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Evaluation of haller cell on CBCT and its association with maxillary sinus pathologies

Introduction: Haller cells, an anatomical variation in paranasal sinuses, have also been suggested as a causative factor in maxillary sinus disease because of their ability to cause narrowing of the infundibulum because of their complex positioning. Research in the past had suggested the probable etiology for maxillary pathology from the obstruction at the osteomeatal complex leading to localized infection and inflammation. These further proceed to the sequel of another sinus pathology. Aim and Objective: The purpose of this study was to calculate the prevalence of Haller cells and to evaluate the association of the presence of Haller cells with maxillary sinus diseases. Materials and Methods: Cone beam computed tomography (CBCT) image volumes of 200 patients were retrieved from Planmeca ProMax 3D Mid machine and evaluated using Romex 3.1 software, in coronal section and keeping slice thickness of 4 mm. In total, 400 sites were analyzed for Haller cells and maxillary sinus disease. Haller cells were identified using criteria given by Mathew et al. Data obtained were subjected to the Chi-square test and Cohen' kappa test for statistical analysis and P values of <0.05 were considered statistically significant. Results: Out of 400 sites, Haller cells were noted at 129 sites and reported with the prevalence of 49%. Maxillary sinus pathology was noted at a total of 144 sites out of which 68 were associated with Haller cells. Maxillary sinusitis in association with Haller cells was reported at 50 sites where as benign mucosal cyst was reported at 18 sites. Conclusion: Haller cells should be used as an important anatomical variation in maxillary sinus pathologies.