 Hello, I am Dr. Segrishan Sainalo, a third year resident from the Department of Radio Diagnosis of Neel Ratham Sarkar Medical College, Polkata, West Bengal. And I am going to present a topic on the role of city-span or panacea rare sinuses for diagnostic evaluation of sinusoidal pathology in a tertiary care hospital in eastern India. And my co-authors are Dr. Sainatana, Dr. Mama Sajid and Professor Dr. Shodha Priyabhaswam. In the introduction, a wide spectrum of diseases and conditions involve the nasal passage and panacea sinuses, which can be collectively termed as sinusoidal diseases. This includes conditions ranging from information, neoplasms, both benign and malignant infections. Their clinical assessment is hampered by bone structures and for that reason, radiological investigations are of paramount importance. City has become the investigation of choice for radiological diagnosis of nasal and sinusoidal diseases as city of panacea sinuses clearly show aero-possified areas like sinuses and details of bony anatomy. City allows evaluation of the patency of sinusoidal passages, diseases or both. City can show anatomy which are not visualized by physical examinations or even in diagnostic nasal endoscopy. Hence, city PNS is the study of choice for the surgeons before considering functional endoscopy sinusoidal. This can play an important role in excluding presence of aggressive infections, malignancies, bony destructions and local infections. City is the investigation of choice for preoperative evaluation of the nasal cavity and panacea sinuses and is the go standard for inflammatory sinus diseases resulting from obstructions. Corner city measures grossly coalesced with the surgical approach as city helps in the diagnosis of anatomical variations, which if unknown can cause intraoperative and postoperative phase complications. City is the preferred study of choice for functional endoscopic sinus surgery. And for materials and methods, the study area is radio diagnosis department of Neurotensharka Medical College. The study population is 40. Inclusion criteria includes patients referred to radio diagnosis department for city scan of PNS for any complaints, patients above the age of 10 years and patients who have undergone endoscopic sinus surgery. They are relevant histopathological and surgical reports are included. Exclusion criteria includes patients with previous history of sinus surgery, patients with any traumatic conditions involving PNS were excluded from the surgery. For statistical analysis, data were entered into a Microsoft Excel spreadsheet and then analyzed by SPSS, person 27.0, SPSS incorporation, Chicago to USA and Grappard Prism version 5. Data had been summarized as mean and standard deviation from numerical variables and count and percentage for categorical variables. Unpaid proportions were compared by chi-square test and fissure exact test as appropriate. Result and analysis. In our study, 39, which is approximately 97.5% of patients had fibro-optic endoscopic sinus surgery and one, which is 2.5% of the patients had surgery and the virus specimens were taken and sent for histopathological evaluation. The clinical examinations, city findings and histopathological diagnosis were recorded for correlation and data analysis. Findings were analyzed, tabulated and results were obtained. A total number of 40 patients who fulfilled the criteria were included in the study. In our study, 8, which is 20% patients were between 11 to 20 years of age. 6 patients, that is 15% of patients were 21 to 30 years of age. 10% were 31 to 40 years of age and 9, which is 22.5% patients were 41 to 50 years of age and 7, which is 17.5% patients were above 50 years of age. The oldest patient was 65 years old and the youngest patient was 12 years old. There was a male predominance as 23 patients were male compared to 17 patients were female. The male to female ratio was 1.35 is to 1. And the age group distribution, which was discussed before, is given as a level form, where we can clearly see that in the age group of 31 to 40, there was maximum number of patients, which is 10. And 25% of patients were between 31 to 40 years of age. Now, for the result analysis, in our study, one patient had nose bleeding and one patient had chronic nasal discharge, 19 patients had headache. Five patients had headache with nasal obstruction, one patient had nasal discharge and 13 patients had nasal obstruction. So approximately 47.5% of patients, which is the maximum had headache. Patients were categorized accordingly to etiology as developmental, inflammatory, neoplastic, and the maximum number of patients were in inflammatory category, which is 32 in number and 80%. In CT findings, 12 patients had agonazide and three patients had concablosia. One patient had concablosia and agonazide. Seven patients had deviated nasal septum. So, and one patient, among the deviated nasal septum, one patient had deviated nasal septum towards the depth. And agonazide, anatomical, as agonazide has anatomical variations. 11 patients had DNS towards right and five patients had DNS towards right, along with agonazide. In our study, the most common inflammatory pathology was sinusitis. 62.5% of patients had the sinusitis, followed by sinus or poly, 30% patient. In CT findings, five patients had anti-ethymine or sinus. Two patients had anti-ethymine and post-ethymine or sinus. And three patients had frontal sinus. One patient had frontal and anti-ethymine or sinus. One patient had frontal sinus only. Frontal sinus, anti-ethymine or sinus and post-ethymine or sinus, involvement. One patient had frontal and anti-ethymine or sinus. 21% had maxillary sinus. And six patients had maxillary sinus. We didn't hear it, but our sinus involved. In CT findings, we found that three patients had sphunger sinusitis. One patient had juvenile nasopharyngeal angiopyroma. 