Computed Tomography Analysis of the Nasal Septal Deviation and Related Paranasal Sinus Pathologies
Abstract
Purpose: Nasal Septum Deviation (NSD), which is defined as a dislocated septum, is a prevalent condition that is mostly asymptomatic; however, it can cause difficulties such as nasal obstruction and rhinosinusitis symptoms. Other Paranasal Sinuses (PNS) disorders, e.g., Osteo Meatal Complex (OMC) obstruction, have been assumed to be correlated with NSD. This study investigates the possible correlation of specific radiological findings of PNS pathologies in patients with or without the existence and direction of NSD. We also discussed the different types of NSD and their incidence among different groups stored by age, gender, etc.
Materials and Methods: This is a cross-sectional study conducted at multiple imaging centers in Iran between July 2019 and February 2020 to estimate the prevalence of deviated nasal septum and correlate between NSD and other findings using paranasal sinus scans. All the individuals who met the inclusion and exclusion criteria were included in the study. NSD types have been classified based on Mladina's method.
Results: We prospectively reviewed PNS CT scans obtained from 254 cases (82 men and 172 women), aged 18 to 81 years (mean: 35.53), evaluated over seven months. Out of 254 cases, 135 (53 %) patients had NSD, without any direction predominance (right-sided vs. left-sided), and equally distributed between genders. The most common NSD types were type V with a frequency of 42.22% and type III with a frequency of 24.44%. Other PNS CT findings were also investigated in our patients, like OMC obstruction, pansinusitis, mucocele, air-fluid level, mucosal thickening, and concha bullosa. There was no statistically significant correlation between any of these pathologies and NSD (P-value >0.05).
Conclusion: Although NSD was observed in more than half of our cases' PNS CTs, there was no significant correlation between NSD and other findings in most subjects. This reveals that the effectiveness of septal repair surgeries in relieving patients' symptoms might not be as high as expected.
2- Ibrahim Sumaily, Jibril Hudise, and Saud. Aldhabaan, "Relation between deviated nasal septum and paranasal sinus pathology." Int J Otorhinolaryngol Head Neck Surg, Vol. 3 (No. 4), p. 786, (2017).
3- Tehnia Aziz, Vincent L Biron, Kal Ansari, Carlos Flores-Mir, "Measurement tools for the diagnosis of nasal septal deviation: a systematic review." Journal of Otolaryngology-Head and Neck Surgery, Vol. 43pp. 1-9, (2014).
4- Sarabpreet Singh Kanwar et al., "Evaluation of paranasal sinus diseases by computed tomography and its histopathological correlation." Journal of Oral and Maxillofacial Radiology, Vol. 5 (No. 2), p. 46, (2017).
5- VK Poorey, Neha Gupta, "Endoscopic and computed tomographic evaluation of influence of nasal septal deviation on lateral wall of nose and its relation to sinus diseases." Indian Journal of Otolaryngology Head, and Neck Surgery Vol. 66pp. 330-35, (2014).
6- Iwona Kucybała, Konrad Adam Janik, Szymon Ciuk, Dawid Storman, and Andrzej Urbanik, "Nasal septal deviation and concha bullosa–do they have an impact on maxillary sinus volumes and prevalence of maxillary sinusitis?" Polish journal of radiology, Vol. 82pp. 126-33, (2017).
7- BN Sharma, OB Panta, B Lohani, and U Nepal Khanal, "Computed tomography in the evaluation of pathological lesions of paranasal sinuses." Journal of Health Research Council, (2015).
8- Gavin Setzen et al., "Clinical consensus statement: appropriate use of computed tomography for paranasal sinus disease." Otolaryngol Head Neck Surg, Vol. 147 (No. 5), pp. 808-16, (2012).
9- Marin Šubarić and Ranko %J International journal of pediatric otorhinolaryngology Mladina, "Nasal septum deformities in children and adolescents: a cross sectional study of children from Zagreb, Croatia." Vol. 63 (No. 1), pp. 41-48, (2002).
10- James Palmer and Ioana Schipor, "Frontal-orbital-ethmoid mucoceles." The frontal sinus pp. 75-81, (2005).
11- Hatice Gül Hatipoğlu, Mehmet Ali Cetin, and Enis Diagn Yüksel, "Concha bullosa types: their relationship with sinusitis, ostiomeatal and frontal recess disease." Interv Radiol, Vol. 11 (No. 3), pp. 145-9, (2005).
