Concha Bullosa Research Articles

Does Rhino-genic Headache Improve after Endoscopic Concha Bullosa Surgery in the Adult Patients?

Background: Pneumatizaton of Middle Turbinate (MT) is one of the common anatomical variations of the Nasal cavitynamed Concha Bullosa. It may be presented with facial pain or headache. There are several surgical techniques to treatConcha Bullosa.Aim of the study: This is to evaluate the improvement of Rhino-genic headache after endoscopic Concha Bullosa surgeryin adult patients.Patients and methods: A prospective comparative study was designed in the Department of Otolaryngology at Al-Jerahat Teaching Hospital in Medical City and private hospital, Baghdad, Iraq, from March 2019 to August 2020. Fortypatients suffering from headaches of Rhino-genic origin of more than six months duration were enrolled in the currentstudy. Nasal examination by zero-degree endoscope revealed unilateral or bilateral MT enlargement with mucosalcontact points to the Osteo-Meatal Complex or the Nasal Septum. All the patients had Nasal and Para-Nasal sinusesCT scan and xylocaine-xylometazoline test. The Forty patients were allocated into two groups, group A patients treatedby Partial Lateral Middle Turbinectomy (PLMT). The 20 patients in group B had been subjected to Middle TurbinateTransverse Excision (MTTE). Patients followed-up every week in the first month and then every two weeks for the nexttwo months. The headache assessment was achieved preoperatively using the Visual Analogue Scale (VAS) and at thethird postoperative month. Statistical analysis was done using the Chi-square test to compare the VAS scores in group Apatients at the third postoperative month to group B patients, and P-value was calculated.Results: Fifty percent of the patients treated by PLMT became free of headache, 35% had a mild headache, and 15%moderate. In contrast, 85%of the patients subjected to MTTE became headache-free, and 15% still with mild headache (Pvalue= 0.031).Conclusions: MTTE is a better option than PLMT in relieving headaches due to contact between Concha Bullosa andOsteo-Meatal Complex or Nasal Septum.

Multidetector computed tomography (MDCT)

The aim of this study was to (1) detect the prevalence of anatomical variations of nose and paranasal sinuses in Chronic Rhinosinusitis (CRS) on ‘Nasal Endoscopy and Computed Tomography’, (2) study association of anatomical variations of nose and paranasal sinuses in Chronic Rhinosinusitis. This hospital based cross sectional study was performed during the period from January 2020 to October 2022 on patient between 20 to 60 yrs. of age referred to the department of Radiodiagnosis for evaluation of MDCT PNS from Dept. of ENT, S.C.B medical college and hospital Cuttack. Diagnostic Nasal Endoscopy and Computed Tomography of nose and Paranasal Sinuses of 80 patients of chronic rhinosinusitis were studied and results were. Maximum patients included in study population was 20-25 years with male predominance. Deviated Nasal Septum was the most common anatomical variation, which was detected in 70(87.5%) patients on Diagnostic Nasal Endoscopy and Agger nasii cells were observed in 60(75%) patients on Computed Tomography. The other anatomical variations like Concha bullosa 56(70%) were diagnosed both by Diagnostic Nasal Endoscopy. Anatomical variations like deviated nasal septum, agger nasi cells, medialised uncinated process, large concha bullosa were associated with chronic rhinosinusitis.

Maxillary sinus aeration analysis using computational fluid dynamics

The maxillary sinus aeration using the computational fluid dynamics (CFD) method based on individual adult patients’ computed tomography (CT) scans were analyzed. The analysis was based on CT images of 4 patients: one with normal nose anatomy and three with nasal septal deviation (NSD) and concha bullosa (CB). The CFD simulation was performed using the Reynolds-Average Simulation approach and turbulence closure based on linear eddy viscosity supplemented with the two-equation k-omega SST model. As a result, it was found that the lower part of NSD has the most significant impact on the airflow change within the maxillary sinuses compared to CB and the upper part of NSD. In a healthy nose, the airflow in the sinuses is continuous, while NSD and CB change this flow into pulsatile. Multiple changes in the direction of flow during one respiratory phase were observed. The flow intensity within the maxillary sinus opening is lower on the NSD side. The concept of vorticity measure is introduced to evaluate and compare various patients qualitatively. Typically, the lowest values of such measures are obtained for healthy airways and the highest for pathological changes in the nasal cavity.

