 Good morning, everyone. Today, I'm going to present my paper on the role of multi-slide CT scanner in the assessment of osteo-metal complex of peronazole sinuses in chronic sinusitis patients. We're going to discuss about the introduction, objectives, material and methods, results, discussion, conclusion and references. So, osteo-metal complex is a small compartment located in the region between the middle turbinate and the lateral nasal bone in the middle muhattis. It represents a final common pathway for drainage and maintenance of the frontal maxillary and the anterior ithmoid cells. Any obstruction by the anatomical variation thus can cause chronic sinusitis. So, in this image we can see this is the orbit, this is the median one of the orbit, this is the middle turbinate, this area is the middle muhattis, this is the nasal symptom, insinid process, inferior turbinate and the maxillary sinus. So, a precise knowledge of the normal anatomy of peronazole sinus is essential, especially for the clinicians, so that they can perform the endoscopic sinus surgery and they can plan the surgery. Conventional radiographs are of limited diagnostic value as they don't allow for a robust analysis of the anatomical variants and has a poor sensitivity for the mucosal disease in the peronazole sinus. CT is a non-invasive procedure, it has ability to delineate anatomical detail and the mucosal disease of the sinus. CT has ability to image distilled structures such as posterior ethmoid and the spinoid sinuses, so for these reasons CT scan is the imaging modality of choice. It is important for the radiologist to be aware of the osteometrial complex variant and describe them in a comprehensive way for the clinicians. Objective of the study is to study the anatomical variations of the osteometrial complex on CT scan and to find frequency of various anatomical variations in the patients of chronic sinusitis, which are attending or coming to the Maharshi Markantation Medical College Hospital. This is a prospective study conducted from January 2021 to December 2021 with sample size of 100 cases and inclusion criteria of clinically diagnosed chronic sinusitis patients. Explosion criteria included patients with previous alteration of the peronazole sinus due to facial trauma or previous surgery or new plasm of the sinonazole mucosa. Material and methods. CT was performed on 128-slide phillip CT scanner. Patients were scanned in supine position. Exile sections were taken in with 1mm thickness and coronal and surgical reformats were done with thickness of 1mm. So, coming to the results. So, this is for the prevalence of the anatomical variation in chronic sinusitis patients and we found that approximately there was 85% anatomical variations noted and only 15% of the patient had normal anatomy with chronic sinusitis. Now, only 39% of the patients had one anatomical variation but there were 61 patients who had more than one anatomical variation of the anatomy with chronic sinusitis. Now, this is the coronal reformat image which demonstrates a deviated nasal septum with convexity towards the right side. On the image on the right hand side which is coronal reformat image it also shows a deviated nasal septum towards the right side with a ponies per and there is a concabulosa seed which is the nematization of the middle middle turbinate. In this coronal reformat image we can see a nematized and deviated unsanitary process seen bilaterally. Now, on this coronal reformat image we can see a paradoxical middle turbinate which is when the concavity of the middle turbinate is present towards the nasal septum. This coronal reformat image represents shows bilateral agonized cells which are the anterior most etymodal air cells. In this coronal reformat image we can see inframarbital etymodal air cell unilaterally which are the helars cells seen on the right side. Now, coming to the discussion with comparison of our study with Anita et al. Anita et al showed anatomical variations in chronic sinusitis patients in approximately 87% and our study showed that 85% of the patient had anatomical variations in chronic sinusitis patients. So, in our study we could see that concabulosa was present unilaterally in 15.3% of the patient, paradoxical turbinate was present in 5.9% of the patients, deviated unsanitary process was present in the 4.7% of the patients, agonized cells were seen in 2.3% of the patients unilaterally and helars cells were seen unilaterally in 1.2% of the patients. Concabulosa was seen bilaterally in 11.7% of the patient, adoxymetral turbinate was seen in 2.3% of the patient, deviated unsanitary process was seen bilaterally in 1.2% of the patient and agonized was seen in 1.2% of the patients bilaterally. So, concluding, this study re-emphasized the fact that anatomical variation in osteometrial complex in chronic sinusitis is frequent, can be multiple and we act as a key factor in causing chronic sinusitis. Best appreciated on CT scan and it should not be excluded exclusively to diagnose chronic sinusitis but CT provides the supplementary clinical data with the history in concluding the patients with the chronic sinusitis patients. So, a careful evaluation of anatomical variation by CT scan is necessary especially for those undergoing endoscopic surgery. The radiologists play a vital role in providing the information required by the soldiers that may predispose patients to increase risk of interoperative complications. And these are my references.