Analysis of inferior nasal turbinate volume in subjects with nasal septum deviation: a retrospective cone beam tomography study

Background

The association of the linear dimensions of the inferior turbinate hypertrophy with nasal septal deviation has been studied recently. However, the volumetric dimensions provide a more accurate status of the turbinate hypertrophy compared to linear measurements. The aim of this study was to analyze the association of inferior nasal turbinate volume with the degree of nasal septal deviation (NSD).

Methods

A retrospective evaluation of the cone beam computed tomography (CBCT) scans of 412 patients was carried out to obtain 150 scans which were included in the study. The scans were categorized into three groups. Group 1 comprised of 50 scans of patients with no inferior turbinate hypertrophy (ITH) and no nasal septal deviation. Group 2 comprised of 50 scans of patients with ITH and no NSD; whereas Group 3 included 50 scans of patients with ITH and NSD. The total turbinate volume of inferior turbinates (bilateral) were determined by using Vesalius 3D software (PS-Medtech, Amsterdam, Netherlands).

Results

The intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologists was 0.82. There were no significant age and gender related changes in the total turbinate volume. Patients in Group 3 had significantly higher (p = 0.001) total turbinate volume compared to Group 2 and Group 1. There was a positive and significant correlation (r = 0.52, p = 0.002) between the degree of septal deviation and total turbinate volume. When the total turbinate volume of the patients with different types of septal deviation was compared in Group 3, a statistically significant difference (p = 0.001) was observed. Regression analysis revealed that the septal deviation angle (SDA) (p = 0.001) had a relationship with total turbinate volume. From the results of the study we can conclude that the total turbinate volume is higher in patients with nasal septal deviation. It can also be concluded that the septal deviation angle has a positive correlation with total turbinate volume. The data obtained from the study can be useful in post-surgical follow up and evaluation of patients with nasal septal deviation and hypertrophied inferior nasal turbinate.

Application of a Cone-Beam Computed Tomography-Based Index for Evaluating Surgical Sites Prior to Sinus Lift Procedures-A Pilot Study

OBJECTIVES

Radiography-based indices can help surgeons perform detailed examinations of the surgical site and predict the surgical difficulty of cases. We aimed to develop and validate a novel CBCT-based index that can predict the surgical difficulty of sinus-augmentation procedures.

MATERIALS AND METHODS

In the first stage, five experienced dental specialists performed a review of the literature and closed group discussions and designed the novel index. In the next stage, the index was validated. CBCT scans of 30 patients scheduled for sinus-augmentation procedures were evaluated and assigned presurgical CBCT evaluation scores (PSCESs) by five examiners. Subsequently, one oral surgeon performed sinus augmentation using the lateral antrostomy technique and assigned surgical difficulty scores (SDSs) to each of the 30 cases along with 2 observers. The PSCESs and SDSs were statistically analysed to determine the interrater reliability and validity of the index.

RESULTS

The interrater agreement of the PSCES among the five presurgical evaluators was 0.85. The PSCES of the five evaluators had highly significant correlation (P < 0.001, r = 0.68 to 0.76) with the SDS. Regression analysis revealed that for every unit increase in the PSCES, there is 0.46 to 0.57 increase in the SDS value.

CONCLUSION

The results of this pilot study revealed that a novel CBCT-based index can be used as a reliable tool for predicting the surgical difficulty of sinus-augmentation procedures. However, the novel index needs to be tested on a larger sample of patients and evaluators for a more concrete validity and reliability.

Large cemento-ossifying fibroma of the mandible involving the infratemporal and parapharyngeal spaces

Cemento-ossifying fibroma is a benign fibro-osseous lesion of the jaws. Cemento-ossifying fibroma develops from the periodontal ligament and contains multipotent stem cells that can form cementum, lamellar bone, and/or fibrous tissue. These tumours occur in the third and fourth decades of life with higher predilection of occurrence in the female population and seldom attain a large size. We report a rare case of cemento-ossifying fibroma in a 45-year-old man involving the body of the mandible and extending into the para-pharyngeal and infratemporal region. This article describes the clinical, radiographic, and histological features of a large cemento-ossifying fibroma of the mandible.