Anatomical Variations

The prevalence of anatomical variations is well documented, and it appears that they are not consistently different between asymptomatic groups and those with proven rhinosinusitis. This is contrary to early reports that labeled them as anatomical "abnormalities," for they now appear to be normal variations. This implies that anatomical variations play a minor role, if

Pneumatized Agger Nasi Cell
Fig. 6.18 a A well-pneumatized agger nasi cell producing a bulge in the lateral nasal wall near the origin of the middle

any at all, in initiating rhinosinusitis or causing it to persist. Perhaps the primary concern of anatomical variations is their tendency to lead the surgeon astray during an operation. For example, a septal deviation is often found with a compensatory concha bullosa on the contralateral side. These findings are as common in an asymptomatic population as in a population with rhinosinusitis (Havas et al., 1988; Lloyd, 1990; Lloyd et al., 1991; Bolger et al., 1991; Jones et al., 1997 a).

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