Journal Article

Assessment of the impact of nasal septum deviation types on sinonasal variations and infundibulum morphometry in relation to gender and age using CT images

Açar, Gülay, Aydoğdu, Demet, Gökşan, Ahmet Safa

2025

Overview

Background Nasal septum deviation (NSD) plays a vital role in paranasal sinus development, influencing sinonasal structures and maxillary sinus volume (MSV). This study aims to identify the NSD types and ascertain their impact on sinonasal variants, MSV, and morphometry of the infundibulum using three-dimensional (3D) computed tomography (CT) scans. Methods CT images of 300 patients (150 females and 150 males), aged between 18 and 70 years, were retrospectively analyzed. The prevalences of NSD types, NS pneumatization (NSP), middle concha bullosa (MCB), paradoxical middle turbinate (PMT), MS mucosal thickening (MSMT), accessory maxillary ostium (AMO), uncinate process (UP) variants, and inferior turbinate hypertrophy (ITH) were evaluated. Also, MSV, MO width (MOW), infundibulum length (IL) and angle (IA) were measured. Statistical analyses of data was done taking into account gender, laterality, and age. Results The greater the degree of NSD, the greater the likelihood of MCB, PMT and ITH occurring on the opposite side. Conversely, AMO, hypoplastic MS, MSMT, and hook-shaped UP were more prevalent on the same side of the deviation. The strongest associations with ipsilateral hyperplastic MS and being a young male were exhibited by PMT and MCB. Moderate and severe NSD, AMO, hook-shaped UP, hypoplastic MS and MSMT were more prevalent in older subjects, while younger subjects had more NSP, extensive MCB, PMT with a significant difference. The mean MSV, MOW and IL were found to be lower in MS on the same side of NSD, while the largest IA was observed in MS with severe NSD, as well as larger IA on the ipsilateral side of deviation, with a significant difference. However, we found that, as the degree of NSDA increased, the mean IL decreased and the mean MOW increased. The mean MOW and IL values indicated a positive correlation with ageing, whereas the MSV and IA values decreased with increasing age. Conclusions Despite their significance, our understanding of how sinonasal structures, MSV, and infundibulum morphometry vary and covary with NSD remains limited, a crucial aspect in the planning of dental implantology and endoscopic sinus surgery.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Accessory maxillary ostium / Adolescent / Adult / Age Factors / Aged / Aging / Analysis / Bone / Care and treatment / Computed tomography / CT imaging / Dentistry / Diagnosis / Endoscopy / Female / Gender / Humans / Hypertrophy / Iatrogenesis / Imaging, Three-Dimensional - methods / Male / Maxillary sinus / Maxillary Sinus - anatomy & histology / Maxillary Sinus - diagnostic imaging / Maxillary sinus mucosal thickening / Medicine / Middle Aged / Middle concha bullosa / Morphometry / Nasal septum / Nasal Septum - abnormalities / Nasal Septum - diagnostic imaging / Nasal septum deviation / Nose / Open source software / Oral and Maxillofacial Surgery / Otolaryngology / Paradoxical middle turbinate / Paranasal sinus / Patient outcomes / Retrospective Studies / Septum / Sex Factors / Sinuses / Statistical analysis / Surgeons / Surgery / Three-dimensional CT / Tomography, X-Ray Computed - methods / Transplants & implants / Trauma / Turbinates - diagnostic imaging / Young Adult