Association between sinonasal anatomical variations, adenoid hypertrophy, and sagittal–vertical skeletal patterns: a retrospective CBCT study in growth period orthodontic patients

Abstract Sinonasal anatomical variations and adenoid hypertrophy may influence upper airway function and craniofacial development. This retrospective study evaluated their association with sagittal and vertical skeletal patterns in growing orthodontic patients using cone-beam computed tomography (CBCT). A total of 125 patients aged 9–15 years were included. Sagittal skeletal patterns were classified using the ANB angle, and vertical skeletal patterns were categorized as normal, hyperdivergent, or hypodivergent. Thirteen sinonasal anatomical variations and adenoid hypertrophy grades were assessed on CBCT images. Nasal septum deviation was the most prevalent anatomical variation (68%), followed by accessory maxillary ostium (54.4%) and middle concha bullosa (43.2%). Grade 2 adenoid hypertrophy was the most common finding (60.8%). No significant associations were identified between sinonasal anatomical variations, adenoid hypertrophy, and either sagittal or vertical skeletal patterns, including after adjustment for age and sex ( p > 0.05). These findings suggest that, although common in growing orthodontic patients, sinonasal anatomical variations and adenoid hypertrophy were not significantly associated with craniofacial skeletal patterns in this sample.