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Altun O, Özen DÇ, Duman ŞB, Dedeoğlu N, Bayrakdar İŞ, Eşer G, Çelik Ö, Sümbüllü MA, Syed AZ. Automatic maxillary sinus segmentation and pathology classification on cone-beam computed tomographic images using deep learning. BMC Oral Health 2024; 24:1208. [PMID: 39390490 DOI: 10.1186/s12903-024-04924-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 09/18/2024] [Indexed: 10/12/2024] Open
Abstract
BACKGROUND Maxillofacial complex automated segmentation could alternative traditional segmentation methods to increase the effectiveness of virtual workloads. The use of DL systems in the detection of maxillary sinus and pathologies will both facilitate the work of physicians and be a support mechanism before the planned surgeries. OBJECTIVE The aim was to use a modified You Only Look Oncev5x (YOLOv5x) architecture with transfer learning capabilities to segment both maxillary sinuses and maxillary sinus diseases on Cone-Beam Computed Tomographic (CBCT) images. METHODS Data set consists of 307 anonymised CBCT images of patients (173 women and 134 males) obtained from the radiology archive of the Department of Oral and Maxillofacial Radiology. Bilateral maxillary sinuses CBCT scans were used to identify mucous retention cysts (MRC), mucosal thickenings (MT), total and partial opacifications, and healthy maxillary sinuses without any radiological features. RESULTS Recall, precision and F1 score values for total maxillary sinus segmentation were 1, 0.985 and 0.992, respectively; 1, 0.931 and 0.964 for healthy maxillary sinus segmentation; 0.858, 0.923 and 0.889 for MT segmentation; 0.977, 0.877 and 0.924 for MRC segmentation; 1, 0.942 and 0.970 for sinusitis segmentation. CONCLUSION This study demonstrates that maxillary sinuses can be segmented, and maxillary sinus diseases can be accurately detected using the AI model.
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Affiliation(s)
- Oğuzhan Altun
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Duygu Çelik Özen
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Şuayip Burak Duman
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey.
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA.
| | - Numan Dedeoğlu
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - İbrahim Şevki Bayrakdar
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - Gözde Eşer
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Inonu University, Malatya, Turkey
| | - Özer Çelik
- Department of Mathematics-Computer, Eskişehir Osmangazi University Faculty of Science, Eskişehir, Turkey
| | - Muhammed Akif Sümbüllü
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Ataturk University, Erzurum, Turkey
| | - Ali Zakir Syed
- Department of Oral and Maxillofacial Medicine and Diagnostic Sciences, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
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Dhole A, Ramteke A, Motwani M. Radiographic Association of Maxillary Sinus Volume in Patients with Deviated Nasal Septum: A Systematic Review and Meta-analysis. Indian J Otolaryngol Head Neck Surg 2024; 76:4929-4936. [PMID: 39376416 PMCID: PMC11455774 DOI: 10.1007/s12070-024-04761-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/15/2024] [Indexed: 10/09/2024] Open
Abstract
The nasal septum, composed of bone and cartilage, maintains nasal alignment and airflow. Deviation, common but potentially problematic, can lead to symptoms like congestion and sinusitis. Maxillary sinus, a key paranasal sinus, influences airflow and drainage. Nasal septum deviation can alter maxillary sinus volume, affecting airflow dynamics and drainage. Cone beam computed tomography (CBCT) and CT imaging are essential for assessing these conditions accurately, providing detailed 3D images and aiding in diagnosis and treatment planning. The study aims to review the radiographic association of maxillary sinus volume in patients with deviated nasal septum. The present review has been registered with PROSPERO-An international prospective register of systematic review CRD42023467988. Eligibility criteria: Studies from 2013 to 2022, in English, on maxillary sinus volume in deviated nasal septum patients. Exclusions: Animal studies, case reports, non-English articles. The Meta-analysis found that consistent association between nasal septum deviation and reduced maxillary sinus volume and no publication bias. The radiographic association of maxillary sinus volume in patients with deviated nasal septum was found to be statistically meaningful.
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Affiliation(s)
- Apeksha Dhole
- VSPM Dental College and Research Centre, Plot no 271, Flat no 7,Vivek Apartment, Central Bazar Road, Ramdaspeth, Nagpur, Maharashtra India
| | - Anwesha Ramteke
- VSPM Dental College and Research Centre, Plot no 271, Flat no 7,Vivek Apartment, Central Bazar Road, Ramdaspeth, Nagpur, Maharashtra India
| | - Mukta Motwani
- VSPM Dental College and Research Centre, Plot no 271, Flat no 7,Vivek Apartment, Central Bazar Road, Ramdaspeth, Nagpur, Maharashtra India
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Osman SAA, Abu Alhaija E, AlWahadni AM, Al Maaitah E, Daher S, Daher H, AlTal H. Evaluation of nasal septal deviation and maxillary bone and nasal airway dimensions and volumes using cone-beam computed tomography in patients with unilateral palatal canine displacement: a retrospective study. Angle Orthod 2024; 94:421-431. [PMID: 39229944 PMCID: PMC11210511 DOI: 10.2319/110523-736.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/01/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVES To detect any association between palatally displaced canine (PDC) and nasal septal deviation (NSD), palatal bone thickness and volume, and nasal airway dimensions and volume. MATERIALS AND METHODS A total of 92 patients were included and subdivided into two groups: group 1, unilateral PDCs (44 patients), and group 2, normally erupted canines (NDCs) (48 subjects). The following variables were measured using cone-beam computed tomography: presence and type of NSD, nasal width, inferior conchae, hard palate and nasal septum thickness, maxillary bone and nasal airway volumes. RESULTS NSD was detected in 77% and 50% of PDC and NDC subjects, respectively. Within the PDC subjects, significant differences between the displaced and nondisplaced sides were detected. Palate thickness was increased in the canine region and reduced in the molar region. Compared with the control group, PDC subjects had reduced palate thickness and lower nasal airway volume. Two predictors were significant for predicting the odds of PDC occurrence: NSD and maxillary bone volume. CONCLUSIONS NSD is more frequent in PDC subjects. PDC subjects have reduced palate thickness and decreased nasal airway volume. In the presence of NSD, the odds of developing PDC increase by 3.35 times, and for each one-unit increase in the maxillary bone volume, the odds of developing PDC decrease by 20%.
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Affiliation(s)
| | - Elham Abu Alhaija
- Corresponding author: Prof Elham Abu Alhaija, College of Dental Medicine, QU Health, Qatar University, PO Box 2713, Doha, Qatar (e-mail: )
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Ahn SJ, Park SE, Choi JY, Min JY, Kim KA, Kim SJ. Internal structural analysis of the nasomaxillary complex in patients with skeletal class III asymmetry: A study on asymmetry patterns. Orthod Craniofac Res 2024; 27:376-386. [PMID: 38058275 DOI: 10.1111/ocr.12739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES To investigate the internal structure of the nasomaxillary complex, including the maxillary sinus, nasal cavity and nasal septum according to the facial asymmetry pattern and to evaluate its correlation with external maxillomandibular asymmetry in Class III patients based on cone-beam computerized tomography (CBCT) images. MATERIALS AND METHODS Facial asymmetry was analysed in a total of 100 Class III patients aged 16 years or older using CBCT scans. Patients were categorized into subgroups based on asymmetry pattern. Measurements of the nasomaxillary complex were obtained from the CBCT scans, including the volume and width of the maxillary sinuses and nasal cavities on deviated and non-deviated sides, as well as the displacement of the nasal septum. Statistical analysis was performed to compare the internal nasomaxillary variables within and between groups, and regression analysis was conducted to evaluate the correlation between facial asymmetry and the internal nasomaxillary variables. RESULTS Group comparisons showed that there were no significant differences in the volume of the maxillary sinus and nasal cavity. However, the direction and extent of nasal septum deviation, as well as the width of the nasal cavity, varied depending on the maxillary asymmetry pattern. Regression analysis indicated a correlation between nasal septum deviation and the difference in maxillary height, while the difference in nasal cavity width was correlated with the difference in maxillary width. CONCLUSION A comprehensive evaluation of the internal nasal anatomy is vital for understanding the intricate relationship between nasal structure and maxillary growth.
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Affiliation(s)
- Sung Jea Ahn
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Song E Park
- Department of Dentistry, Graduate School, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Kyung Hee University Dental Hospital, Seoul, Korea
| | - Jin Young Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
| | - Kyung-A Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Su-Jung Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, Seoul, Korea
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İncebeyaz B, Öztaş B. Evaluation of osteomeatal complex by cone-beam computed tomography in patients with maxillary sinus pathology and nasal septum deviation. BMC Oral Health 2024; 24:544. [PMID: 38730322 PMCID: PMC11088115 DOI: 10.1186/s12903-024-04272-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This study aimed to determine if there is a relationship between the presence of maxillary sinus pathology, nasal septum deviation and various lengths of the osteomeatal complex. METHODS A total of 223 CBCT images were included in the study. The lengths of the osteomeatal complex (maxillary sinus ostium width, infundibulum length, maxillary sinus ostium height) were analyzed. The presence of maxillary sinus pathology, nasal septum deviation, age, sex, right-left, septum deviation level, and the relationship between pathology level and all variables were evaluated. RESULTS The average maxillary sinus ostium width, ostium height and infundibulum length were 3.06 ± 0.70 mm, 30.10 ± 5.43 mm and 8.82 ± 1.86 mm, respectively. Ostium width was significantly higher in the healthy group than in the groups evaluated in the presence of deviation and pathology. A significant difference was found in infundibulum length only between the healthy condition and the condition evaluated in the presence of deviation. No significant difference was observed between the groups in terms of ostium height. In all groups, ostium height and infundibulum length were significantly higher in men than in women. The age group with the highest average ostium height was found in the 35-44 age group (p < 0.001). CONCLUSION Identifying normal and abnormal conditions in the osteomeatal complex area is important for diagnosing the cause of a patient's complaint, guiding the surgical procedures to be performed, and preventing possible complications that may arise during surgical procedures.
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Affiliation(s)
- Burak İncebeyaz
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Besevler, 06500, Turkey.
| | - Bengi Öztaş
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Besevler, 06500, Turkey
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Digilli Ayaş B, Çiçekcibaşı AE, Gökşan AS, Açar G, Aydoğdu D. Clinically relevant morphometric analysis of pterygopalatine fossa and its volumetric relationship with adjacent paranasal sinuses: a CT-based study. Oral Radiol 2024; 40:285-294. [PMID: 38236559 DOI: 10.1007/s11282-023-00735-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES This study aimed to perform morphometric measurements of the pterygopalatine fossa (PPF), the transition zone to critical neurovascular structures. The second aim was to investigate the relationship between the volumes of the PPF and the paranasal sinuses and the effect of nasal septum deviation (NSD) types on all these measurements. METHODS We performed PPF's morphometry and all volume measurements on the CT images of 260 patients (130 male and 130 female, age range 18-79). RESULTS All volumetric measurements and the angle between foramen rotundum (FR) and pterygomaxillary fissure (PMF) were significantly higher in males than females. In contrast, the distance between sphenopalatine foramen (SPF) and PMF was considerably higher in females than in males. The PPF volume, the distance between the pterygoid canal (PC) and maxillary sinus, and the angle between FR and PMF were significantly higher on the right side than on the left. In contrast, the angle between PC and SPF and between greater palatine canal and PPF were considerably higher on the left side than on the right. The angle between PC and SPF decreased markedly with age. Only sphenoidal sinus volume was significantly smaller on the same side as the septal deviation. There was no correlation between PPF volume with maxillary and sphenoid sinus volumes from adjacent paranasal sinuses. CONCLUSIONS Volumetric and morphometric data obtained from PPF and paranasal sinuses can aid clinicians in diagnosing and treating patients by guiding them in selecting the right surgical approach or tools, especially in endoscopic procedures.
