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The relationship among concha bullosa, septal deviation and chronic rhinosinusitis

Year 2013, Volume: 3 Issue: 1, 1 - 7, 01.03.2013
https://doi.org/10.2399/jmu.2013001002

Abstract

Objective: To evaluate the prevalence and types of both concha bullosa and nasal septal deviation and determine their potential relationships with maxillary rhinosinusitis. Methods: Patients admitted to the outpatient clinic of the otorhinolaryngology department with symptoms of rhinosinusitis between January 2009 and April 2010, were retrospectively enrolled in the study. Paranasal sinus computed tomography scans were reviewed for the presence, side and type of concha bullosa, and nasal septal deviation along with rhinosinusitis. Results: Totally 162 patients (324 sides) were studied. Concha bullosa and nasal septal deviation incidences were 42.6% and 46.9%, respectively. The relationship between nasal septal deviation and the presence of concha bullosa was not statistically significant (p=0.06). A total of 45.1% of patients had evidence of maxillary rhinosinusitis. The involvement of the other sinuses was frontal in 28 (17.3%), ethmoid in 48 (29.6%) and sphenoid in 26 (16%) patients. When the location of sinus involvement was taken into consideration, the maxillary rhinosinusitis was more frequently involved in cases with concha bullosa (p=0.04). There was a relationship between right concha bullosa (p=0.013), left concha bullosa (p=0.034), presence of reverse curvature (p=0.043), obliteration of osteomeatal complex (p=0.0008) and rhinosinusitis. There was a relationship between the degree and type of concha bullosa and rhinosinusitis (p=0.030). Rhinosinusitis was detected more frequently (55.5%) in cases with extensive type concha bullosa. Conclusion: Concha bullosa is a frequently encountered variation and leads to susceptibility to rhinosinusitis. For this reason, preoperative and premedicative computed tomography scan is important for the sinus, especially extensive type concha bullosa.

