The effect of paranasal anatomic variations on chronic rhinosinusitis

Abstract

Rhinosinusitis is the inflammation of the paranasal sinus mucosa and the most common pathophysiological event causing rhinosinusitis is the ostiomeatal complex disease. The aim of the study is to determine the prevalence of anatomical variations and mucosal pathologies in paranasal computed tomography images of patients with chronic rhinosinusitis and to reveal the relationship between anatomical variations and sinus pathologies. Anatomical variations and mucosal pathologies in coronal paranasal tomography images were evaluated in 100 patients diagnosed with chronic rhinosinusitis and 32 individuals in the control group without any sinus complaints. The rate of having at least one anatomical variation in the control group was 64.1%, while this rate was 87.5% in patients with chronic rhinosinusitis (p<0.001). The most common variation, Agger nasi cell, was found to be present in 34.3% of the individuals in the control group and in 53.5% in the rhinosinusitis group (p<0.05). In patients with rhinosinusitis, maxillary sinus was affected in 66.5%, anterior ethmoid sinus in 42.5%, frontal sinus in 32.5%, posterior ethmoid sinus in 20%, sphenoid sinus in 18.5% either in isolation or in combination. The relationship between anatomical variations and mucosal pathologies of the sinuses was evaluated. A significant correlation was found between anatomical variations such as Agger nasi cell, concha bullosa, septum deviation, ethmoid bulla and Haller cell with maxillary sinusitis, between Agger nasi cell and septum deviation with frontal sinusitis, and between Agger nasi cell, concha bullosa, septum deviation and ethmoid bulla with ethmoid sinusitis. In conclusion; it was concluded that anatomical variations are an important factor in the development of chronic sinusitis and that not only sinuses but also anatomical variations that impair drainage should be corrected during the surgical treatment of rhinosinusitis.