Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis

Bilgün Çetin

doi:10.15311/selcukdentj.1795752

Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis

Abstract

Background: Anatomical variations of the nasal cavity and paranasal sinuses are common in the pediatric population and may influence sinus ventilation, susceptibility to infection, and craniofacial development. Cone-beam computed tomography (CBCT), frequently used for dental purposes, offers an opportunity to detect these incidental variations in growing individuals. Method: This retrospective study evaluated CBCT scans of 128 patients under 16 years of age, obtained between 2017 and 2025. Images fully capturing the sinonasal region were analyzed for variations of the nasal septum, conchae, ethmoid, maxillary, frontal, and sphenoid sinuses. Variations were recorded as present or absent, and prevalence rates were analyzed by age and sex. Results: The study sample included 68 girls (53.1%) and 60 boys (46.9%), with a mean age of 12.27 ± 2.26 years. The most common bilateral variations were accessory maxillary ostium (39.8%), agger nasi cells (37.5%), and middle concha bullosa (29.6%). For single-structure variations, nasal septal spur (43.2%), nasal septum deviation (38.3%) were most frequently observed. No statistically significant sex differences were found in the distribution of variations (p > 0.05). Conclusion: This study demonstrated that incidental anatomical variations of the nasal cavity and paranasal sinuses are frequent in the pediatric population. Many of these variations may predispose to sinonasal pathology or influence dentomaxillofacial development. Awareness of such findings on CBCT scans is essential for accurate diagnosis, treatment planning, and surgical risk assessment, particularly in dental and maxillofacial practice. Keywords: Cone-beam computed tomography, paranasal sinus, nasal cavity, anatomical variation.

Keywords

References

1. Gruszka K, Aksoy S, Różyło-Kalinowska I, Gülbeş MM, Kalinowski P, Orhan K. A comparative study of paranasal sinus and nasal cavity anatomic variations between the Polish and Turkish Cypriot Population with CBCT. Head & face medicine. 2022;18(1):37.
2. Chaiyasate S, Baron I, Clement P. Analysis of paranasal sinus development and anatomical variations: a CT genetic study in twins. Clinical Otolaryngology. 2007;32(2):93-97.
3. Al-Abri R, Bhargava D, Al-Bassam W, Al-Badaai Y, Sawhney S. Clinically significant anatomical variants of the paranasal sinuses. Oman medical journal. 2014;29(2):110.
4. Perez-Pinas I, Sabate J, Carmona A, Catalina-Herrera C, Jimenez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. The Journal of Anatomy. 2000;197(2):221-227.
5. 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. International journal of dentistry. 2010;2010(1):404982.
6. Yalcin ED, Ararat E. Cone-beam computed tomography study of mandibular condylar morphology. Journal of Craniofacial Surgery. 2019;30(8):2621-2624.
7. Papadopoulou A-M, Bakogiannis N, Skrapari I, Bakoyiannis C. Anatomical variations of the sinonasal area and their clinical impact on sinus pathology: a systematic review. International archives of otorhinolaryngology. 2022;26(3):491-498.
8. Bozdemir E, Gormez O, Yıldırım D, Erik AA. Paranasal sinus pathoses on cone beam computed tomography. Journal of Istanbul University Faculty of Dentistry. 2016;50(1):27.