References

  • Unlu HH, Akyar S, Caylan R, Nalca Y. Concha bullosa. J Otolaryngol 1994;23:23-7.
  • Zinreich SJ, Mattox DE, Kennedy DW, et al. Concha bullosa: CT evaluation. J Comput Assist Tomogr 1988;12:778-84.
  • Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatom- ic variations and mucosal abnormalities: CT analysis for endoscop- ic sinus surgery. Laryngoscope 1991;101:56-64.
  • Stammemberger H. Functional Endoscopic Sinus Surgery. Philadelphia: B.C. Decker; 1991. p. 161-9.
  • Subramanian S, Lekhraj Rampal GR, Wong EF, Mastura S, Razi A. Concha bullosa in chronic sinusitis. Med J Malaysia 2005;60: 535-9.
  • Yousem DM. Imaging of sinonasal inflammatory disease. Radiology 1993;188:303-14.
  • Fokkens WJ, Lund VJ, Mullol J, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2007. Rhinology 2007;45(Suppl 20):1-139.
  • Bhattacharyya T, Piccirillo J, Wippold FJ. Relationship between patient-based descriptions of sinusitis and paranasal sinus comput- ed tomographic findings. Arch Otolaryngol Head Neck Surg 1997;123:1189-92.
  • Royal College of Radiologists Working Party. Making the Best Use of a Department of Clinical Radiology: Guidelines for Doctors. 3rd ed. London: The Royal College of Radiologists; 1995. p. 1-96.
  • Bhattacharyya N. Test-retest reliability of computed tomography in the assessment of chronic rhinosinusitis. Laryngoscope 1999;109:1055-8.
  • Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol 2004;25:1613-8.
  • Hatipoglu HG, Cetin MA, Yuksel E. Concha bullosa types: their relationship with sinusitis, ostiomeatal and frontal recess disease. Diagn Interv Radiol 2005;11:145-9.
  • Joe JK, Ho SY, Yanagisawa E. Documentation of variations in sinonasal anatomy by intraoperative nasal endoscopy. Laryngoscope 2000;110:229-35.
  • Yigit O, Acioglu E, Cakir ZA, Sisman AS, Barut AY. Concha bul- losa and septal deviation. Eur Arch Otorhinolaryngol 2010; 267:1397-401.
  • Arslan H, Aydinlioglu A, Bozkurt M, Egeli E. Anatomic variations of the paranasal sinuses: CT examination for endoscopic sinus sur- gery. Auris Nasus Larynx 1999;26:39-48.
  • Sazgar AA, Massah J, Sadeghi M, Bagheri A, Rasool E. The inci- dence of concha bullosa and the correlation with nasal septal devi- ation. B-ENT 2008;4:87-91.
  • Smith KD, Edwards PC, Saini TS, Norton NS. The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent 2010. pii: 404982. doi: 10.1155/2010/404982
  • Hatipoglu HG, Cetin MA, Yuksel E. Nasal septal deviation and concha bullosa coexistence: CT evaluation. B-ENT 2008;4:227- 32.
  • Collet S, Bertrand B, Cornu S, Eloy P, Rombaux P. Is septal devi- ation a risk factor for chronic sinusitis? Review of literature. Acta Otorhinolaryngol Belg 2001;55:299-304.
  • Lloyd GA. CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. J Laryngol Otol 1990;104: 477-81.
  • Lidov M, Som PM. Inflammatory disease involving a concha bul- losa (enlarged pneumatized middle nasal turbinate): MR and CT appearance. AJNR Am J Neuroradiol 1990;11:999-1001.
  • Caughey RJ, Jameson MJ, Gross CW, Han JK. Anatomic risk fac- tors for sinus disease: fact or fiction? Am J Rhinol 2005:19:334-9.
  • Havas TE, Motbey JA, Gullane PJ. Prevalence of incidental abnormalities on computed tomographic scans of the paranasal sinuses. Arch Otolaryngol Head Neck Surg 1988;114:856-9.
  • This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY
  • NC-ND0) Licence (http://creativecommons.org/licenses/by-nc-nd/3.0/) which permits unrestricted noncommercial use, distribution, and reproduc
  • tion in any medium, provided the original work is properly cited.
  • Please cite this article as: Tunçyürek Ö, Eyigör H, Songu M. The relationship among concha bullosa, septal deviation and chronic rhinosinusitis.
  • J Med Updates 2013;3(1):1-7.

Büllöz konka, septum deviasyonu ve kronik rinosinüzit arasındaki ilişki

Year 2013, Volume: 3 Issue: 1, 1 - 7, 01.03.2013
https://doi.org/10.2399/jmu.2013001002

Abstract

Amaç: Hem büllöz konka hem de nazal septum deviasyonunun prevalans ve tiplerini değerlendirmek ve maksiller rinosinüzitle potansiyel ilişkilerini belirlemek. Yöntem: Ocak 2009 - Nisan 2010 arasında Kulak Burun Boğaz Hastalıkları polikliniklerine rinosinüzit semptomları ile kabul edilen hastalar retrospektif çalışmaya alındı. Bülloz konka, nazal septum deviasyonu ve rinosinüzit varlığı, bulundukları taraf ve tiplerini belirlemek için çekilmiş paranazal sinüs bilgisayarlı tomografi taramaları gözden geçirildi. Bulgular: Toplam 162 hasta (324 taraf) incelendi. Büllöz konka ve septum deviasyon insidansları sırasıyla %42.6 ve 46.9 idi. Nazal septum deviasyonuyla büllöz konkanın bulunması arasında istatistiksel açıdan anlamlı bir ilişki yoktu (p=0.06). Hastaların toplam %45.1'inde maksiller rinosinüzit kanıtı vardı. Diğer sinüslerin tutulumu da saptanmıştı. Örneğin 28 hastada (%17.3) frontal, 48'inde (%29.6) etmoid ve 26'sında (%16) maksiller sinüs tutulmuştu. Sinüs tutulumlarının yerleşimi göz önüne alındığında büllöz konka olgularında daha büyük bir sıklıkla maksiller rinosinüzit mevcuttu (p=0.04). Sağ (p=0.013) ve sol (p=0.034) büllöz konka, ters kurvatür (p=0.043), osteomeatal kompleks (p=0.0008) ve rinosinüzit arasında bir ilişki mevcuttu. Büllöz konkanın derecesi ve tipiyle rinosinüzit arasında bir ilişki vardı (p=0.030). Yaygın tipte büllöz konkası olan hastalarda rinosinüzit daha sık (%55.5) saptanmıştı. Sonuç: Büllöz konka sık rastlanılan bir varyasyon olup rinosinüzite yatkınlaşmaya yol açmaktadır. Bu nedenle preoperatif ve ilaç tedavisi öncesi çekilen bilgisayarlı tomografi taraması sinüs, özellikle yaygın büllöz konka için önem taşır.

