The relationship among concha bullosa, septal deviation and chronic rhinosinusitis

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.

Keywords

• Computed tomography, concha bullosa, CT, nasal septal deviation, rhinosinusitis

Büllöz konka, septum deviasyonu ve kronik rinosinüzit arasındaki ilişki

Öz

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.

Anahtar Kelimeler

• Bilgisayarlı tomografi, BT, büllöz konka, nazal septum deviasyonu, rinosinüzit

Kaynakça

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27. Please cite this article as: Tunçyürek Ö, Eyigör H, Songu M. The relationship among concha bullosa, septal deviation and chronic rhinosinusitis.
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