CLINICAL AND COMPUTED TOMATOGRAPHY CHARACTERISTICS OF CHRONIC BILATERAL RHINOSINITIS PATIENTS SURGERED WITH ENDOSCOPIC RHINOSINUS AND MIDDLE TURBULOPLASTY

ABSTRACT Background: Chronic rhinosinusitis (CRS) is defined as inflammation of the nasal and paranasal sinus mucosa lasting for 12 weeks or longer. This condition causes persistent symptoms and has a significant negative impact on patients’ quality of life. In the pathophysiology of CRS, the middle turbinate plays an important role, as its pathological and anatomical variations—such as concha bullosa or paradoxical curvature—can narrow the osteomeatal complex, which is considered the key mechanism contributing to the disease. Functional endoscopic sinus surgery (FESS) with middle turbinate resection restores normal drainage and ventilation, offering an optimal treatment approach. Objective: To describe the clinical and paraclinical characteristics of patients with bilateral chronic rhinosinusitis undergoing functional endoscopic sinus surgery with middle turbinate remodeling. Subjects and Methods: A cross-sectional descriptive study was conducted on 35 patients with bilateral CRS who underwent FESS with middle turbinate remodeling. Results: The male-to-female ratio was 1.5:1, with a mean age of 45.9 ± 14.6 years. Nasal obstruction and rhinorrhea were the most common symptoms. Most patients had moderate SNOT-22 scores. Endoscopic examination revealed that grade II and grade III nasal polyps were the most frequent findings and were correlated with the severity of clinical symptoms. On computed tomography (CT) imaging, concha bullosa of the middle turbinate was the most common anatomical variation. Most patients had osteomeatal complex involvement, and partial sinus opacification was observed in 42.86% of cases. Conclusion: The patients presented with typical and significant clinical manifestations. Computed tomography proved to be a valuable tool for diagnosis and surgical planning in chronic rhinosinusitis with middle turbinate abnormalities.