Preface

If not coincidence, at least it was in the same decade when endoscopic sinus surgery and computed tomography were introduced to Otolaryngologists, which have changed the approach to sinonasal problems dramatically. Probably, there are no such coincidences in the history of medicine where two new modalities of approaches appeared at the same time, to deal with the same problem and complement each other while doing so. The asset of improved visualization and magnification, available through endoscopes, has revolutionized the understanding of the pathophysiology of sinusitis, and resulted in better appreciation of the anatomy of the paranasal sinuses. However, non-invasive diagnostic endoscopy has its limits, and the deeper structures cannot be evaluated by endoscopy alone . Computed tomography, which has an ability to optimally display bone, soft tissue and air simultaneously, can not only complement endoscopic examination, it can provide a surgical road map delineating the anatomy, defining the obstructing lesions, and noting anatomic variations that may predispose to operative complications.

Computed tomography has scored over plain radiographs and polytomographs as an imaging modality in this area. Even though surpassing CT's capacity to image soft tissue, MRI is less suitable as an imaging modality for evaluation of this area because of the similar signal intensities for bone and air.

CT scanning has become imaging modality of choice and the cooperation required between the Radiologist and the Surgeon is mandatory for both evaluation and treatment of paranasal disorders. It is of paramount importance on the part of the Otolaryngologists to understand interpretation of CT films, Radiological anatomy of the paranasal sinuses, Anatomical variations and the pathology to complement the endoscopy findings for initial screening, surgical planning, reduce postoperative complications and to provide better results.

Though many articles and books are available, there was a need for a book which helps in systematic interpretation of CT films, at ridiculously low price or free of cost. Hereby we make an attempt to accomplish this in this detailed but not exhaustive book with lot of pictures for easy understanding, aiming mainly the beginners and postgraduates.

Prahlada N.B

1st Feb' 1999
Perinthalmanna

Author's Note

Before reading this book kindly review your anatomy from a standard textbook. We suggest "Essentials of endoscopic sinus surgery" by Heinz Stammberger and Michael Hawke and/or "Endoscopic sinus surgery-New Horizons" by Nikhil J. Bhatt. Well, if you are some kind of walking encyclopedia, go ahead.

As such CT scan has become imaging modality of choice for paranasal sinus area, only this modality is discussed. CT sections at most important levels, five coronal and one axial sections are discussed. You may study sections at other levels in relation to these. Most of the pictures in this book were in slide transparency form, few of them very old. The clarity and resolution may have been lost while re-photographing and making them positive prints and also during actual printing process of this book. We regret for the same. Most of these images were interpreted by different Otolaryngologists and Radiologists individually, to avoid observer bias. Still if there are any mistakes please write to us so that we can correct ourselves during reprint or next edition. You must be having a good collection of such pictures. If you wish to be part of the future editions of this book, kindly send them to us. Kindly write to us about, content, form, designing and quality of printing of this book.

Prahlada N.B

1st Feb' 1999
Perinthalmanna