{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T09:47:37Z","timestamp":1782726457436,"version":"3.54.5"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Haller cells (HCs), infraorbital pneumatization of the anterior ethmoidal air cells, are anatomical variants frequently located adjacent to the maxillary sinus ostium. Their presence has been hypothesized to interfere with mucociliary drainage and contribute to the pathophysiology of chronic rhinosinusitis (CRS). Despite numerous imaging-based investigations, the etiological role of Haller cells in CRS remains uncertain. The aim of this meta-analysis is to highlight the association between HC and CRS using data derived from Computed Tomography (CT) and Cone-Beam Computed Tomography (CBCT) imaging. Materials and Methods: Following PRISMA guidelines and a registered protocol in the PROSPERO database, a systematic search across PubMed, EMBASE, and COCHRANE databases led to the inclusion of eight studies published between 2011 and 2024, comprising 2011 patients. The included studies employed multiplane reconstruction techniques and high-resolution imaging protocols. The majority of studies were retrospective, with only one adopting a prospective design. Results: The pooled odds ratio (OR) for the association between HC and CRS was 1.54 (95% Confidence Interval: 0.93\u20132.54; p = 0.09), suggesting a non-significant trend toward a positive correlation. Heterogeneity was substantial (I2 = 87%, p &lt; 0.01), due to differences in study design, populations, and diagnostic criteria, contributing to inconsistency in reported estimates across the studies. Moreover, Egger\u2019s test showed no evidence of publication bias (intercept = 0.67, p = 0.895). Although three studies fulfilled all eleven evaluation criteria outlined by the JBI (Joanna Briggs Institute) checklist, the observed variability limits the interpretability of pooled outcomes. Conclusions: These findings suggest that, while HC may play a role in CRS pathogenesis, the current evidence does not support a statistically significant association. Future prospective research using standardized imaging and diagnostic criteria is essential to clarify the clinical impact of HC in sinonasal disease.<\/jats:p>","DOI":"10.3390\/life16071089","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T08:45:20Z","timestamp":1782722720000},"page":"1089","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Infraorbital Ethmoid Cells (Haller Cells) and Their Role in Chronic Rhinosinusitis: An Evidence-Based Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0024-0237","authenticated-orcid":false,"given":"Alin Horatiu","family":"Nedelcu","sequence":"first","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"},{"name":"Radiology Clinic, Clinical Rehabilitation Hospital Iasi, 700661 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8244-0522","authenticated-orcid":false,"given":"Emil","family":"Anton","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria-Bianca","family":"Andrei","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5836-1517","authenticated-orcid":false,"given":"Otilia Elena","family":"Fr\u0103sinariu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anton","family":"Knieling","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8147-3632","authenticated-orcid":false,"given":"Ancuta","family":"Lupu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6325-7370","authenticated-orcid":false,"given":"Razvan Tudor","family":"Tepordei","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona Alice","family":"Partene Vicoleanu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Statescu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Ursaru","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"},{"name":"Radiology Clinic, \u201cSf Spiridon\u201d County Clinical Emergency Hospital, 700111 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela Carmen","family":"Rusu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorana Caterina","family":"Anton","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7083-8197","authenticated-orcid":false,"given":"Ionela Daniela","family":"Morariu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihaela","family":"Mitrea","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2640-8795","authenticated-orcid":false,"given":"Vasile Valeriu","family":"Lupu","sequence":"additional","affiliation":[{"name":"Grigore T. Popa University of Medicine and Pharmacy Iasi, 16 Universitatii Street, 700115 Iasi, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"ref_1","first-page":"RC01","article-title":"Prevelance of Haller\u2019s Cells: A Panoramic Radiographic Study","volume":"8","author":"Solanki","year":"2014","journal-title":"J. Clin. Diagn. 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