Prevalence and Morphometrics of Haller Cells in Iraqis, and Their Association with Sinusitis and Sino-Nasal Anatomical Variants of Interest Using High-Resolution Computed Tomography

Background: Haller cells (HCs) possess radiological and clinical significance because of their close relationship to the ostiomeatal complex and orbital floor. We aim to determine the prevalence of HCs in an Iraqi population, assess their morphometry, and evaluate their associations with selected sino-nasal anatomical variants, particularly concha bullosa (CB) and Onodi cells (OCs), as well as with sinusitis. Methods: In this retrospective study, high-resolution CT scans were obtained from Baghdad Medical City. Images were reviewed using RadiAnt DICOM Viewer version 2025.2. Haller cells were assessed for laterality and measured on coronal CT for length, width, and sectional area. Data were analyzed in IBM SPSS Statistics version 27. Results: Of 121 assessed CT scans, 103 were included in the final analysis. HCs were found in 36.9% of cases, most commonly as unilateral right-sided cells. Strong positive correlations were observed among HC morphometrics, especially between length and sectional area on both sides (left: ρ = 0.920, p < 0.001; right: ρ = 0.876, p < 0.001). No significant side- or sex-based differences were found concerning any of the morphometrics. Further, no significant associations were found between HCs and sex, nasal septum deviation (NSD), OCs, maxillary sinusitis, or sphenoid sinusitis. Nonetheless, the association between HCs and CB possessed borderline significance (OR = 2.37, 95% CI: 0.86–6.57; p = 0.091). Conclusions: Haller cells were the least common of the evaluated sino-nasal variants and showed generally symmetrical morphometrics despite more frequent right-sided unilateral occurrence. They were not significantly associated with sex, NSD, OCs, or sinusitis, although the borderline association with CB warrants further study.