Study of anatomical variations of ostiomeatal complex in chronic rhinosinusitis patients

Shivakumar Senniappan, Komathi Raja, Ammu Lizbeth Tomy, Chinnu Sudha Kumar, Anjali Mahendra Panicker, Shankar Radhakrishnan


Background: Anatomical variations like nasal septal deviations, concha bullosa, paradoxical middle turbinate, pneumatized or medially bent uncinate etc. can encroach upon the ostiomeatal unit and narrow ostiomeatal channels. The aim of the study was to study the anatomical variations of ostiomeatal complex commonly associated with paranasal sinus disease among patients with chronic sinusitis using computed tomography.

Methods: A prospective longitudinal study was conducted in the ENT department of our hospital for a period of one year. All the adult patients with complaints suggestive of chronic rhinosinusitis for a period of more than 12 weeks, patients with acute exacerbation of chronic rhinosinusitis and with persistent chronic rhinosinusitis requiring surgical intervention are included in our study. Based on our inclusion and exclusion criteria a total of 138 patients were involved in the study.  

Results: In our study we saw the association between various sinusitis and the anatomic variations of the ostiomeatal complex and we found that concho bullosa found to have a strong significant association with maxillary sinusitis (43.6%) and anterior ethmoid sinusitis (42.1%). Most of the patients with posterior ethmoid sinusitis (53.8%) had a statistical significant association in developing deviated nasal septum type of anatomical variant and majority of the patients with sphenoidal sinusitis had a onodi cell type of anatomical variant and their association was found to be statistical significant (p<0.05).

Conclusions: The importance of CT scan and nasal endoscopy is emphasized in patients with persistent symptoms to identify the anatomical variations that may contribute to the development of chronic sinus mucosal disease. 


Chronic rhinosinusitis, Ostiomeatal unit, Computed tomography, Anatomic variation

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