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

Yıl 2024, Cilt: 46 Sayı: 4, 528 - 537, 16.07.2024

Behiye Sarıyıldız , Ilgaz Akdoğan , Ömer Can Kızılay , Gizem Sakallı

https://doi.org/10.20515/otd.1451542

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

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

Etik Beyan

Çalışma Aydın Adnan Menderes Üniversitesi Tıp Fakültesi Etik Kurulu tarafından onaylanmıştır (Karar No: 2021-124 Onay Tarihi: 24/06/2021).

Kaynakça

• 1. Arıncı K, Elhan A. Anatomi. 6. Baskı. Ankara:Güneş Kitabevi, 2016.
• 2. Standring S. (Edited by). Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 41nd Edition, Hollanda: Elsevier Limited, 2016.
• 3. Whyte A, Boeddinghaus R. The maxillary sinus: physiology, development and imaging anatomy. Dento maxillo facial radiology. 2019; 48(8), 20190205.
• 4. Anagnostopoulou S, Venieratos D, Spyropoulos N. Classification of human maxillar sinuses according to their geometric features. Anat Anz. 1991; 173(3):121–30.
• 5. Cho SH, Kim TH, Kim KR, Lee J, Lee D, Kim J, et al. Factors for Maxillary Sinus Volume and Craniofacial Anatomical Features in Adults With Chronic Rhinosinusitis. Arch Otolaryngol Head Neck Surg. 2010; 136(6):610–615.
• 6. Kapusuz GZ, Ozkiris M, Okur A, Karacavus S, Saydam L. The effect of nasal septal deviation on maxillary sinus volumes and development of maxillary sinusitis. Eur Arch Otorhinolaryngol. 2014; 270: 3069-3073.
• 7. Razavi M, Shams N, Pirasteh SMA. Determining the effects of deviated nasal septum on maxillary sinus volume using cone-beam computed tomography. Immunopathologia Persa. 2022; 9(1), e34427-e34427.
• 8. Kazimierczak N, Kazimierczak W, Serafin Z, Nowicki P, Lemanowicz A, Nadolska K, et al. Correlation Analysis of Nasal Septum Deviation and Results of AI-Driven Automated 3D Cephalometric Analysis. Journal of Clinical Medicine. 2023; 12(20):6621.
• 9. Al-Rawi NH, Uthman AT, Abdulhameed E, Al Nuaimi AS, Seraj Z. Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: a cone-beam computed tomography study. Imaging science in dentistry. 2019; 49(1):45-51.
• 10. Denour E, Roussel LO, Woo AS, Boyajian M, Crozier J. Quantification of Nasal Septal Deviation with Computed Tomography Data. J Craniofacial Surg. 2020; 31:1659–1663.
• 11. Baddam P, Kung T, Adesida AB, Graf D. Histological and Molecular Characterization of the Growing Nasal Septum in Mice. J. Anat. 2020; 238:751–764.
• 12. D'Ascanio L, Lancione C, Pompa G, Rebuffini E, Mansi N, Manzini M. Craniofacial growth in children with nasal septum deviation: a cephalometric comparative study. Int J Pediatr Otorhinolaryngol 2010; 74(10):1180-1183.
• 13. Hartman C, Holton N, Miller S, Yokley T, Marshall S, Srinivasan S et al. Nasal Septal Deviation and Facial Skeletal Asymmetries. Anat. Rec. 2016; 299: 295-306.
• 14. Shamaei-Tousi A, Veneziano A, Landi F. Relation between nasal septum deviation and facial asymmetry: an ontogenetic analysis from infants to children using geometric Morphometrics. Applied Sciences, 2022, 12.22: 11362.
• 15. Serifoglu I, Oz İİ, Damar M, Buyukuysal MC, Tosun A, Tokgöz Ö. Relationship between the degree and direction of nasal septum deviation and nasal bone morphology. Head Face Med. 2017; 13(3):1-6.
• 16. Karatas D, Koç A, Yüksel F, Dogan M, Bayram A, Cihan MC. The effect of nasal septal deviation on frontal and maxillary sinus volumes and development of sinusitis. Journal of Craniofacial Surgery. 2015; 26(5):1508-1512.
• 17. Orhan I, Ormeci T, Aydin S, Altin G, Urger E, Soylu E et al. Morphometric analysis of the maxillary sinus in patients with nasal septum deviation. Eur Arch Otorhinolaryngol. 2014; 271(4):727-732.
• 18. Aşantoğrol F, Coşgunarslan A. The effect of anatomical variations of the sinonasal region on maxillary sinus volume and dimensions: a three-dimensional study. Braz J Otorhinolaryngol. 2022; 88(1):118-127.
• 19. Jeon EY, Lee JH, Park SB, Park JT. Three-dimensional Evaluation of Maxillary Sinus Volume in Different Sex Groups Using Cone-beam Computed Tomography. Medico-legal Update. 2020; 20(1).
• 20. Bangi BB, Ginjupally U, Nadendla LK, Vadla B. 3D evaluation of maxillary sinus using computed tomography: a sexual dimorphic study Int. J. Dent., 2017; 2017:1-4.
• 21. Durić M, Rakočević Z, Donić D. The reliability of sex determination of skeletons from forensic context in the Balkans Forensic Sci. Int. 2005; 147(2-3):159-164.
• 22. Uthman AT, Al-Rawi NH, Al-Naaimi AS, Al-Timimi JF. Evaluation of maxillary sinus dimensions in gender determination using helical CT scanning J. Forensic Sci. 2011; 56(2):403-408.
