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

Year 2025, Volume: 12 Issue: 3, 409 - 414, 29.12.2025
https://doi.org/10.15311/selcukdentj.1795752

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.

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.
There are 23 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Radiology
Journal Section Research Article
Authors

Bilgün Çetin 0000-0002-1577-5568

Submission Date October 2, 2025
Acceptance Date November 24, 2025
Publication Date December 29, 2025
Published in Issue Year 2025 Volume: 12 Issue: 3

Cite

Vancouver 1.Çetin B. Anatomical Variations of the Nose and Paranasal Sinuses in Pediatric CBCT Scans: A Retrospective Analysis. Selcuk Dent J [Internet]. 2025 Dec. 1;12(3):409-14. Available from: https://izlik.org/JA95CN85TZ