Anatomical variations and their impact on chronic rhinosinusitis: a retrospective analysis from an Indonesian tertiary hospital

BackgroundChronic rhinosinusitis (CRS) is an inflammation of the paranasal sinus mucosa lasting over 12 weeks. Its etiology includes infections, allergies, immune system failures, anatomical abnormalities, and mucociliary transport disorders. The complex anatomy of the sinonasal region can hinder mucociliary drainage; necessitating CT scans to evaluate predisposing factors and minimize surgical risks. This study aimed to understand the anatomical variations in the paranasal sinuses and their correlation with CRS. ResultsThe study included 128 CRS patients aged 20 to 75, averaging 36.2 years. The most common symptoms were nasal congestion (98%), runny nose (85%), facial pressure (57%), reduced sense of smell (53%), and posterior nasal discharge (43%). Maxillary rhinosinusitis was the most prevalent (88%), followed by ethmoid (84%), frontal (58%), and sphenoid (48%) rhinosinusitis. Anatomical variations were present in 96% of patients, with deviated nasal septum (81.3%), agger nasi pneumatization (73.4%), and frontoethmoidal cells (60.2%) being the most common. Logistic regression indicated a significant association between concha bullosa and maxillary rhinosinusitis (p < 0.05). No significant correlation was found between anatomical variations number and SNOT-22 scores (r = - 0.177, p > 0.05). ConclusionThis study found a high prevalence of anatomical variations in CRS patients, with deviated nasal septum, agger nasi pneumatization, and frontoethmoidal cells being the most common. A significant association was identified between concha bullosa and maxillary rhinosinusitis.