• 23. Tunis TS, Sarig R, Cohen H, Medlej B, Peled N, May H. Sex estimation using computed tomography of the mandible Int J Legal Med. (2017); 131(6): 1691-1700,
• 24. Akhlaghi M, Bakhtavar K, Kamali A, Maarefdoost J, Sheikhazadi A, Mousavi F, et al. The diagnostic value of anthropometric indices of maxillary sinuses for sex determination using CT-scan images in Iranian adults: a cross-sectional study. J Forensic Legal Med. 2017; 49:94–100.
• 25. Sharma SK, Jehan M, Kumar A. Measurements of maxillary sinus volume and dimensions by computed tomography scan for gender determination. Journal of the Anatomical Society of India. 2014; 63(1):36–42.
• 26. Sahlstrand-Johnson P, Jannert M, Strömbeck A, Abul-Kasim K. Computed tomography measurements of different dimensions of maxillary and frontal sinuses. BMC Med Imaging. 2011; 11(8): 1-7.
• 27. Kalsotra G, Saroch P, Gupta A, Kalsotra P, Saraf A. The Variations in Deviation of Nasal Septum and their Impact on Maxillary Sinus Volume and Occurrence of Sinusitis. Indian J Otolaryngol Head Neck Surg. 2023; 75(3):1762-1766.
• 28. Kalabalık F, Tarım EE. Investigation of maxillary sinus volume relationships with nasal septal deviation, concha bullosa, and impacted or missing teeth using cone-beam computed tomography. Oral Radiol. 2019; 35(3):287-295.
• 29. Orhan I, Ormeci T, Aydin S, Altin G, Urger E, Soylu E, et al. Morphometric analysis of the maxillary sinus in patients with nasal septum deviation. Eur Arch Otorhinolaryngol. 2014; 271(4):727-732.
• 30. Lessa AMG, Oliveira VS, Costa RBA Meneses ATR, Crusoé-Rebello I, Costa FWG et al. Anatomical study of the maxillary sinus: which characteristics can influence its volume?. Surg Radiol Anat 2023; 45(1):81–87.
• 31. Kannampurath A, Leela Srikantannair S, Mathew P, Siva Prasad T. Maxillary sinus in gender determination: a morphometric analysis using cone beam computed tomography. Forensic science, medicine, and pathology 2023.
• 32. Iscan MY. Forensic anthropology of sex and body size. Forensic Sci Int 2015; 147(2):107–112.
• 33. Paknahad Z, Shahidi M, Zarei S. Sexual dimorphism of maxillary sinus dimensions using cone-beam computed tomography. J Forensic Sci. 2016; 62(2):395–398.
• 34. Gamba TO, Yamasaki MC, Groppo FC, Silveira HLD, Boscolo SMA, Sanderik GCH, et al. Validation study of a new method for sexual prediction based on CBCT analysis of maxillary sinus and mandibular canal. Arch Oral Biol. 2017; 83:118–123.
• 35. Farias Gomes A, de Oliveira Gamba T, Yamasaki MC, Groppo FC, Haiter Neto F, et al. Development and validation of a formula based on maxillary sinus measurements as a tool for sex estimation: a cone beam computed tomography study. International journal of legal medicine, 2019; 133:1241-1249.
• 36. Teke HY, Duran S, Canturk N, Canturk G. Determination of gender by measuring the size of the maxillary sinuses in computerized tomography scans. Surg Radiol Anat. 2007; 29(1):9-13.
• 37. Akhlaghi M, Bakhtavar K, Kamali A, Maarefdoost J, Sheikhazadi A, Mousavi F, et al. The diagnostic value of anthropometric indices of maxillary sinuses for sex determination using CT-scan images in Iranian adults: A cross-sectional study. J Forensic Leg Med. 2017; 49:94–100.
• 38. Vidya CS, Shamasundar NM, Manjunatha B, Raichurkar K. Evaluation of size and volume of maxillary sinus to determine gender by 3D computerized tomography scan method using dry skulls of South Indian origin. Int J Curr Res Rev. 2013; 5(3):97–100.
• 39. Kanthem RK, Guttikonda VR, Yeluri S, Kumari G. Sex determination using maxillary sinus. J Forensic Dent Sci. 2015; 7(2):163–167.
• 40. Radulesco T, Michel J, Mancini J, Dessi P, Adalian P. Sex estimation from human cranium: forensic and anthropological interest of maxillary sinus volumes. J Forensic Sci. 2018; 63(3):805–808.
• 41. Saccucci M, Cipriani F, Carderi S, Carlo G, D'Attilio M, Rodolfino D et al. Gender assessment through three-dimensional analysis of maxillary sinuses by means of cone beam computed tomography. Eur Rev Med Pharmacol Sci. 2015; 19(2):185-193.
• 42. Al-Rawi NH, Uthman AT, Abdulhameed E, Al Nuaimi AS, Seraj Z. Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: A cone-beam computed tomography study. Imaging science in dentistry, 2019; 49(1):45–51.
• 43. Etemadi S, Seylavi G, Yadegari A. Correlation of the maxillary sinus volume with gender and some of craniofacial indices using cone beam computed tomography. Biosci Biotechnol Res Commun. 2017; 10(3):580–586.