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The ostiomeatal complex was prospectively evaluated in 100 consecutive patients referred for CT scanning. The degree of nasal septal angulation, uncinate process deviation (U-VS angle), infundibular and middle meatus opacification were correlated with maxillary and ethmoid sinus opacification. Patients with more severe nasal septal deviation and more horizontally-oriented uncinate processes had a higher frequency of sinus opacification. However, the differences between patients with and without CT evidence of sinus disease were very small (1.7 degrees to 3.4 degrees). Infundibular opacification most accurately predicted maxillary (76%), and middle meatus opacification most accurately predicted ethmoid sinus disease (78%). There is a small but statistically significant decrease in U-VS angulation and increase in nasal septal deviation in patients with sinusitis. However, the value of performing these measurements is limited. The evaluation of the degree of nasal septal deviation and uncinate process angulation will be most useful in preoperative planning.