Evaluation of the Frequency of Nasal Anatomical Abnormalities and Possible Association with Chronic Rhinosinusitis in CT-imaging of Paranasal sinuses

Abstract

Background & Aim: Associated with long-term discomfort, sinusitis is one of the most common diagnoses in primary care. Given the lack of consensus about the role of anatomical abnormalities and variations of the nasal cavity in the development of chronic rhinosinusitis (CRS), and with regard to a lack of research on the relationship between sinusitis and anatomical abnormalities of the nasal cavity in the past few years, the present study aimed to evaluate the frequency of nasal anatomical abnormalities and possible association with CRS in CT-imaging of paranasal sinusitis of individuals referred to the radiology ward of Ali Ibn Abitaleb Hospital in Rafsanjan, Iran in 2019. 

Materials and Methods: This cross-sectional study was performed on patients with CRS and those without CRS over the age of 18, who underwent CT scans of the paranasal and nasal sinuses. The participants were selected by census sampling based on the inclusion and exclusion criteria. Afterwards, they were divided into two groups of patients with CRS and healthy individuals based on CT scan results and were compared in terms of fundamental anatomical abnormalities detected in CT scans. Data analysis was performed in SPSS version 22, and a P-value of less than 0.05 was considered statistically significant. 

Results: In this study, variables of gender, history of allergic diseases, and unilateral concha bullosa increased the possibility of CRS. In the group of patients with CRS, history of respiratory diseases and age affected the possibility of nasal spine and concha bullosa, respectively. On the other hand, smoking and a history of asthma affected concha bullosa in the group of healthy individuals, whereas the variable of age affected both nasal spine and concha bullosa in these participants. Moreover, a history of asthma, respiratory diseases, and allergic diseases increased the possibility of frontal sinusitis while the risk of ethmoid sinusitis increased by a history of allergic diseases. Furthermore, the variables of age and history of asthma and allergic diseases increased the risk of sphenoid sinusitis, whereas the variables of age, gender, and history of respiratory diseases affected the possibility of maxillary sinusitis (P<0.05).

Conclusion: According to the results of the present study, a history of allergic diseases, male gender, and anatomical variations (nasal spine and concha bullosa) played a key role in the etiopathogenesis of CRS.