11 patients had poly, 25% patients had inflammatory sinusitis and 39 patients had negative extra sinus. One patient had positive extra sinus involvement in CT findings. As a result of CM common versus histopathological diagnosis was statistically significant. P value of 0.0257. Chronic sinusitis has 100% sensitivity, 94% sensitivity, 96% positive predictive value, 100% negative predictive value in diagnosis. For fungal sinusitis, the sensitivity was with low 66%, but specific was high, 97.4%. Positive predictive value and negative predictive value was accordingly. Poly have sensitivity of 90.9%, specificity of 94%, positive predictive value of 90%, and negative predictive value of 100%. And V9 neoplasm, and nasopharyngeal angiopyroma have sensitivity, specificity, positive predictive value, and negative predictive value of 100%. The distribution of CM is given as a table. And here you can see that headache has the highest frequency as a complaint, which corresponds to 47.5% of the total complaints. The distribution of type of sinus pathology includes developmental inflammatory and neoplastics in which inflammatory has 32% numbers of involvement, which corresponds to 80% of the total cases. Distribution of specific CT diagnosis includes fungal sinusitis, juvenile nasopharyngeal angiopyroma, poly sinusitis, and among them sinusitis at 62.5% of involvement. And the sensitivity, specificity, positive predictive value, negative predictive value are given, in which we can see that sinusitis had highest sensitivity and negative predictive value. And JNA had 100% sensitivity, specificity, and the lowest sensitivity is for fungal sinusitis, as well as PPP. Discussion from the above study is given here. The majority of the cases were in the age group of 20 to 40 years, and the least number of patients were in the age group of 70 to 80 years. There was a male predominance compared to females. The male to female is the 1.35 is to 1. The demographic distribution of the patient study is compared with other studies done by Venkatasalam and Bhatt, Prabhakar et al. which Metsan, Devan et al. and Chokkot et al. In our study, the most common presenting symptom was Herak, followed by nasal obstruction similar to finding out Kurswa et al. Most common anatomical variations seen was debuted in the nasal system, which correlates well with the study done by Astrodin et al, Maru, Kutta, Amed et al. and Chokkot et al. DNS was more commonly on the right side. Next common anatomical variant was Agamizia et al. In 48% of cases, followed by NTA et al. In our study, the most common pattern in sinusoidal involvement, most common sinus involved was Maxidri sinus, which is followed by NTA et al. Posteria et al. and Spinal sinuses. Prison study course where we study done by Chaitanya et al. Kurswa et al. where Maxidri sinus was most commonly involved. Ostromator was the most commonly involved pattern in inflammatory sinusitis. In our study, the most common pattern was diagnosed on CT, classified based on their imaging features. Sinus or pathology was inflammatory, 80%, followed by developmental symptoms were 5%, benign neoplasmic 2.5%, and similar findings were also found in studies done by Bidro et al, Khan et al, because still in et al. The most common inflammatory pathology of sinusitis, followed by polyps, which was also found in study done by Azam et al. Diagnosed Angiopyrus, which saw the information of Teregopyrtain fossa and bony erosion. The diagnostic accuracy in our study is 100% and consisted of a study done by Kurswa et al. C-physicist or diagnosed as sinusitis by CT reporting, among them two were confirmed by histopathology, making the sensitivity specificity of its similar to study as described by literature in generics et al, which was a retrospective study. In the present study, a good correlation with benign neoplasm, as evidenced by high sensitivity specificity values in cases of chronic sinusitis, 100% and 94% polyp, 90.9% and 94% benign neoplasm, 100% and 100% respectively. However, poor correlation was noted between in sphungal sinusitis, which was supported by the low sensitivity of 66%. Similar results were noted when the positive and negative active values were calculated for all diagnosis. Limitation of our study has small sensitivity, as the study is relatively small, further studies needed with larger study position to substantiate a clinical effect. For conclusion, past the study emphasized the significant role of CT in diagnosis and characterization of area sinusoidal diseases. CT was able to characterize the penis diseases and the extensions. It is also useful in detecting bony involvement. It proves the better sensitivity specificity of CT in evaluation of various sinusoidal pathologies in the body. The importance of it was to accurately differentiate in cases of hunger sinusitis and high density secretions. CT may be used as go standard imaging modality for evaluating the penis disease. Here are the references which were used during my study. Here are some imaging descriptions with findings. Figure 1 describes coronal non-contrast computer tomography image coronasal sinus, there is also mild deviated nasal septum towards the right. Here are coronal non-contrast computer tomography of coronasal sinus, left, middle turbinate concavulosa. In these two images coronal non-contrast computer tomography image of coronasal sinus shows deviated nasal septum towards the right with bony septum as far. Left side deviated nasal septum with septum as far and compensated right into a turbinate hypertrophy. Figure 4 shows coronal image of coronasal sinus and a large right anterior polyp. In this axial section of the contrast in the CT scan shows a large heterogeneously enhancing juvenile isophenyl angiophiloma centered at left spinor pylate informant with bony adhesion and intra sinus extension and extension into the surrounding area. This picture shows CT scan of coronasal sinus which includes allergy phanga sinusitis involving bilateral maxi-ray sinus with remodeling of left maxi-ray sinus medial valve. Thank you.