Evaluation of the Relationship of Concha Bullosa and Nasal Septal Deviation with Chronic Maxillary Sinusitis Based on Cone Beam Computed Tomography

Document Type : مقاله‌های پژوهشی

Authors

1 Associated Professor, Department of Oral and Maxillofacial Radiology, Rafsanjan Medical Sciences University, Rafsanjan, Iran

2 Assistant Professor, Department of Oral and Maxillofacial Radiology, Qom Medical Sciences University, Qom, Iran

3 Professor, Department of Restorative Dentistry, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

4 Dentist, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

Abstract

Introduction: Due to the possible association between chronic sinusitis and anatomical variations of the area, the present study was performed to determine the prevalence of concha bullosa and nasal septal deviation and their association with chronic sinusitis to increase the success rate of nasal endoscopic surgery by eliminating the predisposing factors.
Methods and Materials: In this cross-sectional study, CBCT images of maxilla from 100 patients referred to the radiology department of Hamadan Dental School in the year 2016-2017 were examined. Pneumatization of middle concha (concha bullosa) on sides, nasal septum deviation, and mucosal thickening were recorded. Data were analyzed by Chi-square test based on gender and age (p value ≤ 0.05).
Results: The results showed that there was no significant difference between the mean age and sex with the presence of concha bullosa (p value > 0.05). 50% of the samples had nasal septum deviation and 42% had chronic sinusitis displaying no significant difference between men and women (p value > 0.05); Also, there was no significant difference between nasal deviation and chronic sinusitis (p value > 0.05), although chronic sinusitis was significantly higher in people with concha bullosa and while concha Bullosa was significantly higher in people with nasal septal deviation (p value < 0.05).
Conclusion: According to the results of the study, concha bullose can be considered as a predisposing factor for chronic sinusitis.
Keywords: Maxillofacial abnormality, Diagnostic imaging, Nasal septum, Sinusitis.

1. Mohapatra SS, Sahu N, Rath S, Sahu M, Padhy RN. Significance of relationship between anatomical variants of middle turbinate and nasal septum in recurrent acute rhinosinusitis patients. Int J Otorhinolaryngol Head Neck Surg 2017; 3(3): 569-75.
2.Stammberger H. Endoscopic endonasal surgery--concepts in treatment of recurring rhinosinusitis. Part I. Anatomic and pathophysiologic considerations. Otolaryng Head Neck 1986; 94(2): 143-7.
3. Perez-Pinas I, Sabate J, Carmona A, Catalina-Herrera CJ, Jimenez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat 2000; 197(2): 221-7.
4. Sheikhi M, Pozve NJ, Khorrami L. Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus J. Dent Res J (Isfahan) 2014; 11(4): 495-501.
5. Som P, Lawson W, Biller H, Lanzieri C. Ethmoid sinus disease: CT evaluation in 400 cases. Part I. Nonsurgical patients. Radiology 1986; 159(3): 591-7.
6. Angelopoulos C, Aghaloo T. Imaging technology in implant diagnosis. Dent Clin N Am 2011; 55(1): 141-58.
7. Bolger WE, Parsons DS, Butzin CA. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 1991; 101(1): 56-64.
8. Bahemmat N, Hadian H. The frequency of nasal septal deviation and concha bullosa and their relationship with maxillary sinusitis based on CBCT finding. Int J Med Sci 2016; 5(11): 152-6.
9. Smith KD, Edwards PC, Saini TS, Norton NS. The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent 2010; 2010: 1-5
10. Zinreich SJ, Kennedy DW, Rosenbaum AE, Gayler B, Kumar AJ, Stammberger H. Paranasal sinuses: CT imaging requirements for endoscopic surgery. Radiology 1987; 163(3): 769-75.
11. Shpilberg KA, Daniel SC, Doshi AH, Lawson W, Som PM. CT of anatomic variants of the paranasal sinuses and nasal cavity: Poor correlation with radiologically significant rhinosinusitis but importance in surgical planning. Am J Roentgenol 2015; 204(6): 1255-60.
12. Göçmen G, Borahan MO, Aktop S, Dumlu A, Pekiner FN, Göker K. Effect of septal deviation, concha bullosa and haller's cell on maxillary sinus's inferior pneumatization; a retrospective study. Open Dent J 2015; 31(9): 282-6.
13. Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. Am J Neuroradiol 2004; 25(9): 1613-8.
14. Sheikhi M, Yasrebi M, Torkzadeh A. Evaluation of the effect of nasal septum deviation on chronic sinusitis. J Isfahan Med Sch 2011; 6(5): 568-73. [In Persian].
15. Smith KD, Edwards PC, Saini TS, Norton NS. The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent 2010.
16. Al-Qudah M. The relationship between anatomical variations of the sino-nasal region and chronic sinusitis extension in children. Int J Pediatr Otorhinolaryngol 2008; 72(6): 817-21.
17. Gouripur K, Kumar U, Janagond AB, Elangovan S, Srinivasa V. Incidence of sinonasal anatomical variations associated with chronic sinusitis by CT scan in Karaikal, South India. Int J of Otolaryngol Head Neck Surg 2017; 3(3): 576-80.
18. Senniappan S, Raja K, Tomy AL, Kumar CS, Panicker AM, Radhakrishnan S. Study of anatomical variations of ostiomeatal complex in chronic rhinosinusitis patients. Int J Otorhinolaryngol Head Neck Surg 2018; 4(5): 1281-6.
19. Ozcan KM, Selcuk A, Özcan I, Akdogan O, Dere H. Anatomical variations of nasal turbinates. Arch Craniofac Surg 2008; 19(6): 1678-82.
20. Frinadya N, Munir D, Rambe AY, Sofyan F, Aboet A, Ashar T. Sinonasal anatomical variation in chronic rhinosinusitis patients based on CT-Scan finding. IJRIAR 2019; 3(4): 196-202.
21. Naderpour M, Lotfi AR, Ayat E, Ebrahim AA, Basiri F. Incidence of anatomic variants in patients with chronic sinusits. Med J Tabriz Univ Med Sci 2009; 31(1): 67-70. [In Persian].
22. Kucybała I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal septal deviation and concha bullosa–Do they have an impact on maxillary sinus volumes and prevalence of maxillary sinusitis? Pol J Radiol 2017; 82(4): 126-133.
23. Sazgar AA, Massah J, Sadeghi M, Bagheri A, Rasool F. The incidence of concha bullosa and the correlation with nasal septal deviation. B-ENT 2008; 4(2): 87-91.
24. Braun H, Stammberger H. Pneumatization of turbinates. Laryngoscope 2003; 113(4): 668-72.