Concha bullosa, nasal septal deviation and paranasal sinusitis; a computed tomographic evaluation

Area of Science:

• Otolaryngology
• Radiology
• Anatomy

Background:

• Concha bullosa, nasal septal deviation (NSD), and paranasal sinusitis are common sinonasal conditions.
• Interconnections between these conditions are suggested but require further investigation.
• Computed tomography (CT) is a key imaging modality for evaluating sinonasal anatomy and pathology.

Purpose of the Study:

• To investigate the potential association between concha bullosa, NSD, and paranasal sinusitis using CT imaging.
• To determine if concha bullosa or NSD are risk factors for developing paranasal sinusitis.
• To assess the predictive value of NSD for the presence and extent of paranasal sinusitis.

Main Methods:

• Retrospective review of 206 nasal and paranasal CT scans from patients with sinonasal symptoms.
• Evaluation of the presence and severity of concha bullosa and NSD.
• Correlation analysis between anatomical variations and the presence/extent of paranasal sinusitis.

Main Results:

• No significant association was found between concha bullosa and paranasal sinusitis.
• Mean NSD was significantly higher in patients with sinusitis compared to controls (p<0.001).
• An NSD of 3.5 degrees or greater demonstrated 77.8% sensitivity and 76.5% specificity for predicting paranasal sinusitis. A positive correlation exists between NSD severity and the number of affected sinuses (r=0.58, p<0.001).

Conclusions:

• Nasal septal deviation is associated with paranasal sinusitis and its severity.
• Concha bullosa does not appear to be significantly associated with paranasal sinusitis.
• An NSD threshold of 3.5 degrees serves as a valuable predictor for identifying paranasal sinusitis.