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Affiliation(s)
- Betül Digilli Ayaş
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey.
| | - Aynur Emine Çiçekcibaşı
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Ahmet Safa Gökşan
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Gülay Açar
- Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
| | - Demet Aydoğdu
- Department of Radiology, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, Turkey
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Madi M, Alsaad SS, AlAssiry N, Attia D, AlAssiry M, Zakaria O. Multilevel Modeling Analysis of Odontogenic Risk Factors and Nasal Septum Deviation Associated with Maxillary Sinus Mucosal Thickening: A Cone-Beam Computed Tomography Study. Dent J (Basel) 2024; 12:74. [PMID: 38534298 DOI: 10.3390/dj12030074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
(1) Background: In this study, the impact of odontogenic risk factors with nasal septum deviation on maxillary sinus mucosal thickening was assessed using Cone-beam computed tomography CBCT. (2) Methods: A total of 328 maxillary sinus regions from 164 patients (85 males and 79 females) were examined. Images were interpreted by dental specialists and Otolaryngologists. Coronal and sagittal sections were examined to assess the proximity of the root tips of posterior maxillary teeth (RPMT) to the maxillary sinus. The periodontal bone loss for all maxillary posterior teeth was also assessed. Consequently, maxillary sinus mucosal thickening (MT) was further classified into three gradings. Multilevel modeling regression analysis was used due to the hierarchical structuring of the data. Four models were developed, a null model with no factors, a model with tooth-level factors (RPMT, PBL, tooth condition, and root length), a model with patient-level factors (gender and nasal septum deviation), and a model with combined patient- and tooth-level factors. Regression estimates (AOR) and 95% confidence intervals (CIs) of individual and tooth factors were calculated. (3) Results: Multilevel regression analysis showed that RPMT was significantly associated with MT of maxillary sinus (p < 0.001), where patients who had RPMT > 0 had higher odds of MT of maxillary sinus. Tooth condition was also found to be significantly associated with MT of maxillary sinus, where teeth with failed RCT (p < 0.001) and teeth with restorations (p < 0.008) had higher odds of MT of maxillary sinus (AOR = 2.87, 95%CI 1.65, 4.42, AOR = 1.64, 95%CI 1.14, 2.36, respectively). (4) Conclusions: In order to plan preoperative treatment for maxillary posterior teeth, it is important to assess the anatomical relationship between the sinus floor and the root tips of the maxillary posterior teeth. Additionally, we establish a better understanding of the clinician before surgical intervention is conducted.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sara S Alsaad
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Nada AlAssiry
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Dina Attia
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Mansour AlAssiry
- Department of Otolaryngology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Singh H, Bhatt A, Kumar M, Deshmukh P. Tonsillitis and Sinusitis: A Narrative Review of Pathogenesis, Diagnosis, and Management. Cureus 2023; 15:e47192. [PMID: 38021555 PMCID: PMC10652663 DOI: 10.7759/cureus.47192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
The review aims for a comprehensive examination of tonsillitis and sinusitis, covering their pathophysiology, diagnosis, and management, with a focus on recent breakthroughs and therapeutic practices. Tonsillitis, marked by inflammation of the tonsils, can result from viral or bacterial infections, particularly Streptococcus pyogenes, with attention to antibiotic resistance trends. This review discusses clinical manifestations, diagnostic criteria, and the importance of distinguishing viral from bacterial causes. Therapeutic interventions like antibiotics and tonsillectomy indications are evaluated within evolving guidelines. Regarding sinusitis, it explores its origins, contributing factors, and classification based on duration and pathophysiology. Viral infections, allergens, and structural anomalies' roles in pathogenesis are highlighted. Diagnostic modalities like imaging and endoscopic exams are assessed for their efficacy in guiding management decisions. The importance of precise diagnosis through clinical examination, microbiological testing, and imaging is emphasized for informed treatment choices. This review also delves into minimally invasive surgical procedures, particularly endoscopic sinus surgery and tonsillectomy, showcasing progress in these areas. In summary, it provides insights into tonsillitis and sinusitis, offering perspectives on their aetiology, diagnosis, and treatment while integrating current research and clinical standards to enhance patient care and healthcare resource utilization.
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Affiliation(s)
- Harshit Singh
- Otolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Asmi Bhatt
- Medicine and Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Mayank Kumar
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Prasad Deshmukh
- Otolaryngology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Göksel S, Güler AY. Is There a Relationship Between Maxillary Sinus's Inferior Pneumatisation and Sinonasal Variations? A Retrospective CBCT Study. J Oral Maxillofac Res 2023; 14:e3. [PMID: 37969952 PMCID: PMC10645475 DOI: 10.5037/jomr.2023.14303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/30/2023] [Indexed: 11/17/2023]
Abstract
Objectives This retrospective study aims to analyse alveolar and palatal process pneumatisation and their relationships with sinonasal variations using cone-beam computed tomography. Material and Methods The study included 500 patients aged 18 to 87 years, involving 1000 maxillary sinuses with cone-beam computed tomography scans. We examined the relationship between inferior maxillary pneumatisation and the following anatomic variations: Haller cell, concha bullosa, paradoxical concha, bifid concha, and septal deviation. Results Among the 1000 maxillary sinuses assessed, we found 223 (22.3%) with alveolar process pneumatisation (APP), 37 (3.7%) with palatal process pneumatisation (PPP), and 23 (2.3%) with the presence of both APP and PPP. Significant relationships were observed between the Haller cell (P = 0.005), nasal septum deviation (P = 0.000), and middle concha bullosa (P = 0.01) with APP. However, there were no significant relationships between the paradoxical middle concha (P = 0.07), bifid middle concha (P = 0.74), and APP. Similarly, significant relationships were observed between the Haller cell (P = 0.001), paradoxical middle concha (P = 0.009), bifid middle concha (P = 0.000), and PPP. However, there were no significant relationships between concha bullosa (P = 0.799) and PPP. Additionally, we found significant relationships between the Haller cell (P = 0.003) and the presence of both APP and PPP. Conclusions This study provides an anatomical basis for imaging diagnosis by investigating the frequency of inferior pneumatisation of the maxillary sinus and its relationship with certain sinonasal variations.
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Affiliation(s)
- Sevde Göksel
- Tepebasi Oral and Dental Health Hospital, AnkaraTurkey.
| | - Arif Yiğit Güler
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ankara Medipol UniversityTurkey.
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Özdemir A, Bayar Muluk N, Tursun S, Şencan Z, Özel G. Maxillary sinus volume and mucosal thickening according to the septal deviation angle and age of the children. J Investig Med 2023; 71:254-264. [PMID: 36803040 DOI: 10.1177/10815589221140598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
We examined the relationship between nasal septal deviation (SD) angle and maxillary sinus volumes by examining the paranasal sinus computed tomography (PNSCT) images in children. In this retrospective study, PNSCT images of 106 children with one-sided nasal SD were included. According to the SD angle, two groups were identified: Group 1 (n = 54): SD angle ≤ 11°, Group 2 (n = 52): SD angle > 11°. There were 23 children between 9 and 14 years and 83 children between 15 and 17 years. Maxillary sinus volume and mucosal thickening were evaluated. In 15- to 17-year age group, maxillary sinus volumes of males were higher than females bilaterally. For each of the males and females, ipsilateral maxillary sinus volume was significantly lower than the contralateral side in all children and in 15- to 17-year age group. In each of the SD angle values (≤11 or >11) separately, ipsilateral maxillary sinus volume was lower; and in the SD angle > 11° group, maxillary sinus mucosal thickening values were higher than those of the contralateral side. In young children in 9- to 14-year age group, bilateral maxillary sinus volumes decreased, in this group maxillary sinus volume was not affected according to the SD. However, in 15- to 17-year age groups, maxillary sinus volume was lower on the ipsilateral SD side; and ipsilateral and contralateral maxillary sinus volumes of the males were significantly higher than those in the females. SD should be treated at an appropriate time to prevent SD-related maxillary sinus volume shrinkage and rhinosinusitis.
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Affiliation(s)
- Adnan Özdemir
- Radiology Department, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Nuray Bayar Muluk
- ENT Department, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Serkan Tursun
- Pediatrics Department, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Ziya Şencan
- ENT Department, Faculty of Medicine, Kırıkkale University, Kırıkkale, Turkey
| | - Gökçe Özel
- ENT Clinics, Private Clinics, Ankara, Turkey
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Muacevic A, Adler JR. Relationship Between Nasal Septal Deviation Angles and Turbinates: A Computed Tomography Study. Cureus 2023; 15:e35253. [PMID: 36825074 PMCID: PMC9942431 DOI: 10.7759/cureus.35253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Background This study aimed to evaluate inferior turbinate hypertrophy caused by nasal septum deviation, nasal septal deviation (SD) angles, and age differences with the help of paranasal computed tomography (CT) and to investigate the relationship between these parameters. Methodology The paranasal sinus CT images of 100 patients (50 males and 50 females) were retrieved from the hospital's picture archiving and communication system. In this retrospective study, patients were examined in two groups. There were 50 patients aged >35 years in group 1 and 50 patients aged <35 years in group 2. The SD side was determined using a coronal image and was mentioned as the ipsilateral side. The contralateral side of the SD side was mentioned as the contralateral side. Additionally, the SD curve angle (SDCA), superior SD angle (SSDA), and diameters and mucosal thicknesses of the inferior turbinates were measured. Concomitant ipsilateral sinusitis and ipsilateral concha bullosa (in the middle concha) were also noted as present or absent. Results In our study, the SDCA values of the ≥35-year age group were significantly higher than those of the <35-year age group (p < 0.05). Furthermore, the SSDA values of the ≥35-year age group were significantly lower than those of the <35-year age group (p < 0.05). In each of the age groups, ipsilateral inferior turbinate mucosal thickness and ipsilateral inferior turbinate diameter values were significantly higher than those of the contralateral sides (p < 0.05). Ipsilateral concha bullosa was present in 30.0% of the <35-year age group and 18.0% of the ≥35-year age group. Ipsilateral sinusitis was present in 34.0% of the <35-year age group and 52.0% of the ≥35-year age group. Conclusions SD and inferior turbinate hypertrophies should be evaluated together and measured with paranasal CT to provide more efficient nasal aeration. Studies with larger patient series are needed to elucidate the etiology.
