AccScience Publishing / JCTR / Online First / DOI: 10.36922/JCTR026180035
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ORIGINAL ARTICLE

Computed tomography-based evaluation of anatomical variations in the sinonasal region in symptomatic patients: A cross-sectional study

Pavan Kalyan Kurelli1* ,  Abhigna Bakam1 ,  Boddupalli Saaketh1 ,  Siva Subba Rao Pakanati1
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1 Department of ENT, Mamata Medical College, Khammam, Telangana, India
JCTR, 026180035 https://doi.org/10.36922/JCTR026180035
Received: 1 May 2026 | Revised: 8 July 2026 | Accepted: 9 July 2026 | Published online: 23 July 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Background: Sinonasal anatomical variations are common structural alterations that influence nasal airflow, sinus drainage, and the safety of functional endoscopic sinus surgery. Computed tomography of the paranasal sinuses (CT PNS) is the gold standard for preoperative assessment of these variations; however, region-specific prevalence data from South Indian cohorts remain limited. Aim: This hospital-based descriptive cross-sectional study aimed to systematically evaluate the prevalence and patterns of key sinonasal anatomical variations in symptomatic patients. Methods: Fifty patients aged 18 years and above who presented to the ear, nose, and throat (ENT) outpatient department of a tertiary care hospital and had undergone CT PNS imaging were enrolled through convenience sampling over a three-month period. Patients with prior sinonasal surgery or recent facial trauma were excluded. CT images were reviewed using standardized high-resolution parameters by an experienced radiologist in collaboration with the ENT team. Data were summarized using descriptive statistics, including frequencies, percentages, means, and standard deviations. Results: Among the 50 patients (mean age, 33.0 ± 14.0 years; 58% female), 70% had a deviated nasal septum, with left-sided deviation being the most common pattern (38.0% of all patients). Septal spurs were present in 46.0%, with spur-induced turbinate impingement in 34.0% of all patients. Inferior turbinate hypertrophy was the most prevalent finding (86.0%), predominantly bilateral (58.0%). Middle turbinate pneumatization (concha bullosa) was identified in 34.0%. Keros type II (62.0%) and Delano type I (74.0%) were the dominant skull base and optic nerve configurations, respectively. Conclusion: Common anatomical variations were frequently identified in symptomatic South Indian patients. Relevance for patients: Systematic CT PNS evaluation is essential for preoperative planning, and region-specific normative data are recommended to enhance surgical safety.

Graphical abstract
Keywords
Computed tomography of the paranasal sinuses
Sinonasal anatomical variations
Deviated nasal septum
Concha bullosa
Keros classification
Functional endoscopic sinus surgery
Funding
None.
Conflict of interest
The authors declare no conflicts of interest.
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Journal of Clinical and Translational Research, Electronic ISSN: 2424-810X Print ISSN: 2382-6533, Published by AccScience Publishing
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