WITHDRAWN: Does Rhino-genic headache improve after endoscopic concha bullosa surgery in the adult patients? A cross sectional study

This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal

Relationship between the Superior Attachment of the Uncinate Process and Pneumatization of the Middle Turbinate—A Radiological Study

Objective: the superior attachment of the uncinate process (SAUP) is highly variable. Lateral types of SAUP are associated with frontal rhinosinusitis. SAUP in the middle turbinate is more common when the middle turbinate is aerated. We aim to refine these findings by studying the relationship between the SAUP type and the different subtypes of pneumatization of the middle turbinate. Methods: 200 CT sinonasal scans were analyzed by an otolaryngologist and a radiologist. All CT scans were analyzed to study the type of the middle turbinate concha bullosa and lamellar cell and the type of SAUP. Results: 379 sides were analyzed. The prevalence of the various types of SAUP were: Type I: 43.80%, Type II: 22.16%, Type III: 16.36%, Type IV: 3.69%, Type V: 9.76%, and Type VI: 4.22%. When studying the pneumatization of the middle turbinate and the SAUP types, we only found a statistically significant association between the lateral attachment of the uncinate process and the presence of a lamellar cell (p = 0.029). Conclusion: lateral types of SAUP are more likely in the presence of a lamellar cell. This finding, therefore, renders checking for lateral SAUP types in the presence of a lamellar cell even more relevant than when studying the pre-surgical CT scan. In those cases, it is advisable to perform a careful and complete uncinectomy.

The role of raftlin in the pathogenesis of chronic rhinosinusitis with nasal polyps.

The aim of this study was to investigate the possible role of raftlin (RFTN) in chronic rhinosinusitis with nasal polyps (CRSwNP). There is no study in the literature investigating the role of RFTN in the pathogenesis of CRSwNP. The present study was designed as a case-control study and conducted between 25.09.2020 and 01.01.2022. CRSwNP and control groups were formed in the study. Serum and tissue samples were taken from each patient in the study and their RFTN levels were measured. While nasal polyps were used for tissue samples in the CRSwNP group, middle meatus mucosa obtained during concha bullosa surgery was used in the control group. The control group included 31 patients (8 female, 23 male) and the CRSwNP group included 49 patients (14 female, 35 male). The mean age of the control group was 40.42 ± 9.99years, while the mean age of the CRSwNP group was 43.47 ± 10.19years. When the groups are compared in terms of gender and age, there were no statistically significant differences (p = 0.78, p = 0.19, respectively). The serum RFTN levels in the control and CRSwNP groups were 7.85 ± 10.87ng/ml, and 7.02 ± 8.59ng/ml, respectively (p = 0.45). The tissue RFTN levels in the control group and CRSwNP group were 87.15 ± 69.91ng/ml, and 66.50 ± 17.10ng/ml, respectively (p = 0.04, statistically significant). RFTN deficiency in nasal polyp tissue may be one of the reasons for the development of CRSwNP. Further studies are needed to elucidate the role of RFTN in CRSwNP.

Evaluation of Paranasal Sinus Volumes and Anatomic Variations in Patients With Rhinogenic Headache

Background: Rhinogenic headache is a common finding that may occur due to features related to the nasal cavity and paranasal sinuses without any underlying rhinological disease. It is thought that paranasal sinus volumes and anatomical variations may have an effect on this symptom. The aim of this study is; to investigate the paranasal sinus volumes and remarkable anatomical variations in patients with rhinogenic headache. Materials and methods: Paranasal sinus tomography images and hospital files of 72 patients who were referred to the otolaryngology department were evaluated retrospectively. The volumes were calculated by the sinus volume index method and the presence of septal spur, concha bullosa, onodi cell, haller cell, agger nasi cell and paradoxical middle turbinate were evaluated as anatomical variations. As the control group, the data of 40 patients who were operated with open technique rhinoplasty for esthetic purposes were taken and the results were compared statistically. Results: The frontal sinus volume index was 4.57 cm3 in the patient group and 6.02 cm3 in the control group, and this difference was statistically significant. No significant difference was found between the two groups in other paranasal sinus volumes. The presence of septal spur was observed more frequently in the patient group, and this result was found to be statistically significant. There was no significant difference between the two groups regarding other anatomical variations. Conclusions: The low sinus volume may have an effect on the formation of rhinogenic headache. The presence of a septal spur may create a possible mucosal contact point, leading to rhinogenic headache.

