Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis.
Improvements in functional endoscopic sinus surgery (FESS) and computed tomography (CT) have concurrently increased interest in the anatomy of the paranasal region. Common anatomical variations are not rare in patients with chronic paranasal sinusitis. The aim of this retrospective study was to analyze the incidence of anatomic variations of the lateral nasal wall in a series of 200 patients with persistent symptoms of rhinosinusitis, after failure of medical therapies, and their correlation with paranasal sinus disease. A detailed analysis of CT scans showed that 140 of 200 (70%) patients had anatomic variations. In particular, 122 patients (87%) were affected by common anatomic variations, and 18 patients (13%) with uncommon variations. There were 85 (60.7%) male and 55 (39.3%) females with ages ranging from 13 to 77 years (mean 45.5 years). The maxillary sinus was most commonly involved, followed by the anterior ethmoid, frontal sinus, posterior ethmoid and sphenoid sinus. Statistically significant association was found between the presence of common anatomic variations - septal deviation, bilateral concha bullosa, medial deviation of uncinate process, Haller cell, ethmoidal bulla hypertrophic, agger nasi cell - and the presence of sinus mucosal disease (p < 0.05). There was no significant correlation between other common and uncommon anatomic variations and mucosal pathologies. The associations were evaluated using the Fisher's exact test, and compared with those reported in the literature. Considering the results obtained, we believe that some anatomic variations may increase the risk of sinus mucosal disease. We therefore emphasize the importance of a careful evaluation of CT study in patients with persistent symptoms and recurrent chronic rhinosinusitis in order to identify those with anatomical variations that may have an increased risk of developing rhinosinusitis.
['Fadda|G L|GL|', 'Rosso|S|S|', 'Aversa|S|S|', 'Petrelli|A|A|', 'Ondolo|C|C|', 'Succo|G|G|']
D000293:Adolescent D000328:Adult D000368:Aged D002908:Chronic Disease D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D010256:Paranasal Sinuses D012189:Retrospective Studies D012220:Rhinitis D012852:Sinusitis D013223:Statistics as Topic D055815:Young Adult
Anatomic variations Chronic rhinosinusitis Endoscopic sinus surgery Computed tomography Paranasal sinuses