الفهرس 
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Abstract
This study evaluates the role of MDCT especially coronal MDCT in evaluation of anatomical variations of nasal and paranasal sinuses in patients with chronic rhinosinusitis and will undergo FESS operations.
This study is designed to make the surgical procedures as safe, accurate, rapid and with less complication as possible. Complete evaluation was recommended for patients who have failed medical treatment and have history suggestive of chronic sinusitis regardless of the findings on routine examination.
This study included 20 patients presented to the outpatient Clinic of otorhinolaryngology in El-Minia University Hospital with signs and symptoms of chronic rhinosinusitis. Their age from 6 years to 45 years with a mean of age 23.45 were representing as 14 females and 6 males.
Every patient was subjected to the following:
a- Full history taking.
b- Complete clinical examinations.
c- CT scanning: All patients were undergone MDCT.
The coronal plane was selected because it was the best view that demonstrates more details about anatomical variations of the nose and paranasal sinuses and related structers.
d- FESS operation.
Most patients with chronic sinusitis can be managed with appropriate medical therapy. Antibiotics, decongestants, and other sinus medications lead to a resolution of mucosal inflammation and the re-establishment of sinus drainage. In advanced cases, however, ostial stenosis and infection may persist, necessitating surgical intervention.
Conclusion:
MDCT of the paranasal sinuses has improved the visualization of paranasal sinus anatomy and has allowed greater accuracy in evaluating paranasal sinus disease.
Surgery in the nose and paranasal sinuses should only performed if the surgeon has a clear understanding of the anatomy of the nose and paranasal sinuses and their variations. Such an understanding comes with the ability to read MDCT in all 3 planes and reconstruct a 3-D picture of anatomy. The surgeon should try to predict the anatomy before operating and if the preoperative assessment proved to be incorrect at surgery, the anatomic reconstruction should be reviewed and any errors identified.
Regular repetition of this technique should improve the surgeon’s ability to read and 3 dimensionally reconstruct the anatomy of the nose and paranasal sinuses and their variations, and improve the surgical outcome.