The Impact of Concha Bullosa and Deviated Nasal Septum on Chronic Rhinosinusitis: A Retrospective CT-Based Study

Background: A CT scan distinctly reveals the structural differences of concha bullosa (CB) and deviated nasal septum (DNS) in many cases. These changes may, however, induce mechanical obstruction in the drainage channel, leading to sinusitis. Objective: Therefore, we performed a retrospective CT-based study to evaluate the influence of CB and DNS on chronic rhinosinusitis (CRS). Materials and Methods: This retrospective cross-sectional study involved 147 patients at the Department of Otorhinolaryngology in a tertiary care institution in Mumbai. We examined the CT scan reports of individuals with chronic sinusitis to find all variations of CB and DNS. Results: Among 147 patients, 68 (46.3%) had CB, including 11 (7.4%) with bulbar CB, 5 (3.4%) with widespread CB, and 52 (34.4%) with lamellar CB. 124 patients, or 84.9% of the total cohort, had DNS. Of these, 46% exhibited left-sided DNS, whereas 54% displayed right-sided DNS. In our study, we identified CB in 17 (34%) of the 50 frontal sinusitis cases, 49 (46.23%) of the 106 maxillary sinusitis cases, 27 (43.55%) of the 62 ethmoidal sinusitis cases, and 12 (33.33%) of the 36 sphenoidal sinusitis cases. Every variant of sinusitis exhibited an increased prevalence of right-sided DNS. We observed no statistically significant correlation between CB and DNS, nor between CB and CRS, nor between DNS and CRS, aside from frontal sinusitis. Conclusion: CRS is a complicated disease with many causes. Differences in anatomy, like concha bullosa and deviated nasal septum DNS, play a big part in how it starts and how long it lasts. This study seeks to elucidate the clinical significance of these discrepancies and their potential impact on patient management by analyzing CT scans in relation to CRS. We advocate the concurrent assessment of the complex etiology and anatomical differences contributing to CRS.