CBCT – RADIOLOGICAL ANATOMY OF THE NASAL CAVITYAND THE PARANASAL SINUSES
Authors: Kutsa S. O. 
Published: April 2022

At present, modern otorhinolaryngology cannot be imagined without such a research method as computed tomography (CT) – a method of non-destructive layer-by-layer study of the object internal structure, which was proposed in 1972 by A. Kormak. The method is based on the measurement and complex computer processing of the difference in X-ray attenuation by different density tissues. Confidently starting in our country in the 80th of the last century, CT is developing, becoming an increasingly perfect method, practically the main X-ray diagnostics method in otorhinolaryngology. Cone-beam computed tomography (CBCT) was first adapted for potential clinical use in 1982 at the Mayo Clinic Biodynamics Research Laboratory (USA). Initially, the technique found application in angiography, in which soft tissues can be brought in to benefit from the possibility of obtaining high temporal and spatial resolution. Available for wide use in the maxillofacial region diagnosis, CBCT became available in 2001 (New Tom QR DVT 9000, Italy). CBCT is a radiological examination method based on the X-rays use by rotating an X-ray tube around a patient to obtain data. It is mainly used in dental practice, but more and more often this technique is introduced into otolaryngological practice. Because modern devices make it possible to obtain all sinuses images at once and characterize them. The biggest advantage of this study is a much lower ionizing radiation dose along with almost the entire range of traditional CT possibilities. The CBCT use is growing in the clinical arena due to its ability to provide 3D information during interventions, its high diagnostic quality (sub-millimeter resolution), and its short scanning times. However, clinical and anatomical evidence pertaining to its efficacy is lacking. The presented article describes the possibilities of using CBCT to characterize the nose and paranasal sinuses anatomical features.
The aim. To show the nose and paranasal sinuses X-ray anatomy by retrospective analysis of cone-beam computed tomography images.
Methods. To study the topographic and anatomical structures of the facial skull in the norm we analyzed 30 CBCT patients’ images (18 men and 12 women aged from 10 to 62 years) in whom there was no nose and paranasal sinuses pathology, or atypical variants of this area development were determined. The study was conducted using Planmeca ProMax® 3D's innovative Maxillofacial tomograph, which covers the entire sinus area, making it an excellent solution for 3D and 2D visualization of the paranasal sinuses. Descriptions are made using Planmeca Romexis viewer software.
Results. With the help of the modern method of radiological examination, particularly CBCT, it is possible to clearly visualize and differentiate the nose and sinuses’ anatomical structure features. As a result of the analysis, we confirmed the fact that the CBCT use is appropriate in patients. This technique allows not only to see but also to measure various indicators (shape, anatomical formations size; contours;) and to compare the nose and paranasal sinuses bone structures. Also, the 3D reconstructions use makes it possible to compare the positions of different anatomical structures of the facial skull. The CBCT effectiveness for assessing the individual anatomy of the nasal cavity and paranasal sinuses has been shown, which can be used both for patients’ preoperative preparation and at the stage of diagnosis and treatment of the nasal cavity and maxillary sinuses various diseases.