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Background and Objectives:Although several studies have failed to confirm an increased incidence of sinusitis in asociation with anatomic factors, the anatomic variations of the nasal cavity and paranasal sinus are considered as important factors in the development of paranasal sinusitis. Materials and Method:To evaluate the effect of anatomic variations in sinusitis, computed tomography (CT) of 165 patients with chronic sinusitis and 70 patients with orbital pathology were reviewed to analyze the mucosal abnormalities and the bony anatomic variations. Results:There were no significant diference in the prevalence of anatomic variations betwen two groups. In patients with deviated septum, paranasal sinusitis was more comon and severe in Conclusion:There was no clinical significance of anatomic variations in formation of sinusitis. In septal deviation, the change of air current may affect the development of sinusitis. The increased airflow in the widened nasal cavity may impair the mucociliary clearing function of the nasal cavity and sinuses, which eventualy induce the stasis of mucus in sinuses and finally results in paranasal sinusitis. (Korean J Otolaryngol 2002 ;45 :1069-72)