An Observational Study of Anatomical Variations of Ostiomeatal Complex affecting Mucociliary Clearance

Abstract

Background
The ostiomeatal complex (OMC) is vital for sinus drainage and mucociliary clearance. Anatomical variations like deviated nasal septum (DNS) and concha bullosa may predispose to chronic rhinosinusitis (CRS). This study assessed the impact of DNS severity and variations on sinus involvement using Lund-Mackay (LM) scores.
Materials and Methods
A retrospective study of 73 patients (>18 years) undergoing Computed Tomography (CT) of paranasal sinuses was conducted. DNS was graded as: I (<5°), II (5–10°), III (10–15°), IV (>15°). Anatomical variations were recorded, and LM scoring applied to all sinuses and OMC. Statistical analysis included Spearman correlation and Chi-square test (p < 0.05 significant).
Results
Mean age was 38.8 ± 13.6 years; 58.9% had right-sided DNS. Concha bullosa was most common (n = 57). Right DNS strongly correlated with ipsilateral anterior ethmoid (ρ = 0.578, p < 0.01) and sphenoid (ρ = 0.460, p < 0.01) sinuses; left DNS correlated with anterior ethmoid (ρ = 0.463, p < 0.01) and maxillary (ρ = 0.311, p < 0.05) sinuses. Chi-square analysis showed significant associations for all right-sided sinuses and for left anterior ethmoid and maxillary sinuses. OMC obstruction was linked to markedly higher LM scores across ipsilateral sinuses.
Conclusion
DNS severity and OMC obstruction significantly affect sinus disease, especially anterior ethmoid and maxillary regions. Common anatomical variants did not independently predict severity. Preoperative CT evaluation should emphasize DNS and OMC for optimal CRS management.