CORRELATION BETWEEN NASAL CAVITY ANATOMY ANDPREDISPOSITION TO CHRONIC SINUSITIS: A RADIOLOGICAL STUDY

Abstract

Background:Chronic sinusitis had been recognized as one of the most prevalent and persistentinflammatory diseases affecting the upper respiratory tract, significantly impairing patients’ qualityof life. Anatomical variations within the nasal cavity and paranasal sinuses had been reported as keycontributing factors to impaired sinus ventilation and mucociliary clearance, thereby predisposingindividuals to recurrent or chronic sinus infections. Structural deviations such as nasal septaldeviation, concha bullosa, paradoxical middle turbinate, and Haller cells had been consideredcrucial in altering airflow dynamics and drainage pathways. Radiological assessment, particularlythrough computed tomography (CT) imaging, had played an essential role in identifying thesevariations with high precision. Therefore, understanding the relationship between nasal anatomy andchronic sinusitis had been important for improving diagnostic accuracy and formulating preventiveas well as surgical strategies.
Aim:The aim of this study had been to investigate the correlation between anatomical variations ofthe nasal cavity and the predisposition to chronic sinusitis using radiological (CT scan) evaluationamong patients presenting with sinus-related complaints.
Methods:This cross-sectional study had been conducted at Faisalabad Medical University,Faisalabad, from May 2024 to April 2025. The study population had comprised 110 participantsaged between 18 and 60 years who had presented with clinical features suggestive of chronicsinusitis, such as nasal obstruction, facial pain, postnasal drip, or recurrent nasal discharge for morethan 12 weeks. Patients with a history of prior nasal surgery, facial trauma, or sinonasal tumors hadbeen excluded. High-resolution computed tomography (HRCT) scans of the paranasal sinuses hadbeen performed for all participants. Radiological evaluation had been done in coronal, axial, andsagittal planes to identify anatomical variations such as nasal septal deviation, concha bullosa,Haller cells, agger nasi cells, and paradoxical middle turbinate. The severity of sinus disease hadbeen scored using the Lund–Mackay system. Data had been analyzed statistically to determine correlations between anatomical variations and the presence or severity of chronic sinusitis usingchi-square and Pearson correlation tests, with p < 0.05 considered statistically significant.
Results:Out of 110 participants, 64 (58.2%) had been males and 46 (41.8%) females, with a meanage of 36.4 ± 9.8 years. Nasal septal deviation had been observed in 68 (61.8%) participants, conchabullosa in 44 (40.0%), paradoxical middle turbinate in 18 (16.4%), Haller cells in 22 (20.0%), andagger nasi cells in 30 (27.3%). Among these variations, nasal septal deviation and concha bullosahad shown a statistically significant association with chronic sinusitis (p = 0.001 and p = 0.003,respectively). The mean Lund–Mackay score had been significantly higher in patients with multipleanatomical variations compared to those with normal anatomy (9.8 ± 2.6 vs. 5.3 ± 1.9; p < 0.01).Additionally, a positive correlation (r = 0.62) had been found between the number of anatomicalvariations and sinus disease severity.
Conclusion:This study had demonstratedthat specific anatomical variations of the nasal cavity,particularly nasal septal deviation and concha bullosa, had been significantly correlated with anincreased predisposition to chronic sinusitis. Radiological evaluation using CT imaging had provedto be a valuable diagnostic tool in identifying these variations and predicting disease severity. Earlyrecognition and appropriate management of anatomical abnormalities could potentially preventchronicity and reduce the need for surgical intervention.