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Eshghpour M, Vaezi T, Samieirad S, Manafi A, Ebrahimpour A, Shams A. Assessment of Maxillary Sinus Variations Post-LeFort: A Systematic Review. World J Plast Surg 2023; 12:3-10. [PMID: 38226188 PMCID: PMC10788108 DOI: 10.61186/wjps.12.3.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/25/2023] [Indexed: 01/17/2024] Open
Abstract
Background The purpose of this article was to systematically review maxillary sinus changes after LeFort. We examined and analyzed the anatomical abnormalities that occurred following LeFort I osteotomy, as well as the abnormalities of maxillary sinus volume (MSV) before and after the operation. Methods A systematic search was conducted on various databases, such as Google Scholar, PubMed, and Scopus. The articles used were in English and original. This study was conducted until September 2023, and after reviewing the articles, several keywords, such as "Maxillary sinus" and "LeFort I osteotomy", were employed. The obtained data were evaluated based on the PICO framework. Results Findings from 15 studies showed that the amount of MSV decreased before and after the operation (considering the three dimensions of the sinus, the measurement was performed linearly). These reduction values differed between men and women, with men having a greater reduction. As is the case with other operations, there were some side effects associated with this type of operation that some patients experienced postoperatively. Conclusion In both male and female patients, the MSV was reduced after one-piece and multi-segment osteotomies. Nonetheless, one-piece LeFort I osteotomy showed a higher reduction in MSV than the multi-segment osteotomy method, according to this systematic review and meta-analysis.
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Affiliation(s)
- Majid Eshghpour
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Science, Mashhad, Iran
| | - Touraj Vaezi
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Science, Mashhad, Iran
| | - Sahand Samieirad
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Mashhad University of Medical Science, Mashhad, Iran
| | - Ali Manafi
- Department of Plastic Surgery, Iran university of Medical Sciences, Tehran, Iran
| | - Alireza Ebrahimpour
- Department of Oral and Maxillofacial Surgery, Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Science, Mashhad, Iran
| | - Abdolrahim Shams
- Department of Oral and Maxillofacial Surgery, Student Research Committee, Faculty of Dentistry, Mashhad University of Medical Science, Mashhad, Iran
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Malpani SN, Deshmukh P. Deviated Nasal Septum a Risk Factor for the Occurrence of Chronic Rhinosinusitis. Cureus 2022; 14:e30261. [PMID: 36381736 PMCID: PMC9650940 DOI: 10.7759/cureus.30261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
The aim of this review article is to determine whether a deviated nasal septum (DNS) is a potential risk factor for the occurrence of chronic rhinosinusitis (CRS). Nasal septal deformities include spur, deviated nasal septum, thickening, and dislocation. Deformities of the nose tip and columella are examples of external deformities, together with the deviated part of either cartilage or both the bony and cartilage part of the dorsum of the nose. Various symptoms of chronic rhinosinusitis include nasal obstruction, nasal or post-nasal drainage, facial pain and pressure, and smell disturbances. For a long time, the deviation of the nasal septum is related to the pathogenesis, progression, and severity of chronic rhinosinusitis. Mechanisms involving mechanical and aerodynamics theory may be used to explain this relationship. Etiology in the occurrence of CRS are allergy, asthma, tooth Infection, immunodeficiency, mucociliary disorders, anatomical irregularities like DNS, concha bullosa, septum spurring, or an expanded cystic middle turbinate or prominent agger nasi cells that compromise the osteomeatal complex. The computed tomography (CT) scan imaging of the nasal cavity and paranasal sinuses has dramatically improved especially since the use of coronary CT scans. These scans make it simple to find even minute changes and abnormalities in bony structures and mucosal pathologies. An increase in the angle of DNS is significantly linked to specific disease patterns in the osteomeatal complex. This review shows that not all subtypes of DNS always result in the development of CRS. Only extremely severe DNS appears to contribute to the etiology of CRS.
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14
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Koparal M, Ege B, Sirik M, Kurt MY, Kurt E. Evaluation of the associations between maxillary sinus dimensions and adenoid hypertrophy using multislice computed tomography. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:459-464. [PMID: 35728775 DOI: 10.1016/j.jormas.2022.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/08/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Adenoid hypertrophy is especially common in childhood, raising the concern that such growth might affect maxillary sinus volumes during the developmental period. This study evaluated the developmental relationships between maxillary sinus volumes and adenoid hypertrophy via computed tomography. MATERIALS AND METHODS It was examined computed tomographic images of 118 individuals: 61 boys and 57 girls. The participants were divided into a healthy control group (n = 59) and an experimental group (with adenoid hypertrophy) (n = 59). Raw data were recorded in DICOM format and analysed using the ITK-SNA algorithm; it was measured the right, left, and total maxillary sinus volumes and adenoid tissue sizes. RESULTS It was found significant between-group differences in the three maxillary sinus volumes and adenoid tissue dimensions (linear maximum anterior and posterior depth; maximum upper and lower height, and maximum width to the right and left) (all p<0.001). On the contrary, there was no significant difference according to sex in terms of either maxillary sinus volumes or linear adenoid tissue measurements. Maxillary sinus volumes increased significantly according to age in both groups. CONCLUSION Adenoid hypertrophy decreases the maxillary sinus volumes, regardless of sex. The impacts of adenoid growth on maxillary sinus aeration and sinus disease should be further investigated.
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Affiliation(s)
- Mehtap Koparal
- Department of Otolaryngology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey.
| | - Bilal Ege
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adiyaman University, Adiyaman, Turkey
| | - Mehmet Sirik
- Department of Radiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Muhammed Yusuf Kurt
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Adiyaman University, Adiyaman, Turkey
| | - Ercan Kurt
- Department of Otolaryngology, Adiyaman University Education and Training Hospital, Adiyaman, Turkey
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15
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Lee S, Fernandez J, Mirjalili SA, Kirkpatrick J. Pediatric Paranasal Sinuses- Development, Growth, Pathology & Functional Endoscopic Sinus Surgery. Clin Anat 2022; 35:745-761. [PMID: 35437820 PMCID: PMC9544638 DOI: 10.1002/ca.23888] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 11/27/2022]
Abstract
The paranasal sinuses (maxillary, frontal, ethmoid, and sphenoid sinuses) are complex anatomical structures. The development and growth of these have been investigated utilizing a number of different methods ranging from cadaveric analysis to modern cross sectional imaging with 3D modeling. An understanding of normal pediatric paranasal sinus embryology and development enables us to better determine when pathology may be affecting the normal developmental process. Cystic fibrosis, chronic sinusitis, deviated nasal septum and cleft lip and palate are some of the conditions which have been shown to effect paranasal sinus development to varying degrees. Functional endoscopic sinus surgery (FESS) is becoming increasingly common and an understanding of sinus anatomy together with when periods of rapid growth occur during childhood is important clinically. Although concerns have been raised regarding the impact of FESS on facial growth, there is limited evidence of this in regards to either changes in anthropomorphic measurements or clinical assessments of symmetry post operatively.
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Affiliation(s)
- Sophie Lee
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Justin Fernandez
- Auckland Bioengineering Institute, University of Auckland, New Zealand
| | - S Ali Mirjalili
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Joshua Kirkpatrick
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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16
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Yamaguchi K, Munakata M, Kataoka Y, Uesugi T, Shimoo Y. Effects of missing teeth and nasal septal deviation on maxillary sinus volume: a pilot study. Int J Implant Dent 2022; 8:19. [PMID: 35428947 PMCID: PMC9012776 DOI: 10.1186/s40729-022-00415-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/30/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Tooth extraction and the projection of the tooth roots into the maxillary sinus are reported to greatly reduce the bone height from the alveolar ridge to the maxillary sinus floor, while missing teeth are reported to lead to the expansion of the maxillary sinus, all of which are important considerations during dental implant treatment for the maxillary molar region. Therefore, assessing the anatomical characteristics of the maxillary sinus acting as complicating factors is crucial before sinus augmentation. We conducted a three-dimensional examination of the effects of missing teeth and nasal septal deviation (NSD) on maxillary sinus volume (MSV). METHODS We selected participants with two or more missing teeth from patients who underwent maxillary sinus augmentation for a unilateral free-end saddle between April 2019 and December 2020. We calculated the MSV and NSD using cone-beam computed tomography (CBCT). We compared the relationships of the presence/absence of teeth and NSD with MSV bilaterally in each patient using the Wilcoxon t-test. p-values < 0.05 denoted statistical significance. RESULTS This study included 30 patients (30 sinuses; 12 men, 18 women). The average patient age was 58.2 ± 10.2 years (men, 60.4 ± 3.7 years; women, 59.2 ± 4.5 years; range, 40-77 years). The mean number of missing teeth was 2.98 ± 1.01: 13 patients had two missing teeth and 17 had three or more missing teeth. Nine patients (30%) had NSD. The mean MSV on the ipsilateral and contralateral sides of the NSD was 21.50 ± 3.84 cm3 and 22.10 ± 3.56 cm3, respectively; thus, NSD did not affect MSV (p = 0.150). The mean MSV on the edentulous and non-edentulous sides was 21.58 ± 3.89 cm3 and 21.77 ± 4.30 cm3, respectively; thus, the MSV was significantly smaller on the edentulous side (p = 0.00036). CONCLUSION Although this study was a limited preoperative study, three-dimensional measurement of the maxillary sinus with CBCT in partially edentulous patients revealed that missing teeth lead to substantial reductions in MSV, while NSD was not associated with MSV.
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Affiliation(s)
- Kikue Yamaguchi
- Department of Implantology Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, Tokyo, 145-8515, Japan.
| | - Motohiro Munakata
- Department of Implantology Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Yu Kataoka
- Division of Biomaterials and Engineering, Department of Conservative Dentistry, Showa University School of Dentistry, Tokyo, Japan
| | - Takashi Uesugi
- Department of Implantology Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, Tokyo, 145-8515, Japan
| | - Yoshiaki Shimoo
- Department of Implantology Dentistry, Showa University School of Dentistry, 2-1-1, Kita-Senzoku, Ota-ku, Tokyo, 145-8515, Japan
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The Relationship Between Degree of Nasal Septum Deviation With Sinonasal Structures and Variations. J Craniofac Surg 2021; 33:e447-e449. [PMID: 34690315 DOI: 10.1097/scs.0000000000008274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 09/14/2021] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT We aimed to evaluate whether the nasal septum deviation affects the development of sinonasal structures. Patients who had undergone paranasal sinus computed tomography (PNS-CT) imaging due to nasal obstruction were divided into 3 groups according to the septal deviation angle; group I: 0° to 9°, group II: 10° to 15°, and group III: >15°. The features of sinonasal structures were recorded when evaluating PNS-CT. There were totally 234 patients, 119 patients in group I, 68 in group II, and 47 in group III. On the opposite side of the deviation, keros 3 was significantly more in group III (P < 0.001). Although the incidence of concha bullosa and agger nasi cell were not affected by the degree of deviation (P > 0.05), the incidence of Haller and Onodi cells were significantly higher in group III (P < 0.001). In addition, all cells were observed more in the opposite side of the deviation in each group (P < 0.001). Maxillary sinus retention cysts and hypoplasia of maxillary and frontal sinuses, as an indicator of the low pneumatization of the sinuses, are seen more on the same side of nasal septum deviation, increasing with the degree of deviation increases (P < 0.001). Nasal septum deviation affects the development of sinonasal structures by affecting the pneumatization. Preoperative PNS-CT evaluation is important in order to be aware of the situations that we may encounter during surgery and to provide adequate treatment.
