Infraorbital Ethmoid Cells (Haller Cells) and Their Role in Chronic Rhinosinusitis: An Evidence-Based Meta-Analysis

Area of Science:

• Otolaryngology
• Radiology
• Medical Imaging

Background:

• Haller cells (HCs) are anatomical variants near the maxillary sinus ostium.
• HCs are hypothesized to impact mucociliary drainage and contribute to chronic rhinosinusitis (CRS).
• The etiological role of HCs in CRS remains uncertain despite imaging studies.

Purpose of the Study:

• To meta-analyze the association between Haller cells and Chronic Rhinosinusitis.
• To evaluate imaging data from Computed Tomography (CT) and Cone-Beam Computed Tomography (CBCT).

Main Methods:

• Systematic literature search following PRISMA guidelines (PubMed, EMBASE, COCHRANE).
• Inclusion of eight studies (2011-2024) involving 2011 patients.
• Analysis of multiplane reconstruction and high-resolution imaging techniques.

Main Results:

• Pooled odds ratio for HC and CRS association was 1.54 (p=0.09), indicating a non-significant trend.
• Substantial heterogeneity (I²=87%) was observed due to variations in study design and criteria.
• No evidence of publication bias was detected (Egger's test).

Conclusions:

• Current evidence does not support a statistically significant association between Haller cells and CRS.
• Haller cells may play a role in CRS pathogenesis, but further investigation is required.
• Prospective research with standardized criteria is essential to clarify the clinical impact of HCs.