• Shahla Mohammed Rasul Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Kawa Abdullah Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.
  • Tania Abubakr Ali X-Ray Center, Ministry of Health, Directorate of Sulaimani, Kurdistan Region, Iraq.



CT scan, Anatomical variations, Agger nasi cell, Aeptal deviation, Concha bullosa



The anatomy of the nasal cavity and paranasal sinuses differs significantly, certain distinct variations are found most frequently among the general population. This makes CT scan an important preoperative investigation in the diagnoses and treatment of rhinosinusitis. 


To evaluate the types and frequency of anatomical variants in the nose and paranasal sinuses depicted by computed tomography (CT) in patients with chronic rhinosinusitis.

Patients and Methods

This study conducted on 76 patients with clinically suspected chronic rhinosinusitis whose age range from 12–77 years, 31 Males and 45 Females. CT scan were done for them in Sulaimani Teaching Hospital/ Department of Radiology, from March 2016 to September 2016. 


In this study, there were 375 variations which were divided on 27 types of variants, 6 of them were more common and represented 66 % of all variations, they were (1) agger nasi cells 79%, (2) nasal septal deviation 78%, (3) concha bullosa 58%, (4) septal spur 46%, (5) onodi cells 36%, (6) anterior clinoid pneumatization 32%. The other 21 less common variants formed 34 %. We found significant association between anterior clinoid pneumatiazation and optic canal dehiscence, also between incidence of atelectatic uncinate process and maxillary sinus hypoplasia. 


The most frequent variations where those involved ethmoidal sinus, nasal septum and middle turbinates, particularly agger nasi cell, nasal septum deviation and concha bullosea.


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