Nasal septum deviasyonu olan kişilerin bilgisayarlı tomografi görüntülerinde sinus maxillaris hacminin hesaplanması ve cinsiyet ile ilişkisi

Öz

Paranasal sinuslerin en büyüğü olan sinus maxillaris (SM) yüzde pek çok anatomik yapı ile komşuluk yapmaktadır. Bu çalışmada nasal septum deviasyonu (NSD) olan olgularda SM morfometrik olarak değerlendirerek, NSD ile ilişkisi olup olmadığını saptamak ve SM hacminin cinsiyet ile ilişkisini tespit etmek amaçlanmıştır. Çalışma Aydın Adnan Menderes Üniversitesi’nde gerçekleştirilmiş olup, 150 kişiye (deviasyonu olanlar 90 kişi, deviasyonu olmayanlar 60 kişi) ait paranasal sinus BT görüntülerinde SM yüksekliği, genişliği ve derinliği ölçüldü. Elde edilen ölçümler eliptik formülde kullanılarak SM hacim hesaplaması yapıldı. NSD olan kişilerde deviasyon yönü değerlendirilip, deviasyon açısı ve deviasyon şiddeti hesaplandı. SM hacmi sağ tarafta 16,88±5,69 cm3, sol tarafta 17,07±5,52 cm3 olarak ölçüldü. Olguların %30’unda sağ septum deviasyonu, %30’unda sol septum deviasyonu saptandı, %40’ında ise deviasyon saptanmadı. Septum deviasyonu olanların %49’unda hafif, %51’inde orta şiddette deviasyon belirlendi. SM hacmi ile septum deviasyonu arasında istatistiksel olarak anlamlı farklılık vardı. SM’i tüm ölçümlerinde erkekler ve kadınlar arasında istatistiksel olarak anlamlı farklılık vardı. Diskriminant analizinde cinsiyetlere göre ayrımda en belirgin değişkenin SM yüksekliği olduğu görüldü. Cinsiyet değerlendirmesi kadınlarda %74,4, erkeklerde ise %65,3 doğruluk oranıyla belirlendi. Çalışmanın sonucunda nasal septum’un deviasyon yönünü SM hacmine etki etmediği saptanmıştır. Tüm ölçümlerde erkeklerde daha yüksek değerler elde edilmiş olup, bulgularımız SM’in morfometrik özellikleri açısından cinsel dimorfizminin önemini ortaya koymaktadır. SM hacim bulgularının klinikte yararlı olacağını ve cinsiyet tayini sürecinde adli tıpta yardımcı olarak kullanılabileceğini düşünmekteyiz.

Anahtar Kelimeler

• nasal septum deviasyonu
• sinus maxillaris hacmi
• bilgisayarlı tomografi
• cinsiyet tayini

Nasal Septum Deviasyonu Olan Kişilerin Bilgisayarlı Tomografi Görüntülerinde Sinus Maxillaris Hacminin Hesaplanması ve Cinsiyet ile İlişkisi

Öz

The sinus maxillaris (SM), the largest of the paranasal sinuses, is located next to numerous facial anatomical features. The objectives of this study were to assess the SM morphometrically in cases of nasal septum deviation (NSD), determine if it is associated with NSD, and clarify the correlation between gender and SM volume. The study was conducted at Aydin Adnan Menderes University and the height, width and depth of the SM were measured in paranasal sinus CT images of 150 subjects (90 with deviated nasal septum and 60 without deviated nasal septum). The obtained measurements were used in the elliptical formula to calculate the SM volume. In patients with deviated septum, the direction of NSD was evaluated and the deviation angle and deviation severity were calculated. SM volume was measured as 16.88±5.69 cm3 on the right side and 17.07±5.52 cm3 on the left side. Right septum deviation was detected in 30% of the cases, left septum deviation was detected in 30%, and no deviation was detected in 40% of the cases. Of those with deviated septum, 49% had mild deviation and 51% had moderate deviation. There was a statistically significant difference between SM volume and septal deviation. There was a statistically significant difference between men and women in all measurements of SM. Discriminant analysis showed that the most prominent variable in discrimination according to gender was SM height. Gender assessment was determined with an accuracy rate of 74.4% in women and 65.3% in men. As a result of the study, it was determined that the deviation side of the nasal septum did not affect the SM volume. Higher values were obtained in men in all measurements and our findings reveal the importance of sexual dimorphism in terms of morphometric properties of the SM. We think that SM volume findings will be useful in the clinic and can be used as an aid in forensic medicine in the process of gender determination.

Anahtar Kelimeler

• nasal septum deviation
• sinus maxillaris volume
• computed tomography
• gender determination

Kaynakça

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