Anatomical Variations of Rhinogenic Headache and Its Relation with Sinusitis: A Computerized Tomography (CT) Scan Study

Background: Variable anatomy, hallmark of sinonasal region is the reason for the etiology of sinonasal symptoms such as rhinogenic headache. This study aimed to investigate the incidence of anatomical variations of the nasal cavity and paranasal sinuses in sinusitis patients with complaint of rhinogenic headache on computed tomography of paranasal sinuses, and the correlation of these variants with a rhinogenic headache. Methods: A prospective cross-sectional study (n=50) of 18-60 years having sinusitis with rhinogenic headache was steered at the Department of Radiology in the PNS Shifa Hospital of Karachi, Pakistan, between June-December 2021. After obtaining written informed consent, all subjects were investigated for various anatomical variants of the sinonasal region detected on computed tomographic scans of paranasal sinuses and were correlated with a rhinogenic headache. The Chi-square test and Pearson correlation were applied for statistical analysis and the level of significance was set at p≤ 0.05. Results:  The most common anatomical variant of sinonasal region detected was agger nasi cells 32(64%) (Right: r/r -0.24, p =0.09; Left: r/r -0.28, p = 0.04), followed by deviated nasal septum 28(56%) (r/r 0.04, p= 0.75), concha bullosa 23(46%) (r/r 0.07, p=0.59), deviated nasal septum with bony spur (r/r 0.07, p=0.62) and other variants. The overall, study found male (68%) predominance. Significant association existed between rhinogenic headache and some of the anatomical variants along with sinus mucosal thickening (p<0.05). Conclusion: The significant association (p<0.05) was found between rhinogenic headache and different anatomical variants like agger nasi cells, left-sided agger nasi cells, right-sided Haller’s cells, left-sided maxillary and ethmoid sinusitis. Keywords: Rhinogenic Headache; CT-PNS; Sinonasal Region; Anatomical Variants

Applanation Ultrasound versus Optical Biometry in the measurement of Axial Length in a Normal Eye

Objectives Accurate measurement of the axial length (AL) of the eye is important to make sure that the patient is emmetropic postoperatively. Multiple studies conducted around the globe compare AL using optical and ultrasound biometry. However, results are still inconclusive, as some studies stated that there is no difference in both modalities, whereas other studies considered optical biometry to be more superior. We aim to compare AL measurements using applanation ultrasound and optical biometry AL Scan, in Islamabad, in order to find out which modality is more superior. Methods This was a prospective cross-sectional study that was conducted at the department of Ophthalmology, PAF Hospital, E9 Islamabad. The study was conducted over a period of eight months, from April to November 2023. Participants were enrolled using non-probability, consecutive sampling. The axial length of each eye was measured by both optical and ultrasound biometer. Results There were 80 eyes of 40 participants including both males (77.5%) and females (22.5%) aged between 16-58 years. The axial length using the optical biometer showed a greater value ranging from 22.01 to 30.18mm with a mean value of 23.89 ± 1.31mm whereas the axial length measured using applanation ultrasound was 21.62 to 30.00mm with a mean of 23.53 ± 1.29mm. The mean difference between both was 0.36 ± 0.21mm which was statistically significant (P &lt;0.005). Conclusion There is a statistically significant difference between the mean readings of the AL measured by the IOL master and ultrasound biometer, so both the devices cannot be used interchangeably