Surgical Approach to Inferior Concha Bullosa: A Case Report and Literature Review

Surgical Approach to Inferior Concha Bullosa: A Case Report and Literature Review

Anatomical Variations on Routine CT Scans Observed in the Paranasal Sinuse

Objective: The aim of current study is to determine the frequency of anatomical variants on routine CT scan observed in the paranasal sinus. Stud Design: Cross-sectional Place and Duration: The study was conducted at Radiology department of Jinnah Hospital, Lahore for the duration of nine months from January 2021 to September 2021. Methods: There were 90 sinus patients of both genders with ages 20-55 years in this study. Cases were recruited after informed written permission was obtained and data such as gender and BMI were collected. The prevalence of various anatomical variations of the sinonasal cavities was determined based on the results of the CT scans. Anatomical differences between individuals with low to no apparent imaging evidence of rhinosinusitis vs those with clinically substantial radiologic evidence of rhinosinusitis were examined in this study. SPSS 21.0 was used to analyze complete data. Results: Among 90 cases, the majority of the patients were males 63 (70%) and 27 (30%) were females with mean age 33.41±8.56 years and mean BMI 23.22 ±5.31 kg/m2. According to Kero’s classification to determine the difference in olfactory fossa depth, most of the patients 62 (68.9%) were in type II, 20 (22.2%) in type I and 8 (8.9%) in type III. In accordance with anatomical variation, we found that most of the patients 65 (72.2%) had deviated nasal septum (DNS) followed by agger nassi cells in 61 (67.8%) cases and concha bullosa in 35 (38.9%) cases. Conclusion: We concluded in this study that the prevalence of anatomical variants among patients of paranasl sinus was higher in which the majority of the patients had deviated nasal septum and agger nassi cells. Keywords: Frontal sinus, Paranasal Sinus, Maxillary sinus, Anatomical variants

EXAMINATION OF THE RELATIONSHIP BETWEEN CONCHA BULLOSA WITH NASAL SEPTUM DEVIATION AND MAXILLARY SINUS PATHOLOGIES USING CONE-BEAM COMPUTED TOMOGRAPHY

ABSTRACT Objective: To evaluate the relationship between concha bullosa (CB) and nasal septum deviation (NSD) with maxillary sinus pathologies with cone-beam computed tomography (CBCT). Materials and Methods: The whole face CBCT data of 700 (383 male and 317 female) patients aged between 6-92 years who applied to Gaziantep University Faculty of Dentistry Department of Dentomaxillofacial Radiology for any reason between 2017-2019 was evaluated retrospectively. CB, NSD and maxillary sinus pathologies were investigated on the images. Results: NSD was found as 64.3%, concha bullosa as 27.9% on the right, 24.1% on the left, and maxillary sinus pathologies were 48.6% on the right and 44.4% on the left. While NSD was towards the left, the absence of right concha bullosa was found to be significant (p < 0.05). No significant relationship was observed between the presence of CB and maxillary sinus pathologies (p > 0.05). There was no significant relationship between NSD and maxillary sinus pathologies (p > 0.05). Conclusion: There was a significant relationship between the presence of CB and NSD, but the presence of CB had no effect on maxillary sinus pathologies. CBCT is an important diagnostic tool in the evaluation of the anatomical variations of the osteomeatal complex and three-dimensional examination of maxillary sinus.

Paranasal Sinus Fungus Ball, Anatomical Variations and Dental Pathologies: Is There Any Relation?

