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Abstract
Objective : To study the association between facial pain and the prevalence of anatomical variation of the
nasal cavity and paranasal sinus.
Design : Retrospective Case - Control Study
Methods : CT paranasal sinus scans and medical records, obtained from adult patients undergoing
evaluation at Maharaj Nakorn ChiangMai Hospital from 1 st January 2001 to 31 st May 2008, were reviewed.
There were 26 patients in the facial pain group and 60 patients in the nonfacial pain. The controlled group
of non facial pain patients were underwent CT scan for non rhinologic diagnosis.The patients with
previous sinus surgery, facial trauma, sinusitis, nasal cavity and paranasal sinus tumors or polyps, and
Lund score > 4 were excluded. The prevalence of each bony anatomical variation was compared.
Data was analyzed using SPSS program version 11.0 : Chi-square test, Fisher’s exact test, t-test, Mann-
Whitney test, p-value, and Odd ratio.
Result : The prevalence of anatomical variation of the nasal cavity and paranasal sinus in facial pain
group (26 patients) were 69.2% of Agger nasi cells, 57.7% of concha bullosa of middle turbinate, 53.8%
of Onodi cells, 30.8% of supreme turbinate, 26.9% of Haller cell, 23.1% of concha bullosa of superior
turbinate, 15.4% of contact deviated nasal septum, 7.7% of paradoxical middle turbinate, and there was no
double middle turbinate found. In the non facial pain group (60 patients), the concha bullosa of middle
turbinate were presented in 60%, Onodi cells 56.7%, Agger nasi cells 53.3%, Haller cell 28.3%, concha
bullosa of superior turbinate 23.3%, paradoxical middle turbinate 6.7%, supreme turbinate 6.7%, double
middle turbinate 3.3%, and contact deviated nasal septum 1.7%. Most of the presented bony anatomical
variations between the two groups showed no significant difference, except the deviated nasal septum
were significantly more common in the facial pain groups than the non facial pain group (p = 0.046 )
(95% CI 1.136 – 101.304).