CT PNS - Coronal - Plain

Overview

CT PNS – Coronal – Plain is a specialized, non-contrast computed tomography (CT) scan that focuses on the paranasal sinuses (PNS) using a single, but crucial, imaging plane: the coronal view. This vertical slice, taken from the front of the face backward, is particularly valuable because it closely mirrors the view surgeons use when performing endoscopic sinus surgeries. Unlike contrast-enhanced scans, the plain coronal CT is designed to highlight the intricate bony structures of the sinuses, nasal septum, and adjacent facial bones without the use of intravenous dye. It remains one of the most requested and clinically significant imaging tools in ENT practice, especially for patients presenting with chronic sinus problems, nasal obstruction, facial trauma, or congenital structural concerns.

Purpose of CT PNS – Coronal – Plain

The coronal view offers a unique perspective, allowing doctors to assess the relationship of sinus structures in a way that is extremely practical for diagnosis and treatment planning. Some of the most common clinical indications include:

1. Chronic and Recurrent Sinusitis

• Evaluates mucosal thickening, air-fluid levels, and obstruction of the sinus drainage pathways.
• Assesses the degree and distribution of chronic inflammation.

2. Nasal Obstruction and Deviated Septum

• Clearly visualizes the nasal septum’s shape and alignment.
• Detects bone spurs, concha bullosa (air-filled middle turbinate), and other variations affecting airflow.

3. Pre-Surgical Planning for Functional Endoscopic Sinus Surgery (FESS)

• Provides surgeons with a detailed “roadmap” of the anatomy as they would see it during surgery.
• Helps identify variations that could complicate surgical procedures, improving safety and outcomes.

4. Nasal Polyps and Mucosal Lesions

• Shows the location and potential impact of polyps or mucous retention cysts.
• Assists in determining whether they block the natural sinus drainage routes.

5. Facial Trauma

• Detects fractures of the sinus walls, nasal bones, and the orbital floor.
• Helps assess displacement of bone fragments and related structural damage.

6. Congenital and Developmental Anomalies

• Identifies underdeveloped or absent sinuses, septal deformities, and other congenital structural changes.

7. Post-Surgical Follow-up

• Monitors healing and bone remodeling after sinus surgery.
• Checks for any residual disease, scar tissue, or complications.

8. Evaluation of Facial Pain and Headaches

• Helps identify or rule out sinus disease as a potential cause of unexplained facial pain or chronic headaches.

Procedure for CT PNS – Coronal – Plain

The test itself is quick, painless, and performed on an outpatient basis. Typically, the procedure is completed in about 10 minutes.

Before the Scan

• Generally, no fasting or special preparation is required.
• Patients are advised to remove glasses, earrings, hairpins, and other metal objects near the face and head to avoid image artifacts.
• Inform the technician if you are pregnant or suspect pregnancy, as radiation exposure should be avoided in such cases unless absolutely necessary.

During the Scan

• The patient lies on the CT scanner table, positioned carefully to ensure accurate coronal imaging.
• The scanner takes thin, vertical slices from the front of the face backward.
• The procedure is entirely painless; patients simply need to remain still for a few seconds to ensure sharp, high-resolution images.

After the Scan

• Patients can return to their normal daily activities immediately, as there is no sedation or contrast dye involved.
• The radiologist reviews the images and prepares a detailed report, which is typically shared with the referring doctor within 24–48 hours.

Benefits of CT PNS – Coronal – Plain

This test offers multiple advantages, particularly in ENT diagnostics and surgical planning:

• High-resolution bone imaging: Ideal for assessing the bony architecture of the sinuses and nasal cavity.
• Surgical relevance: The coronal view replicates the perspective seen during endoscopic sinus procedures, making it a critical guide for surgeons.
• Non-invasive and quick: A routine outpatient procedure without the need for intravenous dye or sedation.
• Safe for contrast-sensitive patients: Suitable for those with allergies to contrast dye or kidney problems.
• Accurate pre- and post-operative assessment: Helps evaluate disease extent before surgery and healing afterward.

Conditions Commonly Diagnosed

• Chronic sinusitis and mucosal thickening.
• Deviated nasal septum and bone spurs.
• Nasal polyps and mucous cysts.
• Fractures affecting the sinus walls, nasal bones, or orbit.
• Congenital anomalies like hypoplastic or absent sinuses.
• Post-surgical residual disease or scar tissue.
• Obstruction of natural sinus drainage pathways.
• Structural causes of chronic facial pain or headache.

Risks and Considerations

While CT PNS – Coronal – Plain is generally safe and low risk, a few points are important:

Radiation Exposure

• CT scans involve exposure to ionizing radiation; however, modern scanners use low-dose techniques to minimize this risk.

Pregnancy

• Typically avoided unless the scan is essential and benefits outweigh the risks.

Motion Artifacts

• Patients need to remain still during the scan; any movement can reduce image clarity.

Limited Soft Tissue Detail

• As a plain (non-contrast) scan, it may not show subtle vascular changes or certain soft tissue abnormalities as clearly as a contrast-enhanced CT.

When Might Your Doctor Recommend It?

Doctors may suggest this scan if you:

• Have frequent or long-lasting sinus infections.
• Suffer from persistent nasal blockage or breathing difficulties.
• Plan to undergo sinus surgery or septoplasty.
• Have facial pain, pressure, or chronic headaches without an obvious cause.
• Are suspected of having nasal polyps, cysts, or mucosal lesions.
• Suffered facial trauma affecting the nasal or sinus bones.
• Need follow-up imaging after sinus surgery.
• Have congenital anatomical differences requiring evaluation.

Conclusion

The paranasal sinuses are delicate, air-filled structures that play an important role in breathing, voice resonance, and facial structure. Problems like chronic infections, trauma, and structural changes can significantly impact comfort and quality of life. CT PNS – Coronal – Plain offers a focused, high-resolution view of these structures, helping ENT specialists and surgeons diagnose problems accurately, plan safe surgeries, and monitor recovery. Its ability to mimic the surgeon’s view during procedures makes it indispensable in modern sinus care.