9. Giaccaglia F, Bruno G, Gracco A, De Stefani A. Incidental findings of the nose and paranasal sinuses in orthodontic patients in the age of development: a retrospective study on CBCTs. European Journal of Paediatric Dentistry. 2022;23(3):189-193.
10. Pak F, Hosseini Pooya SM, Shabani H, Baradaran S, Salim Sadeq U. Comparison of CBCT and ct in terms of dose value of organs at risk in paranasal sinus imaging. Radiation Protection Dosimetry. 2022;198(4):208-213.
11. Al-Qudah M. The relationship between anatomical variations of the sino-nasal region and chronic sinusitis extension in children. Int J Pediatr Otorhinolaryngol. Jun 2008;72(6):817-21. doi: 10.1016/j.ijporl.2008.02.006
12. Kose SK, Aksoy S, Onder M, Oz U, Orhan K. Association among Orthodontic Malocclusions, Paranasal Sinuses Anatomic Variations and Adenoid Vegetation in Children Using CBCT. Children. 2023;10(9):1549.
13. Kiciński P, Podgórski M, Małachowska B, Grzelak P, Polguj M. Development of maxillary sinuses in relation to the development of cranium in children on computed tomography imaging. Scientific Reports. 2024;14(1):23005.
14. Parks ET. Cone beam computed tomography for the nasal cavity and paranasal sinuses. Dental Clinics. 2014;58(3):627-651.
15. Teixeira J, Certal V, Chang ET, Camacho M. Nasal septal deviations: a systematic review of classification systems. Plastic surgery international. 2016;2016(1):7089123.
16. Yenigun A, Fazliogullari Z, Gun C, Uysal II, Nayman A, Karabulut AK. The effect of the presence of the accessory maxillary ostium on the maxillary sinus. European Archives of Oto-Rhino-Laryngology. 2016;273(12):4315-4319.
17. Jones N. CT of the paranasal sinuses: a review of the correlation with clinical, surgical and histopathological findings. Clinical otolaryngology & allied sciences. 2002;27(1):11-17.
18. Ozcan KM, Selcuk A, Özcan I, Akdogan O, Dere H. Anatomical variations of nasal turbinates. Journal of Craniofacial Surgery. 2008;19(6):1678-1682.
19. Bolger WE, Parsons DS, Butzin CA. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. The Laryngoscope. 1991;101(1):56-64.
20. Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ. CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngology–Head and Neck Surgery. 1991;104(4):480-483.
21. Sumaily I, Aldhabaan S, Hudise J. Anatomical variations of paranasal sinuses gender and age impact. Glob J Otolaryngol. 2018;14(1):555877.
22. Kussaba II, Iwaki FV, Silvestre F, Poluha RL, Iwaki LCV, da Silva MC. Presence of Agger Nasi cells and their relationship with frontal recess thickness: a retrospective study in a Brazilian population. Brazilian Journal of Health and Biomedical Sciences. 2024;23(1)
23. Ali IK, Sansare K, Karjodkar F, Saalim M. Imaging analysis of Onodi cells on cone-beam computed tomography. International Archives of Otorhinolaryngology. 2020;24(03): e319-e322.

Details

Primary Language

English

Subjects

Oral and Maxillofacial Radiology

Journal Section

Research Article

Authors

Bilgün Çetin ^*
0000-0002-1577-5568
Türkiye

Publication Date

December 29, 2025

Submission Date

October 2, 2025

Acceptance Date

November 24, 2025

Published in Issue

Year 2025 Volume: 12 Number: 3

DOI

https://doi.org/10.15311/selcukdentj.1795752

IZ

https://izlik.org/JA95CN85TZ

Cite

RIS / Bibtex

APA

Çetin, B. (2025). Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis. Selcuk Dental Journal, 12(3), 409-414. https://doi.org/10.15311/selcukdentj.1795752

AMA

1.Çetin B. Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis. Selcuk Dent J. 2025;12(3):409-414. doi:10.15311/selcukdentj.1795752

Chicago

Çetin, Bilgün. 2025. “Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis”. Selcuk Dental Journal 12 (3): 409-14. https://doi.org/10.15311/selcukdentj.1795752.

EndNote

Çetin B (December 1, 2025) Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis. Selcuk Dental Journal 12 3 409–414.

IEEE

[1]B. Çetin, “Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis”, Selcuk Dent J, vol. 12, no. 3, pp. 409–414, Dec. 2025, doi: 10.15311/selcukdentj.1795752.

ISNAD

Çetin, Bilgün. “Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis”. Selcuk Dental Journal 12/3 (December 1, 2025): 409-414. https://doi.org/10.15311/selcukdentj.1795752.

JAMA

1.Çetin B. Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis. Selcuk Dent J. 2025;12:409–414.

MLA

Çetin, Bilgün. “Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis”. Selcuk Dental Journal, vol. 12, no. 3, Dec. 2025, pp. 409-14, doi:10.15311/selcukdentj.1795752.

Vancouver

1.Bilgün Çetin. Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis. Selcuk Dent J. 2025 Dec. 1;12(3):409-14. doi:10.15311/selcukdentj.1795752