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Morphometric and volumetric evaluation of maxillary sinus in patients with chronic obstructive pulmonary disease using cone-beam CT. Oral Radiol 2021; 38:261-268. [PMID: 34231096 DOI: 10.1007/s11282-021-00553-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The purpose of present study is to assess the maxillary sinuses patients with COPD morphometrically and volumetrically using cone-beam computed tomography (CBCT) images and compared these findings according to in age and gender of control groups. METHODS CBCT images of 80 individuals that exist from 40 patients with COPD and 40 healthy individuals (6 females, 34 males) in the tomography archive were retrospectively analyzed. The volume and surface area of maxillary sinuses in COPD and control group were measured by semi-automatic segmentation method and obtained findings were statistically examinated according to age, gender. RESULTS The study was observed that there was no statistically significant difference between the right maxillary sinus area and the groups, but left maxillary sinus and total sinus area of COPD group were observed to be significantly lower than the control group (p < 0.05). Maxillary sinus volume was found to be statistically significantly lower in patients with COPD than in healthy controls (p < 0.05). CONCLUSIONS CBCT is a practical and effective imaging method for the evaluation of maxillary sinuses. It is thought that inflammatory diseases that cause sinonasal changes such as COPD may affect maxillary sinus sizes.
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Aşantoğrol F, Coşgunarslan A. The effect of anatomical variations of the sinonasal region on maxillary sinus volume and dimensions: a three-dimensional study. Braz J Otorhinolaryngol 2021; 88 Suppl 1:S118-S127. [PMID: 34053909 PMCID: PMC9734263 DOI: 10.1016/j.bjorl.2021.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Anatomical variations in the sinonasal region are remarkably common and these variations may have an impact on maxillary sinus development due to their close anatomical adjacency. OBJECTIVE The aim of this study was to investigate the effect of anatomical variations of the sinonasal region on the width, height, length, and volume of the maxillary sinus. METHODS Cone beam computed tomography records of 120 patients were evaluated. Nasal septum deviation angle was measured for each patient and patients were divided into three groups as mild, moderate, and severe. Sinonasal variations such as nasal septum deviation direction, septal spur, concha bullosa, uncinate process pneumatization, middle concha hypertrophy, inferior concha hypertrophy, paradoxical middle concha and presence of septa in the maxillary sinus were registered. Cone beam computed tomography images were transferred to the SimPlant software thus right and left maxillary sinus volumes and dimensions were measured separately. RESULTS There was a negative and statistically significant relationship between age and left maxillary sinus width (p = 0.015). The relationships between gender and maxillary sinus volumes and dimensions were statistically significant (p < 0.05). Although there were significant relationships between the nasal septum deviation severity, middle concha hypertrophy, inferior concha hypertrophy, paradoxical middle concha, and presence of septa and maxillary sinus dimensions; there was no significant relationship between septal spur, nasal septum deviation direction, concha bullosa, uncinate process pneumatization, and maxillary sinus dimensions. No statistically significant relationship could be determined between maxillary sinus volume and anatomical variations of the sinonasal region. CONCLUSION According to our findings, while certain the variations were found to affect the sinus dimensions; none of the variations was found to be related to the maxillary sinus volume.
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Affiliation(s)
- Firdevs Aşantoğrol
- Erciyes University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Kayseri, Turkey,Corresponding author.
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20
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Alsufyani N, El-Hakim H, Major P. Prevalence of maxillary sinus hypoplasia and association with variations in the sinonasal complex: a cone beam CT study. Clin Oral Investig 2021; 25:5463-5471. [PMID: 33661447 DOI: 10.1007/s00784-021-03854-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 02/19/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Understanding of maxillary sinus hypoplasia (MSH) and associated sinonasal variants is paramount to the diagnostic and therapeutic success of maxillary sinus and maxillary dental implant surgery. The purpose of this work was to explore the prevalence of MSH, frequency of mucosal thickening, and anatomical variations in the sinonasal complex. METHODS Retrospective case-control design based on cone beam CT images of dental patients with MSH and matched for age and gender. MSH type and sinonasal variables were recorded. RESULTS One thousand three hundred seventy cone beam CT scans were analyzed for MSH. MSH prevalence was 6% (n=82), matched with 82 controls= 100 females and 64 males, mean age 37.1±14.1 years. Most MSH were type I, 69.5%, 80.5% unilateral, 65.9% associated with no or mild mucosal thickening. Associated sinonasal anatomical variations were <27% except for deviated/hyperplastic (DH) meatus, 48.8%. Within the MSH group, significant associations were presented between MSH type, mucosal thickening, and DH nasal meatus. MSH group vs controls showed a significant difference in mucosal thickening (OR 5.2, 95% CI 2.0-17.3) and DH meatus (OR 1.6, 95% CI 1.4-2.1). CONCLUSIONS A hypoplastic maxillary sinus with abnormal or absent uncinate process is associated with advanced mucosal thickening and may present with altered anatomy of the lateral wall of the nasal cavity causing its approximation to the orbital floor. CLINICAL RELEVANCE Pre-surgical knowledge of altered anatomy in the sinonasal complex is crucial in dental implant or sinus surgery.
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Affiliation(s)
- Noura Alsufyani
- Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. .,Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada.
| | - Hamdy El-Hakim
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.,Division of Pediatric Surgery, Department of Surgery, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Paul Major
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
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21
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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; 86:78-83. [PMID: 34269029 DOI: 10.17116/otorino20218603178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To determine the impact of various types of unilateral nasal septum deviation (NSD), concha bullosa (CB) and hypertrophic inferior turbinate (HIT) on the development of sinusitis. MATERIAL AND METHODS This study was conducted in the Irkutsk State Medical University and the Irkutsk City Clinical Hospital No. 1 from October 2017 to November 2018. By continuous sampling retrospective analysis of 1300 protocols of paranasal sinuses MSCT of adult patients was performed. We used MSCT scanners Somatom Emotion 16 Siemens and GE BrightSpeed 16. The studies were carried out on the patients lying on the back with the subsequent reconstruction on a graphical station in the coronal and axial projections using the slices around 1 mm in the thickness. Inclusion criteria: unilateral or absence NSD. Exclusion criteria: bilateral NSD, chronic polyposis or allergic rhinitis. We have analyzed 272 protocols: 70 without NSD and 172 with unilateral NSD, on the right side - 89 (52%) and on the left - 83 (48%). 108 (44.6%) patients were male and 134 (55.4%) were female with average age 38.5±12 years. All patients were divided into 4 groups by R. Mladina' classification (1987): with NSD types 1, 2, 3, and 5. The results were evaluated using the Yates corrected chi-square and the Fisher's exact test by Statistica 10.0. RESULTS There were 34 patients with NSD type 1: 12 with sinusitis; 9 had CB: 6 with sinusitis, 3 without it; HIT was in 27 cases: 33% with sinusitis, 67% without it. There were 69 patients with NSD type 2: 12 had sinusitis; 22 had CB: 5 with sinusitis, 17 without it; HIT was in 42 cases: 26% with sinusitis, 74% without it. There were 43 patients with NSD type 3: 26 had sinusitis; 15 had CB: 6 with sinusitis, 9 without it; 30 had HIT: 57% with sinusitis, 43% without it. There were 26 patients with NSD type 5: 11 had sinusitis; 9 had CB: 3 with sinusitis, 6 without it; 24 had HIT: 42% with sinusitis, 58% without it. NSD type 2 was statistically significant prevailed in patients without sinusitis (p=0.000005); NSD type 3 (p=0.03) and the combination of NSD type 1 with contralateral CB (p=0.04) prevailed in patients with sinusitis. CONCLUSION NSD type 3 (by R. Mladina), as well as the combination of type 1 with contralateral CB are have influence to the development of sinusitis. CB and HIT are statistically significant prevailed on the contralateral side to unilateral NSD, but do not affect to development of sinusitis.
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Affiliation(s)
| | - V S Kokhanov
- Irkutsk State Medical University, Irkutsk, Russia
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22
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Leung AK, Hon KL, Chu WC. Acute bacterial sinusitis in children: an updated review. Drugs Context 2020; 9:dic-2020-9-3. [PMID: 33281908 PMCID: PMC7685231 DOI: 10.7573/dic.2020-9-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/29/2020] [Accepted: 10/29/2020] [Indexed: 12/02/2022] Open
Abstract
Background In the pediatric age group, approximately 7.5% of upper respiratory tract infections (URIs) are complicated by acute bacterial sinusitis (ABS). Despite its prevalence, ABS is often overlooked in young children. The diagnosis and management present unique challenges in primary care. This is an updated narrative review on the evaluation, diagnosis, and management of ABS. Methods A PubMed search was performed using the key term ‘acute sinusitis’. The search strategy included clinical trials, meta-analyses, randomized controlled trials, observational studies, and reviews. The search was restricted to the English literature and children. Results Haemophilus influenzae (non-typeable), Streptococcus pneumoniae, and Moraxella catarrhalis are the major pathogens in uncomplicated ABS in otherwise healthy children. In complicated ABS, polymicrobial infections are common. The diagnosis of acute sinusitis is mainly clinical and based on stringent criteria, including persistent symptoms and signs of a URI beyond 10 days, without appreciable improvement; a URI with high fever and purulent nasal discharge at onset lasting for at least 3 consecutive days; and biphasic or worsening symptoms. Conclusion Data from high-quality studies on the management of ABS are limited. The present consensus is that amoxicillin-clavulanate, at a standard dose of 45 mg/kg/day orally, is the drug of choice for most cases of uncomplicated ABS in children in whom antibacterial resistance is not suspected. Alternatively, oral amoxicillin 90 mg/kg/day can be administered. For those with severe ABS or uncomplicated acute sinusitis who are at risk for severe disease or antibiotic resistance, oral high-dose amoxicillin-clavulanate (90 mg/kg/day) is the drug of choice.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, and The Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Paediatrics and Adolescent Medicine, The Hong Kong Children's Hospital, Hong Kong
| | - Winnie Cw Chu
- Department of Imaging & Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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İnal M, Simsek G, Kaya A, Kilic R. Morphometric Analysis of the Fronto-maxillary Sinuses in Adult Patients with Traumatic Septal Deviations. Curr Med Imaging 2020; 15:194-198. [PMID: 31975665 DOI: 10.2174/1573405613666170621091948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/04/2017] [Accepted: 06/13/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of the current study was to investigate a change in the volume of the frontal and maxillary sinuses in patients with nasal septum deviations due to physical trauma. MATERIALS AND METHODS Paranasal sinus computed tomography data of 100 patients admitted to Kirikkale University medical faculty hospital between November 2013 and June 2014 were retrospectively analyzed. The side of the nasal septal deviation, the deviation angle, the severity of the deviation, and bilateral frontal and maxillary sinus volumes were calculated using a computer program. The relationship between sinus volumes and deviated septum characteristics was investigated. RESULTS The maxillary sinus volumes did not differ between the two genders. However, the female patients had significantly decreased frontal sinus volumes when compared with the male patients (p < 0.05). A right-sided septal deviation was found to be associated with a significantly decreased maxillary sinus volume (p < 0.001), and the severity of the deviation was a significant determinant of the maxillary sinus volume (p < 0.001). The age of the patient at the time of the septal trauma was significantly associated with their maxillary sinus volumes. Patients who had experienced this trauma after 12 years of age had significantly increased maxillary sinus volumes when compared with those who experienced the trauma before the age of 12. CONCLUSION A distorted septal anatomy was found to be a significant parameter for developing paranasal sinuses. Right-sided and severe traumatic deviations with an onset before the age of 12 were significantly associated with a decreased maxillary sinus volume.
