PDF herunterladen
CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(01): s00441788909
DOI: 10.1055/s-0044-1788909
Original Research

Anatomical Variations of the Nasal Conchae and Nasal Septum and their Relationships with Alterations in the Maxillary Sinus Mucosa: A Study on Cone-beam Computed Tomography Images

Luara da Silveira Roberto Almeida 
1   Faculty of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
,
Aline da Silva Ruffo 
2   Postgraduation Program in Dentistry, Faculty of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
,
Karina Lopes Devito 
3   Clinical Dentistry Department, Faculty of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
› Institutsangaben Funding The authors declare that they have received no financial support from agencies in the public, private or nonprofit sectors to conduct the present study.
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Introduction In the literature, there is divergence about the relationship between anatomical variations of the turbinates and nasal septum (NS) and alterations in the maxillary sinus (MS) mucosa.

Objective To determine, through cone-beam computed tomography (CBCT) images of Brazilian individuals, the prevalence and relationship of anatomical variations of the turbinates and NS with alterations in the mucosa of the MS, as well as to analyze the relationships of these variables with demographic data.

Methods The present cross-sectional study involved the analysis of 120 CBCT scans using the i-CAT Vision software, conducted by 2 calibrated examiners. The MS, lower and medium turbinates, and NS were evaluated. Data on gender, age, and the side affected by anatomical variation were also collected. The intra- and interexaminer agreements were assessed using Kappa indices. The association was analyzed using the Chi-squared or Fisher exact tests, and measured by the Phi, Cramer V, or Kendall Tau-C values.

Results Most patients presented partial opacification of the MS (89.2%), inferior turbinate hypertrophy (TH) (60.8%), and NS deviation (85%). There were no cases of inferior concha bullosa (CB), while the prevalence of middle CB was of 20%. Variation in the turbinates, CB, and NS were not significantly related to changes in the MS mucosa.

Conclusion We can conclude that, in the evaluated sample, there was no significant associations involving the studied variables.

Keywords

maxillary sinus - sinusitis - turbinates - nasal septum - cone-beam computed tomography


Publikationsverlauf

Eingereicht: 19. Dezember 2023

Angenommen: 17. Juni 2024

Artikel online veröffentlicht:
27. Januar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

Bibliographical Record
Luara da Silveira Roberto Almeida, Aline da Silva Ruffo, Karina Lopes Devito. Anatomical Variations of the Nasal Conchae and Nasal Septum and their Relationships with Alterations in the Maxillary Sinus Mucosa: A Study on Cone-beam Computed Tomography Images. Int Arch Otorhinolaryngol 2025; 29: s00441788909.
DOI: 10.1055/s-0044-1788909
 

