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CT Scan-Normal Sinuses

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CT Scan-Normal Sinuses

CT scan of relatively normal sinuses:

 

LEGEND: + - border of maxillary sinus, * - maxillary sinus ostium, U - uncinate process, E - ethmoid sinuses, IT- inferior turbinate, MT- middle turbinate, S - septum, C - concha bullosa.

Note that the CT scan is a computerized X-Ray taken in the same way as the first diagram is drawn, as if you were able to look head on into the sinuses.

On the CT scan, bone appears white, air appears black, and soft tissue, fluid, or muscle is varying shades of gray. Of note in the bottom portion of the scan is a ray pattern emanating from the teeth. This is as a result of poor penetration of the x-rays through the metal in the teeth.

When evaluating the sinuses for sinusitis, notice the thickening of the lining of the sinus. Note on the patient's left side (your right) at the + sign, there is a very sharp distinct border between the black air in the maxillary sinus and the white bone. As you will see later, sinusitis is manifested by grayish thickening of the lining of the sinus.

The asterisk (*) is at the point where drainage occurs from the maxillary sinus into the nose through part of the ostiomeatal unit. The maxillary sinus ostia is bounded below by the uncinate process (U) and above by the lower bony portion of the ethmoid sinuses (E). A narrowing in this area obviously can be very critical. The ethmoid sinuses, as can be seen, are much smaller than the maxillary sinuses.

On the right side (your left), one can see the middle turbinate (MT) as well as inferior turbinate (IT). There is a slight deviation of the septum (S) to the right side (your left), but in this case it is unlikely that it is causing any obstruction. Of note is that there is air contained in the middle turbinate on the left (C-short for concha bullosa). This represents a normal anatomical variant in which the ethmoid sinuses have pushed down into the middle turbinate. In this case, it does not appear to have caused a problem, but often it will cause a significant enlargement of the middle turbinate and consequently an obstruction on one side of the nose.

 

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