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Affiliation(s)
- Mikail İnal
- Radiology Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Gokce Simsek
- Otolaryngology Head & Neck Surgery Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Ahmet Kaya
- Radiology Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - Rahmi Kilic
- Otolaryngology Head & Neck Surgery Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
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Dikici O, Ulutaş HG. Relationship Between Primary Acquired Nasolacrimal Duct Obstruction, Paranasal Abnormalities and Nasal Septal Deviation. J Craniofac Surg 2020; 31:782-786. [PMID: 31895849 DOI: 10.1097/scs.0000000000006108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the relationship between nasal septal deviation and paranasal abnormalities in the etiology of primary acquired nasolacrimal duct obstruction (PANDO). METHODS A total of 37 (8 men, 29 women) patients (48 eyes with PANDO) between the ages 20 and 77 years (mean age, 52.8 ± 13.1 years) were included in the study. In the axial sections of paranasal sinus computed tomography, the transverse diameters at the most upper part and the most distal part of the nasolacrimal canal were separately measured. In addition, the relationships between PANDO and nasal septal deviation, inferior turbinate hypertrophy, agger nasi cells, paradoxical middle turbinate, concha bullosa, and the angle between the bony inferior turbinate and medial wall of the maxillary sinus were investigated. RESULTS A statistically significant relationship was found between PANDO and the axial location of septal deviation classification, axial angle of septal deviation classification, paradoxical middle turbinate, angle between the bony inferior turbinate and medial wall of the maxillary sinus and inferior meatus measure. CONCLUSION The authors concluded that the location and angle of the nasal septal deviation in the axial plane, width of the angle between the bony inferior turbinate and medial wall of the maxillary sinus, inferior meatus measure, and paradoxical middle turbinate may be effective factors in the etiology of PANDO.
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Affiliation(s)
| | - Hafize Gökben Ulutaş
- Department of Ophthalmology, Health Sciences Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Abstract
OBJECTIVE To investigate the impact of the presence and the severity of the nasal septal deviation (NSD) on the paranasal pneumatization. METHODS Initially, the deviated and contralateral sides was compared to evaluate the impact of the presence of NSD on pneumatization. Then, NSD classification groups were categorized according to the severity of deviation degree; 1: mild (<9°), 2: moderate (9°-15°), and 3: severe (>15°). Pneumatization of all paranasal sinuses, osteomeatal complex (OMC), frontoethmoid recess (FER) and variant structures were compared according to the NSD classification groups separately both for the deviated and the contralateral sides. RESULTS Although there was no statistically significant difference in pneumatization of the paranasal sinuses between the deviated and contralateral sides, a significant difference was observed in OMC and FER diameters. In the deviated side, there was statistically significant difference in ethmoid sinus volume, in FER and OMC diameters between NSD classification groups. In the contralateral side, FER and OMC diameters were found to be significantly different between group 1 and group 2 and between group 1 and group 3, respectively (P = 0.04 and 0.06, respectively). Both the presence and severity of the NSD did not statistically significant influence the pneumatization of variant structures, air cells and vital structures. CONCLUSION The severity of NSD effects the ethmoid sinus volume. The relationship of FER and OMC with NSD is evident, however this may not always be in a proportional pattern. The paranasal pneumatization did not affect Keros type, bone integrity of carotid canal and optic canal.
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An Analysis of Association Between Nasal Bone Morphology and Sinonasal Anatomical Variations. J Craniofac Surg 2020; 31:37-40. [PMID: 31403512 DOI: 10.1097/scs.0000000000005801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The goal of this study was to investigate the association between various sinonasal anatomical variations and the morphological features of lateral nasal bone, using paranasal computerized tomography (PNCT) sections. Two hundred and fifty patients who underwent a PNCT scan because of a prediagnosis of nasal septum deviation or sinusitis were included in the study. For each patient, presence of the following anatomical variations was determined on CT sections: length and thickness of nasal bone, thickness of intermediate nasal bone, pneumatized middle turbinate, paradox middle turbinate, Agger nasi cell, Haller cell, Onodi cell, supraorbital cell, pneumatized uncinate process, and nasal septal deviation. The effect of each anatomical variation on the length and thickness of the lateral nasal bone was investigated. The patients with bilateral pneumatized middle turbinate and the patients with bilateral Agger nasi cell had a thinner lateral nasal bone both on the right and the left sides compared to those without. The patients with bilateral Onodi cell and Agger nasi cell had a longer lateral nasal bone both on the right and the left sides compared to those without. The nasal bone thickness was significantly thicker on the deviation side than the contralateral nasal bone. The nasal bone length was significantly longer on the side of the septum deviation. In this study, we found that sex, presence of Agger nasi and Onodi cells, pneumatization of middle turbinate, and direction of nasal septal deviation influenced the morphology of the nasal bone. For successful nasal surgery, careful examination of preoperative anatomical variations is very important.
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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. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:1377-1388. [PMID: 36237721 PMCID: PMC9431850 DOI: 10.3348/jksr.2019.0169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/04/2020] [Accepted: 04/15/2020] [Indexed: 11/24/2022]
Abstract
Purpose This study aimed to determine whether nasal septal deviation and concha bullosa affect the maxillary sinus volume, and whether this effect is associated with the prevalence of chronic sinusitis. Materials and Methods This study retrospectively reviewed 209 paranasal sinus CT (PNS CT) images of patients with sinonasal symptoms from January 2017 to December 2018. The maxillary sinus volume was measured twice by a radiologist, and statistical analysis was performed using SAS 9.4. Results Intersex comparison of the maxillary sinus volume (on left and right sides) revealed that the volume was significantly larger on both the sides (p < 0.0001) in men compared with that in women. Concha bullosa was found to occur mainly in the concave cavity of the septal deviation (p < 0.0001). No significant association was found between nasal septal deviation and maxillary sinusitis (p = 0.8756) as well as between concha bullosa and maxillary sinusitis prevalence (p = 0.3401) or maxillary sinus volume (both: p = 0.6289, Rt.: p = 0.9522, Lt.: p = 0.9201). Conclusion Although nasal septal deviation and the location of concha bullosa may affect each other, maxillary sinus volume and maxillary sinusitis were neither associated with nasal septal deviation nor concha bullosa.
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Affiliation(s)
- Juyeon Lee
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Sang Man Park
- Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Seung-Whan Cha
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Jin Sil Moon
- Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea
| | - Myung Soon Kim
- Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea
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Olfactory Bulb Microstructural Changes in Patients With Nasal Septum Deviation. J Craniofac Surg 2019; 30:1471-1474. [PMID: 31299746 DOI: 10.1097/scs.0000000000005479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE The aim of this study is to assess the microstructural changes to the olfactory bulb (OB) in patients with nasal septum deviation (NSD) using diffusion tensor imaging and to research the association between these changes and the degree of NSD. METHODS Ninety-six patients with NSD (46 males, 50 females) who received diffusion tensor imaging were assessed by 2 independent readers. The patients were separated into 3 groups according to the NSD angle. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the ipsilateral and contralateral OB were measured in all NSD patients by region of interest. RESULTS According to deviation side, there was significant difference between the right (R) and left (L) OB FA and ADC values across the 3 groups. In patients with left- and right- sided NSD, FA and ADC values for the left and right OB were significantly different between groups 1 and 3, and groups 2 and 3. There was negative correlation between L-FA (r = -0.481, P = 0.001; r = -0.496, P = 0.001) and R-FA (r = -0.705, P = 0.001; r = -0.286, P = 0.02) versus age and deviation angle. However, there was positive correlation between L-ADC versus age and deviation angle (r = 0.493, P = 0.001; r = 0.482, P = 0.001), as well as positive correlation between R-ADC versus age (r = 0.646, P = 0.001). CONCLUSION This is the first study showing ADC increase and FA decrease associated with axonal damage and microstructural integrity loss based on the side of deviation in NSD patients. It has also shown that this abnormality is directly proportional with NSD degree.
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Is the maxillary sinus volume affected by concha bullosa, nasal septal deviation, and impacted teeth? A CBCT study. Eur Arch Otorhinolaryngol 2019; 277:227-233. [PMID: 31542830 DOI: 10.1007/s00405-019-05651-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/12/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE Various mechanisms play an important role in the growth of maxillary sinus cavities. The purpose of this study was to investigate the correlations of maxillary sinus volume (MSV) with nasal septal deviation (NSD), concha bullosa (CB) and impacted teeth using cone-beam computed tomography (CBCT) images. METHODS From 55 patients, a total of 110 maxillary sinus images were obtained and examined. Data including age, gender, impacted third molar, canine teeth, NSD, and CB were examined. MSV was measured using the MIMICS software (Materialise HQ Technologielaan, Leuven, Belgium). All statistical analyses were performed using the SPSS (Statistical Package for Social Sciences, version 21) software and p values < 0.05 were considered to indicate statistical significance. RESULTS Mean volume of the right maxillary sinus was 13.566 cm3, while the left was 13.882 cm3. The rate of patients with right and left impacted third molar teeth was 49.1% and 47.3%, respectively. The rate of right and left impacted canines was 1.8% and 5.5%, respectively. NSD was found in 56.4% of CBCT examinations and right and left CB were observed in 30.9% and 32.7% of the patients' examinations, respectively. Males had a significantly higher mean sinus volume than females for both sides (p < 0.05). There were no significant correlations between MSV and age (p > 0.05). No significant differences were found between MSV and impacted teeth, NSD and CB (p > 0.05). CONCLUSION NSD, CB, impacted teeth, and age were not found to be related to MSV. Gender had an effect on MSV and males had higher mean sinus volume than females.
