Prevalence of Various Anatomical Variants of the Nasal Cavity and Paranasal Sinuses using Multidetector Computed Tomography among Patients Presenting with Chronic Sinusitis

Abstract

Background: Chronic rhinosinusitis (CRS) is a common inflammatory disorder of the nasal cavity and paranasal sinuses. Anatomical variations may influence sinonasal drainage and contribute to disease pathogenesis. Multidetector computed tomography (MDCT) plays a crucial role in identifying these variations and guiding management. This study aimed to determine the prevalence of sinonasal anatomical variants using MDCT and evaluate their association with disease severity and demographic factors in patients with CRS.
Methods: This hospital-based cross-sectional study included 150 patients with clinically and radiologically confirmed CRS. MDCT scans were performed to identify anatomical variants. Statistical analysis was conducted using Chi-square and Kruskal–Wallis tests, with a p-value <0.05 considered significant.
Results: Deviated nasal septum (DNS) was observed in 81 patients (54.0%), paradoxical middle turbinate in 79 (52.7%), agger nasi cells in 79 (52.7%), Haller cells in 77 (51.3%), and concha bullosa in 76 (50.7%). Maxillary and ethmoid sinus involvement was most common (90; 60.0%). No statistically significant association was found between anatomical variants and disease severity: DNS (χ²=2.00, p=0.368), agger nasi cells (χ²=0.43, p=0.806), concha bullosa (χ²=1.02, p=0.601), Haller cells (χ²=2.57, p=0.277), frontal cells (χ²=3.50, p=0.174), maxillary septation (χ²=3.74, p=0.155), accessory ostium (χ²=0.48, p=0.786), uncinate pneumatization (χ²=0.01, p=0.994), and paradoxical middle turbinate (χ²=1.38, p=0.503). No significant gender-based differences were observed, e.g., DNS (χ²=0.000, p=1.000). Age (H=3.845, p=0.146) and symptom duration (H=0.715, p=0.700) were also not associated with severity.
Conclusion: Anatomical variants are highly prevalent in CRS but are not independently associated with disease severity. MDCT remains essential for preoperative evaluation and surgical planning.