References

  • Unlu HH, Akyar S, Caylan R, Nalca Y. Concha bullosa. J Otolaryngol 1994;23:23-7.
  • Zinreich SJ, Mattox DE, Kennedy DW, et al. Concha bullosa: CT evaluation. J Comput Assist Tomogr 1988;12:778-84.
  • Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatom- ic variations and mucosal abnormalities: CT analysis for endoscop- ic sinus surgery. Laryngoscope 1991;101:56-64.
  • Stammemberger H. Functional Endoscopic Sinus Surgery. Philadelphia: B.C. Decker; 1991. p. 161-9.
  • Subramanian S, Lekhraj Rampal GR, Wong EF, Mastura S, Razi A. Concha bullosa in chronic sinusitis. Med J Malaysia 2005;60: 535-9.
  • Yousem DM. Imaging of sinonasal inflammatory disease. Radiology 1993;188:303-14.
  • Fokkens WJ, Lund VJ, Mullol J, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2007. Rhinology 2007;45(Suppl 20):1-139.
  • Bhattacharyya T, Piccirillo J, Wippold FJ. Relationship between patient-based descriptions of sinusitis and paranasal sinus comput- ed tomographic findings. Arch Otolaryngol Head Neck Surg 1997;123:1189-92.
  • Royal College of Radiologists Working Party. Making the Best Use of a Department of Clinical Radiology: Guidelines for Doctors. 3rd ed. London: The Royal College of Radiologists; 1995. p. 1-96.
  • Bhattacharyya N. Test-retest reliability of computed tomography in the assessment of chronic rhinosinusitis. Laryngoscope 1999;109:1055-8.
  • Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol 2004;25:1613-8.
  • Hatipoglu HG, Cetin MA, Yuksel E. Concha bullosa types: their relationship with sinusitis, ostiomeatal and frontal recess disease. Diagn Interv Radiol 2005;11:145-9.
  • Joe JK, Ho SY, Yanagisawa E. Documentation of variations in sinonasal anatomy by intraoperative nasal endoscopy. Laryngoscope 2000;110:229-35.
  • Yigit O, Acioglu E, Cakir ZA, Sisman AS, Barut AY. Concha bul- losa and septal deviation. Eur Arch Otorhinolaryngol 2010; 267:1397-401.
  • Arslan H, Aydinlioglu A, Bozkurt M, Egeli E. Anatomic variations of the paranasal sinuses: CT examination for endoscopic sinus sur- gery. Auris Nasus Larynx 1999;26:39-48.
  • Sazgar AA, Massah J, Sadeghi M, Bagheri A, Rasool E. The inci- dence of concha bullosa and the correlation with nasal septal devi- ation. B-ENT 2008;4:87-91.
  • Smith KD, Edwards PC, Saini TS, Norton NS. The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent 2010. pii: 404982. doi: 10.1155/2010/404982
  • Hatipoglu HG, Cetin MA, Yuksel E. Nasal septal deviation and concha bullosa coexistence: CT evaluation. B-ENT 2008;4:227- 32.
  • Collet S, Bertrand B, Cornu S, Eloy P, Rombaux P. Is septal devi- ation a risk factor for chronic sinusitis? Review of literature. Acta Otorhinolaryngol Belg 2001;55:299-304.
  • Lloyd GA. CT of the paranasal sinuses: study of a control series in relation to endoscopic sinus surgery. J Laryngol Otol 1990;104: 477-81.
  • Lidov M, Som PM. Inflammatory disease involving a concha bul- losa (enlarged pneumatized middle nasal turbinate): MR and CT appearance. AJNR Am J Neuroradiol 1990;11:999-1001.
  • Caughey RJ, Jameson MJ, Gross CW, Han JK. Anatomic risk fac- tors for sinus disease: fact or fiction? Am J Rhinol 2005:19:334-9.
  • Havas TE, Motbey JA, Gullane PJ. Prevalence of incidental abnormalities on computed tomographic scans of the paranasal sinuses. Arch Otolaryngol Head Neck Surg 1988;114:856-9.
  • This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported (CC BY
  • NC-ND0) Licence (http://creativecommons.org/licenses/by-nc-nd/3.0/) which permits unrestricted noncommercial use, distribution, and reproduc
  • tion in any medium, provided the original work is properly cited.
  • Please cite this article as: Tunçyürek Ö, Eyigör H, Songu M. The relationship among concha bullosa, septal deviation and chronic rhinosinusitis.
  • J Med Updates 2013;3(1):1-7.
There are 28 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Özüm Tunçyürek This is me

