The prevalence of anatomical variations in osteomeatal unit in patients with chronic rhinosinusitis

The complexities of the anatomy of the nose and paranasal sinuses, as well as its variations may create technical difficulties during surgery. The significance of these anatomical variations in pathogenesis of rhinosinusitis, which is the commonest disease in the region, is still unclear.

The aims of the study were to study the anatomical variations in the osteomeatal complex in chronic rhinosinusitis (CRS) patients and to compare them with the normal population.

High resolution CT scan of paranasal sinuses images of 240 individuals were reviewed comparing 120 cases of CRS and another 120 patients without CRS problem.

The anatomical variations recorded were: Concha bullosa in 49 (40.8%) CRS cases and 57 (47.5%) in control cases, paradoxical middle turbinates in 14 (12.0%) CRS cases and 27 (23.0%) in control cases, pneumatized uncinate processes were found in 3 cases (3.3%) in both CRS and control groups, Haller's cells (infraorbital ethmoid cell) in 61 (51.0%) CRS cases and 75 (62.0%) cases in the control group, there were pneumatized agger nasi cells in 100 (83.0%) CRS cases and 95 (79.0%) in control subjects and deviated nasal septums in 67 (56.0%) CRS cases compared with 73 (60.8%) in controls.

The most common anatomical variation in the osteomeatal complex in CRS patients was pneumatized agger nasi cells and the least was pneumatized uncinate processes. However the prevalence among both groups is comparable. The detection of a single anatomical variant itself does not establish the genesis of chronic rhinosinusitis except for paradoxical middle turbinate and infraorbital ethmoid cells.