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Sistani SS, Dashipour A, Jafari L, Ghahderijani BH. The Possible Associations of Nasal Septal Deviation with Mastoid Pneumatization and Chronic Otitis. Open Access Maced J Med Sci 2019; 7:2452-2456. [PMID: 31666846 PMCID: PMC6814484 DOI: 10.3889/oamjms.2019.670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 07/03/2019] [Accepted: 07/04/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND: The nasal septum deviation is the most common deformity of the nasal, and that can be congenital or acquired. Despite many studies exist about the impact of nasal septum deviation on chronic sinusitis and also association between chronic otitis and mastoid pneumatization; few studies exist about the impact of nasal septum deviation on chronic otitis and mastoid pneumatization. AIM: The aim of this study was to evaluate the associations of nasal septum deviation and mastoid pneumatization and chronic otitis. METHODS: In this study review, all CT scans of PNS and Mastoid View in the imaging section from Imam Ali hospital in 2016-2017 years and cases of nasal septum deviation were enrolled. The nasal septum deviation was recorded, and the degree of nasal septum deviation in the coronal plane that showed the maximum deviation of the nasal septum was recorded. The volume of the mastoid cells automatically and directly was calculated using three diameter measurements (2 coronal diameters and 1 axial diameter) by the program. The software of SPSS 22 was used for statistical analysis. RESULTS: There was no relationship between nasal septum deviation severity and incidence of mastoid pneumatization in patients with nasal septum deviation (P > 0.05). There was relationship between nasal septum deviation severity and chronic otitis in patients with nasal septum deviation (P < 0.05). In patients with moderate and severe intensity of nasal septum deviation, the volume of mastoid air cells in deviation side was lower than the front side (P < 0.05). CONCLUSION: Based on the results of the CT scan, in patients with moderate and severe nasal septum deviation intensity, the volume of mastoid air cells in deviation side was lower than the front side. Also, there was a relationship between nasal septum deviation severity and chronic otitis.
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Affiliation(s)
- Sharareh Sanei Sistani
- Department of Radiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Dashipour
- Department of Nutrition and Food Sciences, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Laleh Jafari
- Department of Radiology, School of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran
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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; 49:45-51. [PMID: 30941287 PMCID: PMC6444003 DOI: 10.5624/isd.2019.49.1.45] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/13/2018] [Accepted: 12/18/2018] [Indexed: 11/27/2022] Open
Abstract
Purpose To determine the prevalence of concha bullosa (CB) and nasal septal deviation (NSD) and their impact on maxillary sinus volume (MSV). Materials and Methods Cone-beam computed tomographic (CBCT) images of 106 Emirati people were used in this study. The direction and angle of septal deviation were calculated. The presence of CB, which could be unilateral, contralateral, or bilateral in relation to the direction of NSD, was also recorded. MSV was measured using reconstructed Digital Imaging and Communication in Medicine images on Dolphin 3D imaging software version 11.8 premium (Dolphin Imaging, Chatsworth, CA, USA). P values <0.05 were considered to indicate statistical significance. Results CB was detected in 37.7% of the sample; 20.7% of the sample showed single unilateral CB and 16.6% had single bilateral CB. NSD was seen in 74.5% of the sample. In the participants with CB, 45.5% showed mild deviation, 34.4% showed moderate deviation, and only 12.5% showed severe septal deviation. CB, but not NSD, was associated with significantly higher MSV on the affected side (P=0.001). Conclusion Although NSD was observed in more than two-thirds of the sample and CB was present in more than one-third of the sample, only CB had a significant impact on MSV.
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Affiliation(s)
- Natheer H Al-Rawi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Asmaa T Uthman
- Department of Dental Surgical Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
| | - Elaf Abdulhameed
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmed S Al Nuaimi
- Department of Clinical Research-Clinical Affairs Directorate, Primary Health Care Corporation (PHCC), Doha, Qatar
| | - Zahra Seraj
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Kalabalık F, Tarım Ertaş E. Investigation of maxillary sinus volume relationships with nasal septal deviation, concha bullosa, and impacted or missing teeth using cone-beam computed tomography. Oral Radiol 2018; 35:287-295. [PMID: 30484216 DOI: 10.1007/s11282-018-0360-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 10/23/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The aim of this retrospective study was to investigate the correlations of maxillary sinus volume with nasal septal deviation, concha bullosa, impacted teeth, and missing teeth in the maxillary posterior region on maxillary sinus volume using cone-beam computed tomography (CBCT) images. METHODS The study cohort comprised 252 CBCT images of 252 patients retrospectively selected from the records in our CBCT archive. All CBCT images were exported to 3D modeling software for calculation of maxillary sinus volumes. Nasal septal deviation cases were grouped as mild, moderate, and severe. Concha bullosa was classified as lamellar, bulbous, and extensive. Maxillary sinus volume differences were evaluated by comparing the bilateral sinus volumes in patients with nasal septal deviation, unilateral concha bullosa, and unilateral impacted or missing maxillary posterior teeth. RESULTS The findings revealed that males had a significantly higher mean sinus volume than females (p < 0.01) and that sinus volume tended to decrease with age (p < 0.05). In moderate and severe nasal septal deviation cases, the maxillary sinus volume was significantly smaller on the same side as the deviation than on the contralateral side (p < 0.05). There were no significant correlations between maxillary sinus volume and concha bullosa, unilateral impacted teeth, or unilateral missing teeth (p > 0.05). CONCLUSIONS The present findings suggest that maxillary sinus volume is smaller on the same side as the deviation in moderate and severe septal deviation cases and that the maxillary sinus volume tends to decrease with increasing age.
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Affiliation(s)
- Fahrettin Kalabalık
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Izmir Katip Celebi University, Aydinlik Evler Mahallesi, Cemil Meric Caddesi, 6780 Sokak No: 48, 35640, Cigli, Izmir, Turkey.
| | - Elif Tarım Ertaş
- Dentistanbul Dental Hospital, Yildiz Caddesi No: 71, Besiktas, Istanbul, Turkey
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Evaluation of the Characteristics and Association Between Schneiderian Membrane Thickness and Nasal Septum Deviation. J Craniofac Surg 2018; 29:683-687. [PMID: 29419587 DOI: 10.1097/scs.0000000000004254] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Nasal septum deviation (NSD) is an anomaly that disturbs normal mucus drainage in sinuses, leading to recurrent sinusitis. Sinusitis, infections, and mucosal irritations are the potential causes of Schneiderian membrane thickening (SMT). The aim of this study was to evaluate the characteristics and association between NSD and SMT along with factors such as age, gender, and tooth groups using cone-beam computed tomography (CBCT) imaging. METHODS The maxillary sinus and nasal cavity of 249 patients (136 females and 113 males) were examined retrospectively using CBCT. The statistical analysis was performed to determine the association between SMT, NSD, gender, and age. RESULTS No statistically significant relation was detected between NSD and SMT. The NSD was found in 50.6% of patients without gender predilection. Age was not associated with the presence of NSD. The mean thickness of the membrane was least in the third molar region and highest in the first molar region. The average SMT was found to be higher in males for all the examined tooth areas (P ≤ 0.05). CONCLUSION A retrospective evaluation of CBCT images emphasized the concept that NSD was not a factor that affected the thickening of maxillary sinus mucosa. The CBCT imaging could be used for evaluating the maxillary sinuses and nasal septum.
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The Effect of Unilateral Concha Bullosa on Olfactory Bulb Volume: an Assessment by Magnetic Resonance Imaging. J Craniofac Surg 2018; 29:400-402. [PMID: 29084110 DOI: 10.1097/scs.0000000000004086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In this study, the authors compared the right and left olfactory bulb volumes by magnetic resonance image findings of patients with unilateral concha bullosa (CB). METHODS The cranial magnetic resonance imaging studies of 24 patients having unilateral CB were reviewed. There were 10 males and 14 females ranging in age from 29 to 51 years (mean age, 29 ± 15.2 years). The volumes of both olfactory bulbs (contralateral and ipsilateral to the concha bullosa side) were calculated by using the computer program. RESULTS The average values for olfactory bulb volumes were 46.57 ± 8.03 mm in the CB side of the nasal cavity and 54.80 ± 10.031 mm in the normal side of the nasal cavity. We found a statistically significant difference in olfactory bulb volume between the contralateral and ipsilateral to the concha bullosa side of the patients (t = -3.08 and P < 0.01 for CB side, t = -3.47 and P < 0.01 for left normal side). CONCLUSION Our results may point out a possible relationship between CB and ipsilateral decreased olfactory bulb volume, yet the exact mechanism still remains unclear. Decreased nasal air flow on the CB side may be attributed to the pathophysiologic mechanism of this finding. Also, the significant reduction in olfactory bulb volumes ipsilateral to CB compared with the contralateral olfactory bulb volumes seems to support our hypothesis.
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Mogre D, Banhegyi G, Tsang HK, Leong SC. Anatomical variants of the paranasal sinuses in patients with mid-facial segment pain: Our experience of a cohort of twenty-three patients. Clin Otolaryngol 2018; 43:1410-1414. [PMID: 29908045 DOI: 10.1111/coa.13174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2018] [Indexed: 11/29/2022]
Affiliation(s)
- D Mogre
- Department of Otorhinolaryngology-Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - G Banhegyi
- Department of Otorhinolaryngology-Head and Neck Surgery, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - H K Tsang
- Department of Anaesthesiology and Pain Management, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
| | - S C Leong
- Department of Otorhinolaryngology-Head and Neck Surgery, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
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Sapmaz E, Kavaklı A, Sapmaz HI, Ögetürk M. Impact of Hard Palate Angulation Caused by Septal Deviation on Maxillary Sinus Volume. Turk Arch Otorhinolaryngol 2018; 56:75-80. [PMID: 30197803 DOI: 10.5152/tao.2018.2987] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/16/2018] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the effect of hard palate angulation caused by septal deviation on the volume of the maxillary sinus. Methods Coronal computed tomographic (CT) scans of 1568 patients aged from 18 to 60 were examined. CT scans of 402 patients were included in the study. On these scans, the maxillary sinus volume, the angle of the nasal septal deviation, and the angulation of the hard palate were calculated using the ImageJ software. Each maxillary sinus volume was statistically compared with each other and with those in the control group. Correlations between palatal angulation and septal deviation were determined. Results Deviated nasal septum whether with or without deflection of the hard palate was noted to have caused changes in the volume of the maxillary sinus in both female and male patients. The volume of the maxillary sinus on the deviated side was less than that of the opposite side, and the differences between the volumes of both sinuses were statistically significant (p<0.05). No significant differences were noted when compared with the control group. A positive correlation was observed between the nasal septal deviation angle and the angulation of the hard palate. Conclusion Regardless of whether or not it affects the hard palate, nasal septal deviation reduces the volume of the maxillary sinus on the deviated side but does not affect the total volume of the maxillary sinuses. Significant differences between the volumes on the two sides can lead to facial asymmetry.
