 Hello everyone. Myself, Dr. Deepali Vittal Trimukhey, working as a second year junior resident in Department of Radio Diagnosis at Mikhail Vaalavankar Rural Medical College, Patna Kirti. So my topic for paper presentation is anatomical variations of pharynism sinuses and its association with sinusitis. Chronic sinusitis refers to ongoing thromptom sinus infection inflammation. It is a common pathology encountered day to day, pharynism sinuses variation are commonly seen in patients of chronic sinusitis and hence need further assessment. CT is an excellent modality for evaluation of anatomy variants and pathology related to pharynism sinuses especially prior to FESS that is functional endoscopic sinus surgery. This study is a case series which correlates anatomical variation of pharynism sinuses and its association with chronic sinusitis. The aim of my study is to evaluate prevalence of anatomical variants of pharynism sinuses and its likely association with chronic sinusitis and to evaluate the variant that strongly contributes to chronic sinusitis. The type of study is retrospective. My study included 50 patients with symptoms of sinusitis who underwent CT in past two months in our department, exclusion criteria included patients with sinusoidal malignancy and history of accidental facial injuries. The anatomy of pharynism sinuses was evaluated in both bone and soft tissue window and findings were further included in the study. Falling parameters were observed in the study first is involved sinuses that is frontal, maxillary, ethomodal and spinoidal air sinuses, deviated meso-ceptum, humidized middle turbinate that is concabulose, ethomodal air cell that is phylocell and paradoxical middle turbinate. So, the first image is axial CT bone window which demonstrates concabulose in right middle turbinate and nasal septum deviation towards the left side. The second image is coronal CT bone window which demonstrates paradoxical left middle turbinate. The third image is the coronal CT bone window which shows phylocell on the left side. In this slide, the first image shows marked mucosal thickening of bilateral maxillary sinuses and infigure turbinate hypertrophy. The second image is a case of frontal sinusitis and the third image is a case of spinoidal sinusitis. Among the 50 patients who underwent CT, the most common type of sinus involvement was maxillary sinus which comprised of almost 64% followed by frontal, ethomodal sinus and spinoidal sinus. Anatomical variants observed in these patients were deviated nasal septum was present in almost 36% of cases, concabulose in 30% followed by inferior turbinate hypertrophy in 14% hyalurcell in 4% and paradoxical middle turbinate in 2%. Notably, the presence of deviated nasal septum showed a relatively higher association with sinus involvement occurring in 36% of sinus cases, concabulose, another anatomical variant was found in 30% of sinus patient further suggesting a potential relationship with sinusitis. So concluding my study, deviated nasal septum is a prevalent factor in chronic sinusitis patient potentially contributing to disruption in normal mucosiliary clearance of the paranesal sinuses. Anatomical variations such as hyalurcell although incidentally found in sinusitis patient lack a strong correlation to the condition. Taking this anatomical variation can guide surgeons in performing functional endoscopic sinus surgeries by providing crucial information about patient specific factors. Thank you.