OBJECTIVES:To study the various anatomical variations of the osteomeatal complex and their incidence in patients with chronic rhinosinusitis. DESIGN: A prospective study was done on 100 computed tomography scans of patients with chronic rhinosinusitis. RESULTS: Various types of anatomical variations were observed in the study viz. concha bullosa, septal deviation, paradoxical middle turbinate, retroverted uncinate process, enlarged ethmoid bulla, haller cells, agger nasi cells, onodi cells and pneumatization of vomer. The most frequent anatomical variation found was septal deviation (30%), followed by presence of concha bullosa (26%). CONCLUSION: Variations are common in the osteomeatal complex. These variations may predispose to sinusal diseases and hence require correction. Also, preoperative detection of such variations by computed tomography avoids complications during functional endoscopic sinus surgery.

-OBJECTIVE:To determine the prevalence of concha bullosa in patients suffering from chronic rhinosinusitis and to examine its possible relationship to osteomeatal unit blockage, the latter being a precursor for rhinosinusitis. DESIGN: A prospective study of prevalence of concha bullosa and blockage of ipsilateral osteomeatal unit was done on 200 computed tomography scans of patients with chronic rhinosinusitis. RESULTS: Of the 200 CT scans with Chronic Rhinosinusitis, the incidence of concha bullosa 34%. Of this, 31 cases (45.6%) were of extensive type, 21 cases (30.9%) were of bulbous type and 16 cases (23.5%) were of lamellar type. There was no statistically significant association between any type of concha bullosa with ipsilateral osteomeatal unit block either in right side or left side. CONCLUSION: There is no statistically significant relationship between presence of concha bullosa and ipsilateral osteomeatal unit blockage that leads to block in drainage of anterior group of paranasal sinuses. There is a significantly higher occurrence of the ostium of bulbous type of concha bullosa opening into the hiatus semilunaris.

To determine the prevalence of anatomic variations in patients suffering from chronic rhinosinusitis (CRS) and to compare them with normal population. DESIGN: This is a case control study. A prospective study of anatomic variations was done on 100 computed tomography (CT) scans of patients with chronic rhinosinusitis. Prevalence of anatomic variations in control group was assessed by studying 100 CT scans of non-CRS patients. RESULTS: Even though proportion of concha bullosa was more among chronic rhinosinusitis patients compared to normal individuals, it was statistically not significant. There was no significant difference in the prevalence of paradoxical middle turbinate, retroverted uncinate process, overpneumatized ethmoid bulla and septal deviation in chronic rhinosinusitis patients compared to normal individuals. There was significantly lesser proportion of individuals having haller cells and agger nasi cells in chronic rhinosinusitis compared to normal individuals. CONCLUSION: There is no significant prevalence of anatomic variations in osteomeatal unit in patients with chronic rhinosinusitis. The anatomic variations may predispose to pathological changes only if they are bigger in size. More detailed studies are recommended in this regard as a good knowledge of complex anatomy of the paranasal sinuses is essential to understand chronic rhinosinusitis and to plan its treatment.