Role of anatomical variations in chronic non polipoid rhinosinusitis

Introduction: Chronic rhinosi-nusitis (CRS) is a significant health problem. The osteomeatal complex (OMC) obstruction represents a key factor in the development of this pathology. We report our experience on the evaluation of the presence of anatomical variations of the OMC and nasal septum in patients with and without CRS. We analyzed also the impact of these variations, alone or in combination, on the onset of CRS. Methods: This is a retrospective study. Patients affected by chronic rhinosinusitis (CRS group) submitted to volumetric computed tomography (VCT) of the nose and paranasal sinuses before they underwent functional endoscopic sinus surgery were recruited. Patients without disease of the nose or paranasal sinuses submitted to VCT for other indications were considered as control group (N-CRS group). Results: 138 patients were included in this study, 78 were included in the CRS group and 60 in the N-CRS group. Concha bullosa was detected in 71.8% and 53.4% of the CRS group and N-CRS group, respectively; P=0.03. Analyzing the contextual presence of more than one anatomical variation, we found that 70 (89.8%) of the 78 patients with CRS exhibited more than one concomitant ipsilateral variation, while 42 (70%) of the 60 N-CRS subjects had more than one concomitant ipsilateral variation, and this difference was statistically significant (P=0.004). In our study, we observed a correspondence between the site of the multiple variations and the site of paranasal sinuses involved in the CRS group.(P=0.045) Conclusions: Anatomic variations could facilitate the onset or persistence of CRS.