Objective:The purpose of this study was to investigate the relationship between anatomical variations and the fungus ball (FB), and the association between odontogenic etiologies and the maxillary sinus FB.Methods:We analyzed the clinical records of 66 patients who underwent endoscopic sinus surgery for FB. The anatomical variations determined were nasal septal deviation (NSD) and direction, presence of Onodi and Haller cell, concha bullosa and lateral recess of the sphenoid sinus. Further, dental X-ray records were reviewed to detect any possible odontogenic etiologies in patients with maxillary sinus FBs.Results:There were 41 female and 25 male patients. Positive fungal culture was found in 60 patients (91%) and the causative fungus was Aspergillus species in all cases. The correlation between NSD and localization of the maxillary sinus FB was statistically significant (p=0.0409). Maxillary sinus FB was more common on the concave side of the NSD. Presence of dental pathologies was significantly associated with maxillary sinus FB compared to the healthy side (p=0.0011). For sphenoid sinus FB, NSD was detected in a similar number for both the affected and unaffected side and there were no significant correlations (p>0.05). However, the relationship between sphenoid sinus FB and presence of lateral recess was significant (p=0.0262).Conclusion:Our study revealed that the maxillary sinus FB was more common on the concave side of the deviated septum. Also, dental pathologies or a presence of dental treatment history were associated with maxillary sinus FB.

Evaluation of the Relationship of Concha Bullosa and Nasal Septal Deviation with Chronic Maxillary Sinusitis Based on Cone Beam Computed Tomography

Introduction: Due to the possible association between chronic sinusitis and anatomical variations of the area, the present study was performed to determine the prevalence of concha bullosa and nasal septal deviation and their association with chronic sinusitis to increase the success rate of nasal endoscopic surgery by eliminating the predisposing factors.
 Methods and Materials: In this cross-sectional study, CBCT images of maxilla from 100 patients referred to the radiology department of Hamadan Dental School in the year 2016-2017 were examined. Pneumatization of middle concha (concha bullosa) on sides, nasal septum deviation, and mucosal thickening were recorded. Data were analyzed by Chi-square test based on gender and age (p value ≤ 0.05).
 Results: The results showed that there was no significant difference between the mean age and sex with the presence of concha bullosa (p value > 0.05). 50% of the samples had nasal septum deviation and 42% had chronic sinusitis displaying no significant difference between men and women (p value > 0.05); Also, there was no significant difference between nasal deviation and chronic sinusitis (p value > 0.05), although chronic sinusitis was significantly higher in people with concha bullosa and while concha Bullosa was significantly higher in people with nasal septal deviation (p value < 0.05).
 Conclusion: According to the results of the study, concha bullose can be considered as a predisposing factor for chronic sinusitis.

Sakit Kepala pada Variasi Anatomi Hidung dan Sinus Paranasal

The anatomical variations of the nasal and sinus paranasal can cause headaches. The most common variants have deviated septum, concha bullosa, and agger nasi cells. These variations can cause narrowing of the osteomeatal complex. Computed tomography was the primary modality for evaluating anatomical variations of the nasal and paranasal sinuses in diagnosis and management. Functional endoscopic sinus surgery was generally performed to restore the sinuses' drainage and ventilation in anatomical variations. It has been reported a 45-year-old woman with a congested left nostril and headache that has gotten worse since 2 months ago and computed tomography of the paranasal sinuses show thickening of the bilateral maxillary sinus mucosa, bilateral anterior ethmoid, left septum deviation, concha bullous, and right inferior turbinate hypertrophy. Functional Endoscopy Sinus Surgery was performed, found anatomical variations namely, deviation septum, concha bullosa, agger nasi cells and supra agger cells. The operation gave satisfactory results. Correct evaluation of anatomical variations based on history, physical examination and investigations can assist in patient management and avoid errors during surgery. The operation gave a satisfactory result for managing symptoms on patient with anatomical variation of nasal and paranasal sinuses when compared with medicamentosa.Keywords: anatomical variations, agger nasi cells , concha bullosa, deviated septum, headache, supra agger cell