  • References

  • 1 Rao N, Datta G, Singh G. To study the role of nasal septal deviation and its relation to sinonasal pathology. Indian J Otolaryngol Head Neck Surg 2022; 74 (Suppl. 02) 755-759
    CrossrefPubMedSuche in Google Scholar
  • 2 Malpani SN, Deshmukh P. Deviated nasal septum a risk factor for the occurrence of chronic rhinosinusitis. Cureus 2022; 14 (10) e30261
    CrossrefPubMedSuche in Google Scholar
  • 3 Cellina M, Gibelli D, Cappella A, Martinenghi C, Belloni E, Oliva G. Nasal cavities and the nasal septum: Anatomical variants and assessment of features with computed tomography. Neuroradiol J 2020; 33 (04) 340-347
    CrossrefPubMedSuche in Google Scholar
  • 4 Alsaggaf ZH, Almadfaa AO, Marouf AA. et al. Sinusitis and its association with deviated nasal septum at a tertiary hospital: A retrospective study. J Taibah Univ Med Sci 2022; 17 (06) 1065-1069
    CrossrefPubMedSuche in Google Scholar
  • 5 Moshfeghi M, Abedian B, Ghazizadeh Ahsaie M, Tajdini F. Prevalence of nasal septum deviation using cone-beam computed tomography: a cross-sectional study. Contemp Clin Dent 2020; 11 (03) 223-228
    CrossrefPubMedSuche in Google Scholar
  • 6 Al-Rawi NH, Uthman AT, Abdulhameed E, Al Nuaimi AS, Seraj Z. Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: A cone-beam computed tomography study. Imaging Sci Dent 2019; 49 (01) 45-51
    CrossrefPubMedSuche in Google Scholar
  • 7 Kalaiarasi R, Ramakrishnan V, Poyyamoli S. Anatomical variations of the middle turbinate concha bullosa and its relationship with chronic sinusitis: a prospective radiologic study. Int Arch Otorhinolaryngol 2018; 22 (03) 297-302
    Thieme ConnectPubMedSuche in Google Scholar
  • 8 Shetty SR, Al-Bayatti SW, Al Kawas S. et al. A study on the association between the inferior nasal turbinate volume and the maxillary sinus mucosal lining using cone beam tomography. Heliyon 2022; 8 (03) e09190
    CrossrefPubMedSuche in Google Scholar
  • 9 Subbotina MV, Kokhanov VS. [The effect of various types of nasal septal deviation, concha bullosa and hypertrophic inferior turbinate on the development of sinusitis]. Vestn Otorinolaringol 2021; 86 (03) 78-83
    CrossrefPubMedSuche in Google Scholar
  • 10 Lee J, Park SM, Cha SW, Moon JS, Kim MS. Does nasal septal deviation and concha bullosa have effect on maxillary sinus volume and maxillary sinusitis? A retrospective study. Daehan Yeongsang Uihakoeji 2020; 81 (06) 1377-1388
    CrossrefPubMedSuche in Google Scholar
  • 11 Liu J, Qian Z, Yan Z, Yang X, Wang N. Asymmetry of inferior turbinate in patients with nasal septum deviation and its significance for nasal ventilation surgery. Eur Arch Otorhinolaryngol 2022; 279 (05) 2423-2431
    CrossrefPubMedSuche in Google Scholar
  • 12 Atsal G, Demir E, Yildirim O, Edizer DT, Olgun L. The relationship between degree of nasal septum deviation with sinonasal structures and variations. J Craniofac Surg 2022; 33 (05) e447-e449
    CrossrefPubMedSuche in Google Scholar
  • 13 Shetty SR, Al Bayatti SW, Al-Rawi NH. et al. Analysis of inferior nasal turbinate width and concha bullosa in subjects with nasal septum deviation: a cone beam tomography study. BMC Oral Health 2021; 21 (01) 206
    CrossrefPubMedSuche in Google Scholar
  • 14 Nangia S, Giridher V, Chawla P. Evaluation of the role of nasal endoscopy and computed tomography individually in the diagnosis of chronic rhinosinusitis. Indian J Otolaryngol Head Neck Surg 2019; 71 (Suppl. 03) 1711-1717
    CrossrefPubMedSuche in Google Scholar
  • 15 Gregurić T, Prokopakis E, Vlastos I. et al. Imaging in chronic rhinosinusitis: A systematic review of MRI and CT diagnostic accuracy and reliability in severity staging. J Neuroradiol 2021; 48 (04) 277-281
    CrossrefPubMedSuche in Google Scholar
  • 16 Roland LT, Marcus S, Schertzer JS, Wise SK, Levy JM, DelGaudio JM. Computed tomography findings can help identify different chronic rhinosinusitis with nasal polyp phenotypes. Am J Rhinol Allergy 2020; 34 (05) 679-685
    CrossrefPubMedSuche in Google Scholar
  • 17 Papadopoulou AM, Bakogiannis N, Skrapari I, Bakoyiannis C. Anatomical variations of the sinonasal area and their clinical impact on sinus pathology: a systematic review. Int Arch Otorhinolaryngol 2022; 26 (03) e491-e498
    Thieme ConnectPubMedSuche in Google Scholar
  • 18 Shetty SR, Al Bayatti SW, Al-Rawi NH. et al. The effect of concha bullosa and nasal septal deviation on palatal dimensions: a cone beam computed tomography study. BMC Oral Health 2021; 21 (01) 607
    CrossrefPubMedSuche in Google Scholar
  • 19 Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol 2004; 25 (09) 1613-1618
    PubMedSuche in Google Scholar
  • 20 Shetty S, Al-Bayatti S, Alam MK. et al. Analysis of inferior nasal turbinate volume in subjects with nasal septum deviation: a retrospective cone beam tomography study. PeerJ 2022; 10: e14032
    CrossrefPubMedSuche in Google Scholar
  • 21 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33 (01) 159-174
    CrossrefPubMedSuche in Google Scholar
  • 22 Calvo-Henríquez C, Mota-Rojas X, Ruano-Ravina A, Martinez-Capoccioni G, Lattomus K, Martin-Martin C. Concha bullosa. A radiological study and a new classification. Acta Otorrinolaringol Esp (Engl Ed) 2019; 70 (03) 145-150
    CrossrefPubMedSuche in Google Scholar
  • 23 Qureshi MF, Usmani A. A CT-Scan review of anatomical variants of sinonasal region and its correlation with symptoms of sinusitis (nasal obstruction, facial pain and rhinorrhea). Pak J Med Sci 2021; 37 (01) 195-200
    CrossrefPubMedSuche in Google Scholar
  • 24 Alnatheer AM, Alkholaiwi F. Concha bullosa of the inferior turbinate. Cureus 2021; 13 (10) e19089
    CrossrefPubMedSuche in Google Scholar
  • 25 Koşar MI, Tetiker H, Uğuz Gençer C, Çullu N, Köseoğlu S. The incidence of pneumatised inferior turbinate and relation to close anatomic structures. Folia Morphol (Warsz) 2019; 78 (03) 621-625
    CrossrefPubMedSuche in Google Scholar
  • 26 Madani GA, El-Din WAN, Essawy AS, Hussain K, Fattah IOA. Nasal septal anatomical variations among Saudi population and their possible coincidence with sinusitis: a computed tomography scan study. Anat Cell Biol 2022; 55 (04) 423-432
    CrossrefPubMedSuche in Google Scholar
  • 27 Anand Chavadaki J, Raghu K, Patel VI. A retrospective study of establishment of association between deviated nasal septum, sinusitis and chronic dacryocystitis. Indian J Otolaryngol Head Neck Surg 2020; 72 (01) 70-73
    CrossrefPubMedSuche in Google Scholar
  • 28 Janovic N, Janovic A, Milicic B, Djuric M. Relationship between nasal septum morphology and nasal obstruction symptom severity: computed tomography study. Rev Bras Otorrinolaringol (Engl Ed) 2022; 88 (05) 663-668
    CrossrefPubMedSuche in Google Scholar
  • 29 Jadia S, Qureshi S, Agrawal S, Singh SG. Effect of deviated nasal septum on maxillary sinus volume and occurrence of sinusitis. Indian J Otolaryngol Head Neck Surg 2019; 71 (Suppl. 03) 1871-1875
    CrossrefPubMedSuche in Google Scholar
  • 30 Bekin Sarikaya PZ, Bayar Muluk N. Relationship between nasal septal deviation angles and turbinates: a computed tomography study. Cureus 2023; 15 (02) e35253
    CrossrefPubMedSuche in Google Scholar
  • 31 Papadopoulou AM, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical variations of the nasal cavities and paranasal sinuses: a systematic review. Cureus 2021; 13 (01) e12727
    CrossrefPubMedSuche in Google Scholar