Abstract

OBJECTIVE: This study aims to investigate the paranasal sinus anatomic variations (PNSV) presenting with the lesion and the relation with the lesion side in the patients with a diagnosis of inverted papilloma (IP) and to identify the role of PNSV in IP etiology.

METHODS: Between January 2013 and December 2019, computed paranasal sinus tomography of a total of 35 patients (24 males, 11 females; mean age: 52.5±13.9 years; range, 17 to 85 years) who were histopathologically diagnosed with IP were retrospectively analyzed. Among the patients, the IP sides and healthy sides were identified. As PNSV, septal deviation (SD) concha bullosa (CB), frontal sinus hypoplasia (FH), maxillary sinus hypoplasia (MH), double middle turbinate (DMT), Haller cell (HH) and Agger Nasi (AN) were investigated. General anatomical variation distribution and differences in anatomic variation between the IP side and healthy side were examined.

RESULTS: The most common PNSVs on the healthy side were SD (40%), CB (31.4%), AN (17.1%), and FH (8.6%). The most common PNSVs on the IP side were MH (8.6%) and HH (17.1%), respectively. The incidence of CB on the IP side was found to be statistically significantly lower (11.4% vs. 31.4%; p=0.039). Although SD was the most common variation on the healthy side, there was no statistically significant difference compared to the IP side (p=0.405).

CONCLUSION: Factors involved in IP etiology affect both nasal cavities simultaneously. In general, IP is seen unilaterally and anatomic variations are one of the important factors which cause a difference between the two nasal cavities. These anatomic variations such as CB and SD, which can narrow the nasal cavity and cause compensatory changes in the contralateral nasal mucosa, may have a facilitatory role in the etiology of IP when combined with other etiological factors.