Sinonasal anatomic variations and relationship with sinonasal inflammatory mucosal disease: a computed tomography study

Yıl 2020, Cilt: 10 Sayı: 3, 348 - 353, 30.09.2020

Esin Kurtuluş Öztürk , Saffet Öztürk , Şükrü Turan , Berat Acu

https://doi.org/10.16899/jcm.746980

Öz

Objective: To evaluate sinonasal anatomic variations on the paranasal computed tomography (CT) scans and to investigate association with sinonasal inflammatory mucosal disease.

Materials and Methods: Between January 2019 and December 2019, paranasal CT scans of 279 adult patients were retrospectively analyzed. Patients data were obtained from medical and imaging records. On CT examinations, each anatomic variation was evaluated with respect to side and bilaterality. We investigated statistically coexistence between anatomic variations and presence of sinonasal inflammatory mucosal disease.

Results: Our results showed high prevalence of sinonasal anatomic variations. The most common anatomic variation was nasal septal deviation (65.2 %), followed by concha bullosa (41.6 %)and septal spur (28.7 %). We found a statistically significant relationship between concha bullosa and sinonasal inflammatory mucosal disease (p=0.009) which was observed especially in bulbous (p=0.048) and extensive types(p=0.017). No significant association was noted with the other anatomic variations.

Conclusion:
Concha bullosa, particularly bulbous and extensive types have a tendency to cause sinonasal inflammatory mucosal disease.
Key words: Sinonasal cavity, anatomic variation, computed tomography, mucosal disease, rhinosinusitis

Anahtar Kelimeler

Sinonasal cavity, anatomic variation, computed tomography, mucosal disease, rhinosinusitis

Kaynakça

• 1. Avsever H, Gunduz K, Karakoc O, Akyol M, Orhan K. Incidental findings on cone-beam computed tomographic images: paranasal sinus findings and nasal septum variations. Oral Radiol. 2018;34(1):40-8.
• 2. Krouse JH. Inflammatory sinonasal disease. Facial Plast Surg Clin North Am. 2004;12(4):407-14, v.
• 3. Hoang JK, Eastwood JD, Tebbit CL, Glastonbury CM. Multiplanar sinus CT: a systematic approach to imaging before functional endoscopic sinus surgery. AJR Am J Roentgenol. 2010;194(6):W527-36.
• 4. Rao VM, el-Noueam KI. Sinonasal imaging. Anatomy and pathology. Radiol Clin North Am. 1998;36(5):921-39, vi.
• 5. Yousem DM. Imaging of sinonasal inflammatory disease. Radiology. 1993;188(2):303-14.
• 6. Scarfe William C. AC. Maxillofacial Cone Beam Computed Tomography. William C. Scarfe CA, editor: Springer International Publishing; 2018.
• 7. Perez P, Sabate J, Carmona A, Catalina-Herrera CJ, Jimenez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000;197 ( Pt 2):221-7.
• 8. Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope. 1991;101(1 Pt 1):56-64.
• 9. Scuderi AJ, Harnsberger HR, Boyer RS. Pneumatization of the paranasal sinuses: normal features of importance to the accurate interpretation of CT scans and MR images. AJR Am J Roentgenol. 1993;160(5):1101-4.
• 10. Stammberger H. F.E.S.S. : endoscopic diagnosis and surgery of the paranasal sinuses and anterior skull base ; the Messerklinger technique and advanced applications from the Graz School: Graz, Austria : University Ear Nose and Throat Hospital; 2006.
• 11. Beale TJ, Madani G, Morley SJ. Imaging of the paranasal sinuses and nasal cavity: normal anatomy and clinically relevant anatomical variants. Semin Ultrasound CT MR. 2009;30(1):2-16.
• 12. 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(5):561-70.
• 13. Yadav RR AM, Humagain M, Mishra D. Assessment of anatomical variations of nose and paranasal sinuses in multidetector computed tomography. Journal of Institute of Medicine. 2017;April, 39:1.
• 14. Lee S, Lane AP. Chronic rhinosinusitis as a multifactorial inflammatory disorder. Curr Infect Dis Rep. 2011;13(2):159-68.
• 15. Dasar U, Gokce E. Evaluation of variations in sinonasal region with computed tomography. World J Radiol. 2016;8(1):98-108.
• 16. 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. AJR Am J Roentgenol. 2015;204(6):1255-60.
• 17. Kaygusuz A, Haksever M, Akduman D, Aslan S, Sayar Z. Sinonasal anatomical variations: their relationship with chronic rhinosinusitis and effect on the severity of disease-a computerized tomography assisted anatomical and clinical study. Indian J Otolaryngol Head Neck Surg. 2014;66(3):260-6.
• 18. Jones NS. CT of the paranasal sinuses: a review of the correlation with clinical, surgical and histopathological findings. Clin Otolaryngol Allied Sci. 2002;27(1):11-7.
• 19. 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;2010.
• 20. 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(9):1613-8.
• 21. Fadda GL, Rosso S, Aversa S, Petrelli A, Ondolo C, Succo G. Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis. Acta Otorhinolaryngol Ital. 2012;32(4):244-51.
• 22. Kaya M, Cankal F, Gumusok M, Apaydin N, Tekdemir I. Role of anatomic variations of paranasal sinuses on the prevalence of sinusitis: Computed tomography findings of 350 patients. Niger J Clin Pract. 2017;20(11):1481-8.
• 23. Blake C. Alkire NB. An Assessment of Sinonasal Anatomic Variants Potentially Associated With Recurrent Acute Rhinosinusitis. The Laryngoscope. 2010;120:631–4.
• 24. Robert J. Caughey MJJ, Charlie W. Gross, Joseph K. Han. Anatomic Risk Factors for Sinus Disease: Fact or Fiction? American Journal of Rhinology. 2005;19(4):334-9.