. Fat Prolapse

23. Onodi

24. Persistent Adenoids In Adult 56 yrs

25. Pneumatised Superior Turbinate

26. Multiple Variations

27. Multiple Variations

28. Anatomical Variations In Nose &
Paranasal Sinuses
• It is said that if there are more than one
anatomical variations there is more propensity
for sinus infection but this may not be the
case

29. Disclaimer
• The information contained in the presentation is based on the personal
experience and cases collected at Choithram Hospital Indore over the last
20 years.
• It is intended for the use of Medical students ENT post graduates &
Radiology post graduates
• The views expressed are purely on personal opinion. viewers can make
their own opinion. For any confusion please contact sole author.
• Everybody is allowed to copy or download the material best suited to him.
I am not responsible for any controversies arising out of the presentation.
• For any suggestions or corrections you may please contact
phatak_shrikant@yahoo.in

30. Anatomical Variations In Nose &
Paranasal Sinuses
• Thank you