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Affiliation(s)
- Emrah Sapmaz
- Department of Otorhinolaryngology, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Ahmet Kavaklı
- Department of Anatomy, Fırat University School of Medicine, Elazığ, Turkey
| | - Hilal Irmak Sapmaz
- Department of Anatomy, Gaziosmanpaşa University School of Medicine, Tokat, Turkey
| | - Murat Ögetürk
- Department of Anatomy, Fırat University School of Medicine, Elazığ, Turkey
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Abstract
OBJECTIVES The olfactory bulb (OB) plays a pivotal role in the processing of olfactory information. The aim of this study was to investigate the OB volume changes and its possible associations with nasal septal deviation. STUDY DESIGN Cross-sectional study. SETTING Otolaryngology Department of Bozok University School of Medicine and Neurology Department of Yozgat State Hospital. SUBJECTS AND METHODS Ninety patient's cranial magnetic resonance imaging (MRI) studies (46 males and 44 females, mean age 36 ± 13.4 years; range 18-56 years) with isolated nasal septal deviations were recruited for the study. Olfactory bulb volumes in all study subjects were evaluated in T2-weighted coronal MRI images by planimetric manual contouring. RESULTS Nasal septal deviation angles were found to range between 5° and 23.21° (mean 13.6° ± 3.58°). The right-sided deviations included 17 mild (<9°, Group I), 20 moderate (9°-15°, Group II), and 16 severe (15° and up, Group III) patients. The left-sided deviations included 14 mild (<9°, Group I), 13 moderate (9°-15°, Group II), and 10 severe (15° and up, Group III) subjects. Olfactory bulb volumes were calculated in both right- and left-sided deviation groups. In the patients with left-sided septal deviations of Groups I, II, and III, the left OB volumes of Groups I, II, and III were 46.49 ± 3.87, 47.46 ± 3.36, and 60.68 ± 5.65 mm and the right OB volumes were 53.37 ± 3.76, 56.47 ± 4.43, and 76.69 ± 6.84 mm, respectively. The statistical evaluation of the right OB volumes did not produce significant difference between Groups I and II (P = 0.73). The authors demonstrated statistically significant differences in comparison of Groups I to III and Groups II to III (P = 0.002 and P = 0.016, respectively). In the right septal deviation group for Groups I, II, and III, mean volumes of right OB volumes were 45.59 ± 4.46, 48.63 ± 3.78, and 61.35 ± 5.84 mm, respectively, and the left OB volumes were 54.67 ± 4.73, 57.65 ± 4.53, and 75.84 ± 7.67 mm, respectively. There was no statistically significant difference between Groups I and II (P = 0.95) left OB volumes in the right-sided deviation group, but statistically significant difference was demonstrated in Groups I to III and Groups II to III compartments (P = 0.002 and P = 0.003). CONCLUSION In our study, while mild and moderate septal deviations lacked any significant affect on OB volumes, severe deviations were found to have significant impact on these parameter. Additionally the contralateral OB volumes in the severe septum deviation group were significantly bigger when compared to the ipsilateral OB volumes. Further multidisciplinary studies are required to evaluate the clinical significance of OB volume changes in diagnosis and follow-up of several otolaryngologic or nonotolaryngologic diseases.
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The effects of choanal atresia on development of the paranasal sinuses and turbinates. Surg Radiol Anat 2017; 39:1143-1147. [PMID: 28289870 DOI: 10.1007/s00276-017-1842-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 02/27/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE The objective of this study was to evaluate the volume of paranasal sinuses (PNS) and turbinate in patients with unilateral choanal atresia (CA). MATERIALS AND METHOD Computed tomography images of PNS in 11 individuals with unilateral CA were evaluated retrospectively. Mucosal thickness and volume of the maxillary, frontal and sphenoidal sinuses were determined, in addition to the volume of the middle and inferior turbinate. The unaffected nasal side of patients was used as a control group for the measurements. The results comprised the measurements of the atresic side compared to those of the healthy side. RESULTS There was no significant difference between the atresic and healthy side of the nose in patients with CA with respect to mucosal thickness and volume of the PNS (the maxillary, frontal and sphenoidal sinuses) and the middle and inferior turbinate (p > 0.050). CONCLUSION The complete absence of nasal unilateral airflow had no effect on the development of the PNS and the middle and inferior turbinate. Moreover, mucosal thickness in the sinuses was similar to that in the control group.
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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; 82:126-133. [PMID: 28348652 PMCID: PMC5347520 DOI: 10.12659/pjr.900634] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 09/02/2016] [Indexed: 12/20/2022] Open
Abstract
Background The aim of the study was to assess if the presence of nasal septal deviation and concha bullosa is connected with the development of sinuses and the incidence of inflammation within them. Material/Methods We retrospectively analysed 214 patients who underwent paranasal sinus computed tomography. There were 125 females and 89 males, the mean age being 47.67±16.74 years (range 18–97). Exclusion criteria included: age under 18 years, prior sinonasal surgery and S-shaped septum. Results Mean volume of the right maxillary sinus was 17.794 cm3, while for the left one it was 17.713 cm3. Nasal septal deviation was found in 79.9% of computed tomography examinations and concha bullosa was observed in 42.1% of the patients’ examinations. There was an association between the presence of unilateral or dominant concha bullosa and contralateral direction of septal deviation [right-sided (p=0.039), left-sided (p=0.003)]. There was higher incidence of bilateral maxillary sinusitis in patients with septal deviation (p=0.007). Bilateral concha bullosa did not influence the incidence of bilateral maxillary sinusitis (p=0.495). Neither septal deviation (right sided: p=0.962; left-sided: p=0.731), nor unilateral/dominant concha bullosa (right: p=0.512; left: p=0,430) affected the asymmetry in volumes of maxillary sinuses. Bilateral concha bullosa was connected with larger volume of maxillary sinuses (right sinus: p=0.005; left sinus: p=0.048). Conclusions Nasal septal deviation, contrary to concha bullosa, has influence on the development of maxillary sinusitis. There is a connection between the presence of concha bullosa and direction of septal deviation. Only bilateral concha bullosa affects maxillary sinus volumes.
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Affiliation(s)
- Iwona Kucybała
- Students' Scientific Group at the Department of Diagnostic Imaging, Chair of Radiology, Jagiellonian University Medical College, Cracow, Poland
| | - Konrad Adam Janik
- Students' Scientific Group at the Department of Diagnostic Imaging, Chair of Radiology, Jagiellonian University Medical College, Cracow, Poland
| | - Szymon Ciuk
- Students' Scientific Group at the Department of Diagnostic Imaging, Chair of Radiology, Jagiellonian University Medical College, Cracow, Poland
| | - Dawid Storman
- Students' Scientific Group at the Department of Diagnostic Imaging, Chair of Radiology, Jagiellonian University Medical College, Cracow, Poland
| | - Andrzej Urbanik
- Department of Diagnostic Imaging, Jagiellonian University Medical College, Cracow, Poland
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Serifoglu I, Oz İİ, Damar M, Buyukuysal MC, Tosun A, Tokgöz Ö. Relationship between the degree and direction of nasal septum deviation and nasal bone morphology. Head Face Med 2017; 13:3. [PMID: 28245851 PMCID: PMC5331660 DOI: 10.1186/s13005-017-0136-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 02/24/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Nasal septal deviation may affect nasal bone growth and facial morphology. Knowledge of nasal morphologic parameters may plays an important role in planning successful rhinoplasty and septoplasty operation. The aim of our study was to evaluate the relationship between the direction and degree of nasal septal deviation with nasal bone morphology, along with factors such as age and gender. METHODS Maxillofacial computed tomography (CT) of 250 patients with nasal septal deviation was analyzed retrospectively in this study. We excluded patients with factors that could affect their nasal bone morphology, and a total of 203 patients (111 males, 92 females; mean age, 36.23 years; age range, 18-79 years) were evaluated. The nasal deviation angle was measured on coronal CT images as the angle between the most deviated point of the septum, and the midline nasal morphology was determined by measuring nasal length, internasal angle and lateral and intermediate nasal thickness on both sides. RESULTS The deviation of nasal septum has been detected as to the right in 107 patients (52.7%) and to the left in 96 patients (47.3%). Lateral and intermediate nasal bone thickness and nasal bone length were significantly greater on the ipsilateral deviation side (Table 3). No significant correlation was found between the variation of the nasal deviation angle and nasal bone morphology (Table 4). There were significant differences between the sexes for all investigated parameters except for the nasal deviation angle (p = 0.660). We found that the only internasal angle increases with aging (p = 0.002). CONCLUSION The study shows that the direction of nasal septal deviation may be a factor that affects nasal bone morphology.
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Affiliation(s)
- Ismail Serifoglu
- Department of Radiology, Bagcilar Training and Research Hospital, Istanbul, Turkey.
| | - İbrahim İlker Oz
- Department of Radiology, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | - Murat Damar
- Department of Head and Neck Surgery, Bulent Ecevit University Faculty of Medicine, Zonguldak, Turkey
| | | | - Alptekin Tosun
- Department of Radiology, Giresun University Faculty of Medicine, Giresun, Turkey
| | - Özlem Tokgöz
- Department of Radiology, Antalya Eğitim ve Araştırma Hastanesi, Antalya, Turkey
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Lee HW, Kang SH, Jang KH, Kim DS, Shin SH, Ye MK. Changes in Etiologies and Clinical Characteristics of Operated Unilateral Sinus Diseases: Comparison Study between 2005 and 2015. JOURNAL OF RHINOLOGY 2017. [DOI: 10.18787/jr.2017.24.1.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Hyo-Won Lee
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Seung-Hyun Kang
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Kyu-Ho Jang
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Deok-Soo Kim
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Seung-Heon Shin
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
| | - Mi-Kyung Ye
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea
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Spiranskaya OA, Malavina US, Pashkova AE, Rusetsky YY, Makhambetova EA, Lipsky KB. The state of the nasal septum and paranasal sinuses in a population of the children evaluated based on the results of computed tomography. ACTA ACUST UNITED AC 2017. [DOI: 10.17116/rosrino20172533-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Comment on the Effect of Nasal Septal Deviation on Frontal and Maxillary Sinus Volumes and Development of Sinusitis. J Craniofac Surg 2016; 27:533. [PMID: 26967089 DOI: 10.1097/scs.0000000000002350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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The Effect of Nasal Septal Deviation on Frontal and Maxillary Sinus Volumes and Development of Sinusitis. J Craniofac Surg 2016; 26:1508-12. [PMID: 26106997 DOI: 10.1097/scs.0000000000001809] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to determine the possible role of nasal septal deviation on volume of maxillary and frontal sinuses. Between February 2011 and October 2013, paranasal sinus computed tomography (CT) findings of 732 patients (410 males, 322 females) who were admitted to Ear Nose and Throat Department of Kayseri Research and Training Hospital were retrospectively analyzed. By excluding the other coexistent sinonasal pathologies, 83 consecutive patients with nasal septal deviations were included in the study. The volume of each maxillary and frontal sinus (ipsi- and contralateral to the deviation side) was also calculated using the computer program. There was no statistically significant difference between ipsilateral and contralateral maxillary sinus volumes in group 1 and group 3 (P > 0.05). There was a statistically significant difference between ipsilateral and contralateral maxillary sinus volumes in group 2 (P < 0.05). There was no statistically significant difference between ipsilateral and contralateral frontal sinus volumes in group 1, group 2, and group 3 (P > 0.05). Moderate septal deviation significantly affects the volume of maxillary sinus. Mild and severe septal deviation does not significantly affect the volume of maxillary sinus. Effect of septal deviation on frontal sinus volume was not detected. The probability to encounter maxillary and frontal sinusitis ipsilateral to the all septum deviation groups was significantly increased in both right- and left-sided subjects.
