title: Anatomic variants of the paranasal sinuses in patients with recurrent acute rhinosinusitis.
abstract: BACKGROUND
  The incidence and potential disease impact of paranasal sinus anatomic variants in patients with recurrent acute rhinosinusitis (RARS) has important implications for management, including surgery, but is incompletely defined.
  
  
  METHODS
  A retrospective review of 26 patients with RARS who had undergone computed tomography (CT) was performed. Patient demographics, RARS severity and comorbidities were reviewed. CT scans were reviewed for the incidence of anatomic variants in all patients. The pattern of inflammatory changes was explored in the subset of patients with acute rhinosinusitis at the time of CT. Potential correlation between the presence of anatomic variants and disease severity were investigated.
  
  
  RESULTS
  In the patient cohort who met inclusion criteria, the most common variants included agger nasi cell (88.5%), concha bullosa (53.8%), infraorbital cell (50%), and deviated nasal septum with middle meatus obstruction (42%). In exploring correlations with RARS severity, type 2 frontal cells correlated with a greater number of years with RARS (0.0363). In the 23 patients who underwent CT at the time of an acute infection, no statistically significant correlation was found between severity or location of inflammatory changes and the presence of anatomic variants.
  
  
  CONCLUSIONS
  This study describes the incidence of anatomic variants in a cohort of patients with RARS. A correlation between the presence of anatomic variants and the pattern of inflammatory changes was not identified.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Patricia Anne
authors.initials: PA
authors.lastname: Loftus
authors.affiliation: Department of Epidemiology and Population Health, Division of Biostatistics, Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Juan
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medical College, New York, NY.
authors.forename: Abtin
authors.initials: A
authors.lastname: Tabaee
mesh_terms: D000208:Acute Disease; D000328:Adult; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D012220:Rhinitis / Q000453:epidemiology / Q000473:pathology*; D012852:Sinusitis / Q000453:epidemiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: anatomic variants; chronic rhinosinusitis; deviated nasal septum; paranasal sinus; recurrent acute rhinosinusitis