Relation between Nasal Septal Deviation and Pneumatization of Mastoid Air Cells – A Computerised Tomographic Study

N Vinay Kumar,Associate Professor, Department Of Anatomy, Government Medical College, Palakkad, Kerala , ,T S Gugapriya

doi:10.21276/aanat.2018.4.2.5

N Vinay Kumar, Associate Professor, Department Of Anatomy, Government Medical College, Palakkad, Kerala + Show 2 more

Open Access

https://doi.org/10.21276/aanat.2018.4.2.5

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Abstract

Introduction: The environment of middle ear cavity gets regulated mostly by pneumatized mastoid air cell system (MACS). Many theories exist that details the process of pneumatization of this MACS. The nasal septal deviation (NSD) has been shown to be instrumental in influencing pneumatization of paranasal sinuses to varied degrees. The effect of NSD on the pneumatization of MACS remains questionable due to limited literature available. And so this study was done to find the relation between the side of NSD and extent of Pneumatization of MACS on that side by computerized tomographs of Paranasal sinus region. Subjects and Methods: 120 CT images of paranasal region from archives of radiology department were studied for NSD. The NSD was classified according to the nasal septal angle. The extent of pneumatization of mastoid region was studied and classified. The relation between severe NSD and extent of mastoid pneumatization was noted. Results: NSD was found to be right sided in 90% cases studied and 20, 45, 55 were seen belonging to group I, II and III NSD respectively. The mean NSA was found to be 13.5o. Mastoid region was observed to be hypo pneumatized in the side of NSD in 42 cases of group III NSD. Conclusion: The findings of the study puts forth the need for assessment of NSD and planning possible correction of NSD prior to middle ear and mastoid surgeries for successful results.

Highlights

The environment of middle ear cavity gets regulated mostly by pneumatized mastoid air cell system (MACS)
With the availability of only few studies, there exist a lacuna about the effect of nasal septal deviation (NSD) upon MACS pressure and postnatal pneumatization
This study was done to find out the relation between the degree of NSD and extent of pneumatization of MACS

Summary

Introduction

The environment of middle ear cavity gets regulated mostly by pneumatized mastoid air cell system (MACS). It is said to be either genetically mediated or environmentally induced.[1] Studies have proposed a linear increase in degree of pneumatization with age.[5,6] Two hypotheses exist that substantiates intra and inter individual variations in the pneumatization of MACS They being, the genetic theory where pneumatization was claimed to be determined genetically and the environmental theory where the amount of pneumatization was shown to be dependent on the postnatal diseases involving the middle ear.

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