The association between sinonasal anatomical variants and the laterality of orbital complications in pediatric acute rhinosinusitis

Aviv Daniel, Rosa Novoa, Itay Pansky, Itai Hazan, Lior Friedrich, Sofia Kordeluk, Erez Tsumi, Oded Cohen, Oren Ziv

Research output: Contribution to journalArticlepeer-review


Introduction: As the role of sinonasal anatomical variants as predisposing factors in determining the lateralization of acute rhinosinusitis-related orbital complications (ARS-OC) in pediatrics remains a topic of debate, this study further explores the potential association between anatomical variations and ARS-OC. Methods: A retrospective study was conducted on children who had been admitted with ARS-OC using medical records and sinus CT scans to compare anatomical differences between the affected and contralateral sides. This study aimed to identify bony anatomical disparities that may impact OC laterality secondary to ARS. The anatomical features examined included septal deviation, concha bullosa, lamina papyracea dehiscence (LPD), and uncinate process abnormalities. Results: The CT scans of 57 pediatric patients (114 sides) were reviewed. Our results indicated that bony anatomical variations were associated with ARS-OC laterality (63 % vs. 37 %, P = 0.006), yielding an odds ratio of 2.91. Additionally, our study revealed a significant association between ipsilateral LPD with the increased risk of ARS-OC (39 % vs. 1.8 %, P < 0.05), with an odds ratio of 34.3 compared to the opposite side. Conclusions: LPD might play a role in the pathophysiology of pediatric ARS-OC, as it is associated with a significantly higher risk of affecting the ipsilateral side. Further research is necessary to determine whether LPD is a causative factor or a result of ARS.

Original languageEnglish
Article number111958
JournalInternational Journal of Pediatric Otorhinolaryngology
StatePublished - May 2024
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2024 Elsevier B.V.


  • Acute rhinosinusitis
  • Anatomical variants
  • Computed tomography
  • Orbital complications
  • Pediatrics


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