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Martínez-Capoccioni G, Varela-Martínez E, Martín-Martín C. Silent sinus syndrome an acquired condition and the essential role of otorhinolaryngologist consultation: a retrospective study. Eur Arch Otorhinolaryngol 2016; 273:3183-8. [PMID: 26965897 DOI: 10.1007/s00405-016-3965-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 03/01/2016] [Indexed: 10/22/2022]
Abstract
The silent sinus syndrome (SSS) is a rare clinical entity characterized by painless spontaneous enophthalmos, hypoglobus, and facial deformities secondary to chronic maxillary sinus atelectasis. The aim of this study was to present an SSS diagnostic feature and evaluate the relationship between nasal septum deviation and maxillary sinus volume. A retrospective chart review of the clinical characteristics of 20 patients diagnosed with SSS between January 2013 and July 2014 were analyzed by the Department of Otorhinolaryngology of University Hospital Complex of Santiago de Compostela. 14 patients were females and six males. The mean age was 43 years (range 28-67 years). The right maxillary sinus was involved in 12 patients and the left maxillary sinus in eight patients. There was no statistical difference between gender and the presence of SSS. Maxillary sinus sizes were significantly smaller on the same side as the deviation (p < 0.01). 14 patients were treated with functional endoscopic sinus surgery (FESS) with maxillary antrostomy. We concluded that patients with SSS usually present with facial asymmetry, and the best approach to document and show all facial asymmetries for these patients are the frontal and craneo-caudal photographs. The present study demonstrates that, in adult patients, SSS generally presents a septal deviation to the affected maxillary sinus. We recommend performing a paranasal sinus CT scan when the patient has a deviated nasal septum, retraction of the malar eminence (evidenced from the viewpoint cranio-caudal facial) and hypoglobus. FESS performing postero-anterior uncinectomy and enlargement of the maxillary ostium is recommended to restore sinus pressure and prevent progression of the enophthalmos, hypoglobus and facial deformities.
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Affiliation(s)
- Gabriel Martínez-Capoccioni
- Servizo Galego de Saúde, Department of Otorhinolaryngology, University Hospital Complex of Santiago de Compostela, C/Choupana s/n. 15706, Santiago de Compostela, A Coruña, Spain.
| | - Ernesto Varela-Martínez
- Servizo Galego de Saúde, Department of Otorhinolaryngology, University Hospital Complex of Santiago de Compostela, C/Choupana s/n. 15706, Santiago de Compostela, A Coruña, Spain
| | - Carlos Martín-Martín
- Servizo Galego de Saúde, Department of Otorhinolaryngology, University Hospital Complex of Santiago de Compostela, C/Choupana s/n. 15706, Santiago de Compostela, A Coruña, Spain
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Maxillary Sinus Aeration in Allergic Rhinitis. J Craniofac Surg 2016; 26:e288-90. [PMID: 26080233 DOI: 10.1097/scs.0000000000001558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE We aimed to investigate the relationship between allergic rhinitis, which is an important reason of nasal obstruction, and maxillary sinus aeration. PATIENTS AND METHODS Three hundred fifteen patients who have a complaint of nasal obstruction and scheduled to undergo skin prick test (SPT) with a suspicion of allergic rhinitis (AR) were enrolled for this study. Thirty-two patients with positive SPT result and 30 patients with a negative SPT result were determined as group 1 and 2 (control group), respectively. A 3-dimensional reconstruction of computed tomography images of the 62 patients was used to assess and calculate maxillary sinus volumes (MSVs). RESULTS Total maxillary sinus volumes were measured as 21.87 cm(3) and 30.15 cm(3) in group 1 and group 2, respectively. A statistically significant difference was observed between the MSVs of the groups (P < 0.001). CONCLUSION Total maxillary sinus volumes were found to be significantly smaller for patients with a positive SPT compared to patients with a negative SPT. Thus, we may conclude that AR has a negative impact on maxillary sinus aeration.
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Do altitude and climate affect paranasal sinus volume? J Craniomaxillofac Surg 2015; 43:1059-64. [DOI: 10.1016/j.jcms.2015.05.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/02/2015] [Accepted: 05/19/2015] [Indexed: 11/22/2022] Open
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Günbey E, Günbey HP, Uygun S, Karabulut H, Cingi C. Is preoperative paranasal sinus computed tomography necessary for every patient undergoing septoplasty? Int Forum Allergy Rhinol 2015; 5:839-45. [PMID: 25963400 DOI: 10.1002/alr.21545] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 03/02/2015] [Accepted: 03/24/2015] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to determine whether anterior rhinoscopy (AR), nasal endoscopy (NE) and paranasal sinus computed tomography (PNS CT) can predict other sinonasal obstructive pathologies in the setting of nasal septal deviation (NSD), and to evaluate the impact of preoperative PNS CT on the decision for a surgical procedure in patients with NSD. METHODS A total of 262 patients with NSD were evaluated using AR, NE, PNS CT, and the visual analogue scale (VAS) for nasal obstruction. The diagnostic values of AR, NE, and PNS CT for sinonasal obstructive pathologies, and the impact of preoperative PNS CT on the decision for a surgical procedure in patients with NSD were evaluated. RESULTS PNS CT showed concomitant nasal pathologies in the 62 of 262 patients (23.6%) with NSD. Positive predictive value (PPV) and negative predictive value (NPV) of NE for concomitant nasal pathologies were 0.75 and 0.069, respectively. The sensitivity of NE for sinonasal pathologies was significantly higher in the patients with mild NSD than in the patients with moderate-severe NSD. The decision for a surgical procedure was changed in 22 of 262 (8.3%) patients after a PNS CT. CONCLUSION We recommend performing preoperative PNS CTs on patients in whom septoplasty is planned, if they have obstructive middle turbinate hypertrophy, if one is unable to evaluate the middle meatus and posterior nasal cavity because of an anteriorly severe deviation or a nasal polyp, and in patients with chronic sinusitis based on clinical and endoscopic findings.
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Affiliation(s)
- Emre Günbey
- Department of Otolaryngology, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
| | - Hediye Pınar Günbey
- Department of Radiology, Ondokuz Mayıs University, School of Medicine, Samsun, Turkey
| | - Seda Uygun
- Department of Anatomy, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Hayriye Karabulut
- Department of Otolaryngology, School of Medicine, Gazi University, Ankara, Turkey
| | - Cemal Cingi
- Department of Otolaryngology, School of Medicine, Osmangazi University, Eskişehir, Turkey
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Demir UL, Akca ME, Ozpar R, Albayrak C, Hakyemez B. Anatomical correlation between existence of concha bullosa and maxillary sinus volume. Surg Radiol Anat 2015; 37:1093-8. [PMID: 25772518 DOI: 10.1007/s00276-015-1459-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 03/07/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE The objective of this study was to assess the effects of concha bullosa variation on maxillary sinus volume and uncinate angle. METHOD The study group included 169 patients (338 sides) who underwent either surgical or medical treatment with the diagnosis of chronic rhinosinusitis. The paranasal sinus computed tomography of these patients was analyzed to measure maxillary sinus volume, uncinate angle and existence of concha bullosa. Subsequently, these variables were evaluated to find out possible relationship inbetween. RESULTS Mean maxillary sinus volume and uncinate angle at right and left sides were 15.21 ± 0.47 and 15.51 ± 0.48 mm(3), 30.57 ± 0.62° and 30.20 ± 0.68°, respectively. There was no difference between patients with or without concha bullosa in regard to maxillary sinus volume and uncinate angle at both sides. Maxillary sinus volume and degree of uncinate angle did not show any significant correlation at both sides; r = -0.124, p = 0.107 and r = -0.136, p = 0.078. CONCLUSION In conclusion, concha bullosa is a common anatomical variation at nasal cavity. The existence of concha bullosa does not have any association with the volume of maxillary sinus and angle of uncinate process.
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Affiliation(s)
- Uygar Levent Demir
- Department of Otolaryngology, Uludag University Medical School, Gorukle, Nilufer, 16059, Bursa, Turkey.
| | - M E Akca
- Department of Otolaryngology, Uludag University Medical School, Gorukle, Nilufer, 16059, Bursa, Turkey
| | - R Ozpar
- Department of Radiology, University of Uludag, Bursa, Turkey
| | - C Albayrak
- Department of Otolaryngology, Uludag University Medical School, Gorukle, Nilufer, 16059, Bursa, Turkey
| | - B Hakyemez
- Department of Radiology, University of Uludag, Bursa, Turkey
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Abstract
BACKGROUND Severe facial injuries can compromise the upper airway by reducing airway volume, obstructing or obliterating the nasal passage, and interfering with oral airflow. Besides the significant impact on quality of life, upper airway impairments can have life-threatening or life-altering consequences. The authors evaluated improvements in functional airway after face transplantation. METHODS Between 2009 and 2011, four patients underwent face transplantation at the authors' institution, the Brigham and Women's Hospital. Patients were examined preoperatively and postoperatively and their records reviewed for upper airway infections and sleeping disorders. The nasal mucosa was biopsied after face transplantation and analyzed using scanning electron microscopy. Volumetric imaging software was used to evaluate computed tomographic scans of the upper airway and assess airway volume changes before and after transplantation. RESULTS Before transplantation, two patients presented an exposed naked nasal cavity and two suffered from occlusion of the nasal passage. Two patients required tracheostomy tubes and one had a prosthetic nose. Sleeping disorders were seen in three patients, and chronic cough was diagnosed in one. After transplantation, there was no significant improvement in sleeping disorders. The incidence of sinusitis increased because of mechanical interference of the donor septum and disappeared after surgical correction. All patients were decannulated after transplantation and were capable of nose breathing. Scanning electron micrographs of the respiratory mucosa revealed viable tissue capable of mucin production. Airway volume significantly increased in all patients. CONCLUSIONS Face transplantation successfully restored the upper airway in four patients. Unhindered nasal breathing, viable respiratory mucosa, and a significant increase in airway volume contributed to tracheostomy decannulation.
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