Year 2021, Volume 7 , Issue 2, Pages 170 - 176 2021-03-04

The relationship between nasal septal deviation and anatomical variations of the paranasal sinus

Oğuzhan DİKİCİ [1] , Osman DURGUT [2]

Objectives: The aim of this study was to determine the relationship between septum deviation and anatomic variations of the paranasal sinus.

Methods: A total of 157 (79 males, 78 females) patients between the ages of 17 and 77 years (mean age: 33.7 ± 14.9 years) were included in the study. Using paranasal sinus computed tomography imaging, anatomical variations including nasal septal deviation, Agger nasi cells, Haller cells, Onodi Cells, sphenoid sinus pneumatisation, paradoxical middle turbinates, middle turbinate pneumatisation, maxillary sinus septa,vertical septa in the sphenoid sinus, optic nerve dehiscenceand cribriform plate lamina lateralis height were evaluated.

Results: Agger nasi cells were present in 47.1% of cases, Haller cells were seen in 5% of cases and Onodi cells were observed in 23.6% of cases. In 70.1% of cases, one vertical septa in the sphenoid sinus was observed. Maxillary sinus septa was observed in 16.5% of cases. There was a significant negative correlation between the female gender and increased sphenoid sinus pneumatisation (p = 0.035). There was a positive correlation between maxillary sinus septa and the presence of Onodi cells (pright =0.045, pleft = 0.017). There was also a negative correlation between maxillary sinus septa and sphenoid sinus pneumatisation (pright = 0.001, pleft = 0.005).

Conclusions: In our study, we found that maxillary sinus septa, Agger nasi, Haller cells, cribriform plate lamina lateralis height, sphenoid sinus septation and Onodi cells were interrelated. We recommend that surgeons evaluate patients with these variations to prevent complications.

Agger nasi, Haller cells, Onodi cells, Sinus Surgery, Maxillary sinus Septa
  • 1. Şahin C, Yilmaz YF, Titiz A, Özcan M, Özlügedik S, Ünal A. [The Anatomic Variations of Paranasal Sinuses : Computerized Tomography Study]. KBB ve BBC Dergisi 2007;15:71-3. [Article in Turkish]
  • 2. Vaid S, Vaid N. Normal anatomy and anatomic variants of the paranasal sinuses on computed tomography. Neuroimaging Clin N Am 2015;25:527-48.
  • 3. Koo SK, Kim JD, Moon JS, Jung SH, Lee SH. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: a retrospective radiologic study. Auris Nasus Larynx 2017;44:561-70.
  • 4. Yücel A, Dereköy FS, Yılmaz MD, Altuntaş A. [Effects of sinonasal anatomical Variations on paranasal sinus infections]. Kocatepe Tıp Dergisi 2004;5:43-7. [Article in Turkish]
  • 5. Kaplan Y, Müderris S, Kunt T. [Tomographic analysis of sinonasal variations and relationship with sinusitis]. C Ü Tıp Fakültesi Derg 2004;26:29-36. [Article in Turkish]
  • 6. Vaezi A, Cardenas E, Pinheiro-Neto C, Paluzzi A, Branstetter IV BF, Gardner PA, et al. Classification of sphenoid sinus pneumatization: relevance for endoscopic skull base surgery. Laryngoscope 2015;125:577-81.
  • 7. Keros P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Z Laryngol Rhinol Otol 1962;41:809-13.
  • 8. Mladina R. The role of maxillar morphology in the development of pathological septal deformities. Rhinology 1987;25:199-205.
  • 9. Yılmazsoy Y, Arslan S. Med HS. [Assessment of the prevalence of Haller cell variation and the relation between Haller cell variation and maxillary sinusitis]. J Health Sci Med 2018;1:54-8. [Article in Turkish]
  • 10. Nouraei SAR, Elisay AR, Dimarco A, Abdi R, Majidi H, Madani SA, et al. Variations in paranasal sinus anatomy: implications for the pathophysiology of chronic rhinosinusitis and safety of endoscopic sinus surgery. J Otolaryngol Neck Surg 2009;38:32-7.
  • 11. Daghighi M, Daryani A, Nejad KC, Daghighi M, Daryani A, Nejad KC, et al. Evaluation of anatomic variations of paranasal sinuses. Internet J Otorhinolaryngol 2012;7:7-11.
  • 12. Lebowitz RA, Brunner E, Jacobs JB. The agger nasi cell: radiological evaluation and endoscopic management in chronic frontal sinusitis. Oper Tech Otolaryngol Head Neck Surg 1995;6:171-5.
  • 13. Khojastepour L, Haghnegahdar A, Khosravifard N. Role of sinonasal anatomic variations in the development of maxillary sinusitis: a cone beam CT analysis. Open Dent J 2017;11(Suppl-1, M5):367-74.
  • 14. Efendić A, Muharemović E, Skomorac R, Bečulić H, Šestić S, Halilović B, et al. Anatomic variations of posterior paranasal sinuses and optic nerve. Med Glas 2017;14:49-54.
  • 15. Özer F, Çağıcı CA, Özer C, Kızılkılıç O, Yılmazer C, Özlüoğlu LN. [The progress of the optic nerve in the coronal paranasal sinus tomography]. Turk Otolarengoloji Ars 2013;47:15-20. [Article in Turkish]
  • 16. Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities. Laryngoscope 1991;101:56-64.
  • 17. Birkin T, Acar T, Esen Ö. [The anatomical variations of the sinonasal region and its relationship with sinus diseases]. Tepecik Eğit Hast Derg 2017;27:236-42. [Article in Turkish]
  • 18. Kalaiarasi R, Ramakrishnan V, Poyyamoli S. Anatomical variations of the middle turbinate concha bullosa and its relationship with chronic sinusitis: a prospective radiologic study. Int Arch Otorhinolaryngol 2018;22:297-302.
  • 19. Caversaccio M, Boschung U, Mudry A. Historical review of Haller’s cells. Ann Anat 2011;193:185-90.
  • 20. Shpilberg KA, Daniel SC, Doshi AH, Lawson W, Som PM. CT of anatomic variants of the paranasal sinuses and nasal cavity: poor correlation with radiologically significant rhinosinusitis but importance in surgical planning. Am J Roentgenol 2015;204:1255-60.
  • 21. Kara A, Güven M, Yılmaz MS, Elden H, Demir D. [Keros classification and evaluation of cribriform plate depth asymmetry of the population in Marmara region]. Sakarya Med J 2018;8:352-8. [Article in Turkish]
Primary Language en
Subjects Otorhinolaryngology
Journal Section Original Articles

Orcid: 0000-0002-3413-8994
Author: Oğuzhan DİKİCİ (Primary Author)
Institution: Department of Otorhinolaryngology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey

Orcid: 0000-0002-3518-2903
Author: Osman DURGUT
Institution: Department of Otorhinolaryngology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Application Date : November 11, 2019
Acceptance Date : September 8, 2020
Publication Date : March 4, 2021

EndNote %0 The European Research Journal The relationship between nasal septal deviation and anatomical variations of the paranasal sinus %A Oğuzhan Dikici , Osman Durgut %T The relationship between nasal septal deviation and anatomical variations of the paranasal sinus %D 2021 %J The European Research Journal %P -2149-3189 %V 7 %N 2 %R doi: 10.18621/eurj.645582 %U 10.18621/eurj.645582