Hülya Eyigör This is me

Murat Songu This is me

Publication Date March 1, 2013
Published in Issue Year 2013 Volume: 3 Issue: 1

Cite

APA Tunçyürek, Ö., Eyigör, H., & Songu, M. (2013). Büllöz konka, septum deviasyonu ve kronik rinosinüzit arasındaki ilişki. Journal of Medical Updates, 3(1), 1-7. https://doi.org/10.2399/jmu.2013001002
AMA Tunçyürek Ö, Eyigör H, Songu M. Büllöz konka, septum deviasyonu ve kronik rinosinüzit arasındaki ilişki. Journal of Medical Updates. March 2013;3(1):1-7. doi:10.2399/jmu.2013001002
Chicago Tunçyürek, Özüm, Hülya Eyigör, and Murat Songu. “Büllöz Konka, Septum Deviasyonu Ve Kronik rinosinüzit arasındaki ilişki”. Journal of Medical Updates 3, no. 1 (March 2013): 1-7. https://doi.org/10.2399/jmu.2013001002.
EndNote Tunçyürek Ö, Eyigör H, Songu M (March 1, 2013) Büllöz konka, septum deviasyonu ve kronik rinosinüzit arasındaki ilişki. Journal of Medical Updates 3 1 1–7.
IEEE Ö. Tunçyürek, H. Eyigör, and M. Songu, “Büllöz konka, septum deviasyonu ve kronik rinosinüzit arasındaki ilişki”, Journal of Medical Updates, vol. 3, no. 1, pp. 1–7, 2013, doi: 10.2399/jmu.2013001002.
ISNAD Tunçyürek, Özüm et al. “Büllöz Konka, Septum Deviasyonu Ve Kronik rinosinüzit arasındaki ilişki”. Journal of Medical Updates 3/1 (March 2013), 1-7. https://doi.org/10.2399/jmu.2013001002.
JAMA Tunçyürek Ö, Eyigör H, Songu M. Büllöz konka, septum deviasyonu ve kronik rinosinüzit arasındaki ilişki. Journal of Medical Updates. 2013;3:1–7.
MLA Tunçyürek, Özüm et al. “Büllöz Konka, Septum Deviasyonu Ve Kronik rinosinüzit arasındaki ilişki”. Journal of Medical Updates, vol. 3, no. 1, 2013, pp. 1-7, doi:10.2399/jmu.2013001002.
Vancouver Tunçyürek Ö, Eyigör H, Songu M. Büllöz konka, septum deviasyonu ve kronik rinosinüzit arasındaki ilişki. Journal of Medical Updates. 2013;3(1):1-7.