Revisiting the Anatomy of the Paranasal Sinuses and their Radiological Correlations in Sinusitis: A Mini Review

This mini review aims to revisit the anatomy of the paranasal sinuses and highlight key radiological correlations relevant to the diagnosis, classification, and management of sinusitis.
A narrative mini-review was conducted using standard anatomy texts and peer-reviewed literature focusing on paranasal sinus anatomy, embryological development, anatomical variations, and imaging features of sinusitis. Emphasis was placed on radiological evaluation using high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI).
The maxillary, frontal, ethmoidal, and sphenoidal sinuses demonstrate complex anatomy, variable development, and close relationships with vital structures. HRCT remains the imaging modality of choice for assessing sinonasal anatomy, drainage pathways, and obstructive patterns. MRI provides complementary information in evaluating soft-tissue disease and complications. Common anatomical variations, including concha bullosa, deviated nasal septum, Haller cells, Onodi cells, sinus hypoplasia, and pneumosinus dilatans, were identified as important contributors to impaired sinus drainage and recurrent or chronic sinusitis. Distinct imaging patterns were noted in acute, chronic, and allergic fungal rhinosinusitis, as well as in orbital, intracranial, and osseous complications.