Nasal septal deviation and concha bullosa coexistence: CT evaluation

The discussion of the incidence of sinusitis in patients with nasal septal deviation and concha bullosa has been accompanied by some controversy. In this study, we assess the incidence, in conjunction with concha bullosa and nasal septal deviation, of sinus, ostiomeatal and frontal recess disease on either side in the same patients.

We reviewed the CT studies conducted between 2003 and 2005 of the paranasal sinuses of 130 patients. All examinations were performed for the evaluation of a symptom referable to the sinonasal region. Fifty-eight patients had both nasal septal deviation and concha bullosa. We recorded the presence and degree of septal deviation, the direction of septal deviation, and sinus, ostiomeatal and frontal recess disease.

Twenty-six patients had deviation to the right. Of these patients, nine had sinusitis on the left and ten had sinusitis on the right. Thirty-two patients had deviation to the left. Of these patients, 14 patients had sinusitis on the left and 17 had sinusitis on the right. No statistical difference was found (p > 0.05). Likewise, no correlation was found with frontal recess or ostiomeatal disease.

The incidence of the coexistence of nasal septal deviation and concha bullosa is high (44.6%). There does not appear to be a statistically significant difference between the laterality of sinus, ostiomeatal and frontal recess disease (p > 0.05). The incidence of sinusitis in severe nasal septal deviation is higher when compared with mild (p = 0.001) and moderate groups (p < 0.001).