Prevalence of Nasal Septal Deviation, Concha bullosa, and Infundibular Size and their Association with Maxillary Sinusitis by Computed Tomography in Filipinos with Paranasal Sinus Disease

Data are limited regarding anatomic variations of the paranasal sinuses (PNS) in the Filipinos. Although several studies have described the relationship between concha bullosa as well as nasal septal deviation and PNS disease, only few have investigated the relationship between the infundibular size and maxillary sinusitis. 

This study aims to report the prevalence of nasal septal deviation, concha bullosa, and infundibular size, and to determine their association with CT-confirmed maxillary sinusitis in Filipino patients. 

We retrospectively reviewed CT-scans of 200 patients from June 2015 to June 2016. Examinations requested intended to evaluate the symptoms referable to sinonasal disease. The presence of maxillary sinusitis, concha bullosa, nasal septal deviation, and infundibular size were recorded. Anatomic variants and infundibular size as well as their relationship with maxillary sinusitis were evaluated using logistic regression. 

Maxillary sinusitis was diagnosed in 98 (49%) patients, and in 146 of 400 (36.5%) sinuses. Concha bullosa was reported in 74 (37%) and nasal septal deviation in 130 (65%) patients. Most of the septal deviations were <9 degrees (93.8%), and none were severe. A greater proportion of males had maxillary sinusitis (p=0.017). Patients with maxillary sinusitis had a larger infundibular size compared to patients without sinusitis (p=0.017). Only male gender (p=0.004) and infundibular size (p=0.023) had an association with maxillary sinusitis.

No association was seen between nasal septal deviation or concha bullosa and maxillary sinusitis. Increase in infundibular size led to increased odds of maxillary sinusitis, though the results should be interpreted with caution due to differences in group characteristics.