CT for nasal septal deviation: Is turbinate surgery necessary in septoplasty?

Abstract

Objectives: Septoplasty with or without turbinate surgery is performed by many otorhinolaryngologists. However, the surgical methods largely rely on clinical judgment alone. The purpose of this study is to investigate the correlation between deviated nasal septum and inferior turbinate with compensatory hypertrophy on paranasal sinus computed tomography and to suggest a guideline for septal and turbinate surgery. Methods: Computerized tomography scans of paranasal sinus of 20 patients with nasal septal deviation and compensatory hypertrophied inferior turbinate were taken and reviewed. Measurements of angle of septal deviation, thickness of mucosa and conchal bone, and projection angle of inferior turbinate using PACS (picture archiving and communicating system) were obtained. Three-dimensional reconstruction images were obtained by surface rendering technique on the same patients using a software with personal computer. Each measurement was compared to that of opposite side of nasal cavity. Results: The inferior turbinate of the concave side underwent a increase in thickness and projection angle and manifested a significant expansion of volume ( P < 0.05, wilcoxon signed rank test), but the correlation between deviated septal angles and volumes of inferior turbinate was not significant ( P > 0.05, spearman test). Conclusion: Septoplasty and concomitant inferior turbinate surgery that manipulates conchal bone and soft tissue of turbinate is necessary for the patients with a complaint of nasal obstruction. The data gathered using 3-D reconstruction images in this study are of importance to the decision-making process of nasal surgery including the turbinates.