12- Skipper Seabold and Josef Perktold, "Statsmodels: Econometric and statistical modeling with python." in Proceedings of the 9th Python in Science Conference, (2010), Vol. 57 (No. 61): Austin, TX, pp. 10-25080.
13- Soo Kweon Koo, Jong Deok Kim, Ji Seung Moon, Sung Hoon Jung, and Sang Hoon Lee, "The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: a retrospective radiologic study." Auris Nasus Larynx, Vol. 44 (No. 5), pp. 561-70, (2017).
14- Emre Köse, Emin Murat Canger, and Duygu Göller Bulut, "Cone beam computed tomographic analysis of paranasal variations, osteomeatal complex disease, odontogenic lesion and their effect on maxillary sinus." Meandros Medical And Dental Journal, (2018).
15- Demet Yazici, "The analysis of computed tomography of paranasal sinuses in nasal septal deviation." Journal of Craniofacial Surgery, Vol. 30 (No. 2), pp. e143-e47, (2019).
16- Gisma Ahmed Madani, Wael Amin Nasr El-Din, Asmaa S Essawy, Khamrunissa Hussain, Islam Omar Abdel Fattah, "Nasal septal anatomical variations among Saudi population and their possible coincidence with sinusitis: a computed tomography scan study." Anatomy and Cell Biology, Vol. 55 (No. 4), pp. 423-32, (2022).
17- J Janardhan Rao et al., "Classification of nasal septal deviations—relation to sinonasal pathology." Indian J Otolaryngol Head Neck Surg. Vol. 57pp. 199-201, (2005).
18- Jee Hye Wee et al., "Classification and prevalence of nasal septal deformity in Koreans according to two classification systems." Acta Otolaryngol, Vol. 132 (No. sup1), pp. S52-S57, (2012).
19- SH Lin and CY Ho, "Paranasal sinus pathologies in patients presenting with headache as the primary symptom." Cephalalgia, Vol. 26 (No. 4), pp. 423-27, (2006).
20- Ali Ebrahimi, Mohammad Hosein Kalantar Motamedi, Amin Shams, and Nasrin Nejadsarvari, "Health and social problems of rhinoplasty in Iran." World journal of plastic surgery, Vol. 5 (No. 1), pp. 75-76, (2016).
21- Gregory G Capra, Peter N Carbone, David P Mullin, "Paranasal sinus mucocele." Head and neck pathology, Vol. 6pp. 369-72, (2012).
22- Fatma Caylakli, Haluk Yavuz, Alper Can Cagici, Levent Naci Ozluoglu, "Endoscopic sinus surgery for maxillary sinus mucoceles." Head and Face Medicine, Vol. 2 (No. 1), pp. 1-5, (2006).
23- Mahshid Razavi, Nasim Shams, and Seyed Mohammad Ali Pirasteh Persa, "Determining the effects of deviated nasal septum on maxillary sinus volume using cone-beam computed tomography." Immunopathologia, Vol. 9 (No. 1), pp. e34427-e27, (2022).
24- Sanem Okşan Erkan, Zeynel Abidin Erkan, Birgül Tuhanioğlu, Süheyl Haytoğlu, Zekiye Güney, "The relationship between septal deviation and concha bullosa." The Turkish Journal of Ear Nose, and Throat, Vol. 27 (No. 2), pp. 74-78, (2017).
25- Ali FA Rajashree, P Deepthi, and B Viswanatha, "Impact of concha bullosa on osteomeatal complex drainage and septal deviation." Res Otolaryngol, Vol. 7 (No. 1), pp. 1-4, (2018).
26- Mosaad Abdel-Aziz, Hassan El-Hoshy, Khaled Azooz, Nader Naguib, Ahmed Hussein, "Maxillary sinus mucocele: predisposing factors, clinical presentations, and treatment." Oral and maxillofacial surgery, Vol. 21pp. 55-58, (2017).
27- João Paulo Nunes Drumond, Bruna Bianca Allegro, Neil Ferreira Novo, Sérgio Luís de Miranda, and Wilson Roberto Sendyk, "Evaluation of the prevalence of maxillary sinuses abnormalities through spiral computed tomography (CT)." International archives of otorhinolaryngology, Vol. 21 (No. 02), pp. 126-33, (2017).
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