NAZAL SEPTUM DEVİASYONU'NUN NAZOFARENGEAL HACİM ÜZERİNE ETKİSİ

Year 2025, Volume: 26 Issue: 4, 307 - 316, 13.10.2025

Rabia Koca , Nihal Gürlek Çelik , Burcu Akman

https://doi.org/10.18229/kocatepetip.1606052

Abstract

AMAÇ: Nazal septum deviasyonu (NSD), nazofaringeal hava akımı dinamiklerini ve solunum fonksiyonunu önemli ölçüde etkileyen yaygın bir anatomik bozukluktur. Bu çalışmada, NSD morfolojilerinin incelenmesi, nazofarenks hacmi (NV) üzerine etkilerinin değerlendirilmesi ve NSD açısı ile hava yolu hacmi arasındaki ilişkinin araştırılması amaçlandı.
GEREÇ VE YÖNTEM: 18 ila 70 yaşları arasındaki 100 hastanın baş bilgisayarlı tomografi (BT) taramaları üzerinde retrospektif bir araştırma yürütüldü. Segmentli yapılar Segment 3D aracı kullanılarak mm3 cinsinden hacimsel olarak ölçüldü. NSD'deki anatomik varyasyonlar belirlendi. Çalışmada, NSD açıları ITK-SNAP arayüzü aracılığıyla ölçüldü. NSD açıları ile NV arasındaki korelasyonlar değerlendirildi. Cinsiyete ve yaşa göre farklılıkları belirlemek için istatistiksel analizler yapıldı.
BULGULAR: NSD açısı hastaların %67'sinde 5° veya daha fazlaydı. Dört farklı NSD türü belirlendi. Bunlar sağ ve sol konkav C şeklinde, dorsoventral S şeklinde ve kaudal-rostral S şeklindedir. Hem koronal (r = -0,635, p<0,01) hem de aksiyel (r = -0,652, p<0,01) düzlemlerde NSD açısı ile NV arasında anlamlı negatif korelasyon gözlendi. NSD açısı 5° veya daha büyük olan hastalar, daha küçük açılara sahip olanlara kıyasla belirgin şekilde azalmış NV'ye sahipti (p<0,05). Ek olarak, yaş (ortalama ± SD; 33,04±14,42) ve NV (r = 0,245, p=0,014) arasında pozitif bir korelasyon gözlendi. Bu, sapma açılarının artırılmasının NV'yi önemli ölçüde azalttığını ve potansiyel olarak solunum verimliliğini etkilediğini göstermektedir.
SONUÇ: Bu çalışma, daha büyük NSD açıları ile azalmış NV arasında anlamlı bir korelasyon olduğunu göstermektedir. Bu bulgu, NSD'nin burun hava akışını olumsuz etkileyebileceğini ve üst hava yolu tıkanıklığına neden olabileceğini göstermektedir. Bu sonuçlar, açıklanamayan solunum semptomları olan hastalarda doğru NSD değerlendirmesinin klinik önemini vurgulamaktadır. Ayrıca, gelişmiş tanı ve tedavi yaklaşımlarının yolunu açmaktadır.

Keywords

Nazal septum deviasyonu , Nazofaringeal hacim , Bilgisayarlı tomografi , Morfometrik analiz , 3B görüntüleme.

THE EFFECT OF NASAL SEPTUM DEVIATION ON NASOPHARYNGEAL VOLUME

Abstract

OBJECTIVE: Nasal septum deviation (NSD) is a common anatomical abnormality that significantly impacts nasopharyngeal airflow dynamics and respiratory function. This study aimed to examine NSD morphologies, evaluate their effects on nasopharyngeal volume (NV), and investigate the relationship between NSD angle and airway volume.
MATERIAL AND METHODS: A retrospective analysis was conducted on head computed tomography (CT) scans from 100 patients aged 18 to 70. Segmented structures were measured volumetrically in mm3 using the Segment 3D tool. Anatomical variations in NSD were identified. In the study, NSD angles were measured via the ITK-SNAP interface. Correlations between NSD angles and NV were assessed. Statistical analyses were performed to determine differences according to gender and age.
RESULTS: The NSD angle was 5° or greater in 67% of patients. Four different NSD types were identified. These are right and left concave C-shaped, dorsoventral S-shaped and caudal-rostral S-shaped. A significant negative correlation was observed between NSD angle and NV in both coronal (r = -0.635, p<0.01) and axial (r = -0.652, p<0.01) planes. Patients with NSD angles of 5° or greater had notably reduced NV compared to those with smaller angles (p<0.05). Additionally, a positive correlation was observed between age (mean ± SD; 33.04±14.42) and NV (r = 0.245, p=0.014). This suggests that increasing deviation angles substantially reduces NV, potentially affecting respiratory efficiency.
CONCLUSIONS: This study demonstrates a significant correlation between larger NSD angles and reduced NV. This finding indicates NSD may negatively impact nasal airflow and cause upper airway obstruction. These results highlight the clinical importance of accurate NSD assessment in patients with unexplained respiratory symptoms. They also pave the way for improved diagnostic and therapeutic approaches.

Keywords

Nasal septum deviation , Nasopharyngeal volume , Computed tomography , Morphometric analysis , 3D imaging.

Ethical Statement

Approval for the study was received from Amasya University Non-Interventional Clinical Research Ethics Committee (Approval Date: 06.04.2023; Approval No: 2023/44-06).

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