English

BACKGROUND Computerized Tomography (CT) scan plays a very important role in decision making before planning any surgical intervention on paranasal sinuses and is also the modality of choice during management and post-surgical follow-ups. Knowledge of different morphologies of paranasal sinuses is an important prerequisite for surgical decision making. This study was done to describe the impact of gender and age on anatomical and morphological presentations of paranasal sinuses using CT in the North Indian Population. METHODS A cross-sectional type of descriptive study was conducted in the Department of Anatomy in collaboration with the Department of Radiodiagnosis of M. L. N. Medical College and Kriti Scanning and Research Centre, Allahabad (Prayagraj) Uttar Pradesh, to describe various morphological presentations of paranasal sinuses. Based on the findings, the gender and age group variations of paranasal sinuses were evaluated and discussed along with the types of the frontal air cells and concha bullosa. RESULTS Overall 120 subjects were analysed based on their CT-scan findings (72 males and 48 females). The frequencies of major sinus variations were observed as Onodi cells in 19.2 %, Concha bullosa in 47.5 %, Frontal air cells in 25 %, Maxillary sinus septation in 7.5 % and Supraorbital cells in 15 % of the study population. CONCLUSIONS Anatomical variations of paranasal sinuses are very common. These variations must be identified by the radiologists in preoperative computerised tomography evaluation to reduce the risk of intraoperative complications. CT scan provides a virtual roadmap to the surgeon and improves the success of management strategies. KEY WORDS Anatomical Variations, Paranasal Sinuses, Concha Bullosa, Onodi Cell

A Comparative Study of CT Scan and Nasal Endoscopic Findings of Lateral Wall of Nose, in Headache of Rhinogenic Origin.

Headache disorders are rated among the ten most disabling conditions worldwide. Contact points like septal spur, septal deviation, concha bullosa and bulla ethmoidalis can cause rhinogenic headache (RH). Diagnostic nasal endoscopy (DNE) is an essential part of evaluation of sinonasal disease and is the key to understanding anatomical variations. As compared to CT paranasal sinus (CT PNS), DNE is cheaper and has wider availability, being part of the basic training of present ENT curriculum. We conducted a prospective observational study from September 2018 to June 2020 on 202 patients who were diagnosed to have RH. The aim of this study was to the define the role of DNE as the primary examination for early and accurate diagnosis of rhinogenic headache as compared to CT PNS. RH patients were evaluated with DNE followed by CT PNS. Evaluation of the findings of anatomical variations of lateral wall of nose on DNE and CT PNS was done. In our study the most common anatomic variations in order of frequency in both DNE and CT PNS was deviated nasal septum, impacting spur and unilateral concha bullosa. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of DNE for the various anatomical variations was statistically better than CT PNS findings. We conclude that DNE is a better than CT PNS as a diagnostic technique to detect various anatomical variations, thus initiating early management of RH.

The Role of Concha Bullosa in Chronic Rhinosinusitis: A Single Centre Study

Introduction: Chronic rhinosinusitis (CRS) is a common and persistent illness that otorhinolaryngologists encounter commonly. It is an important cause of morbidity and accounts for major loss of income. Anatomical variations of the lateral wall of the nose have been reported which can predispose to CRS. The aim of the present study was to determine the percentage of concha bullosa in patients with CRS and to ascertain its relationship with chronic rhinosinusitis. Aim of the study: To determine the percentage of concha bullosa in patients with chronic rhinosinusitis and to determine the relationship between concha bullosa and chronic rhinosinusitis. Methods: This was a hospital based prospective one-year study done during the period from June 2019 to December 2020 was conducted at the outpatient department of ENT, Shaheed Monsur Ali Medical College and Hospital, Uttara, Dhaka, Bangladesh. Sample size in this study were selected 57 patients. Result: Of the 57 patients in our study, 21 were males and 36 were females (Figure-1). Of these 36.84% male patients 21 showed concha bullosa and of the 63.84 female patients 326 showed concha bullosa on CT nose and PNS and DNE. The most common age group showing concha bullosa was 21-30 years 23(40.35%) (Table 1). The most common symptom found in our study was headache in 57(100.00%). The next commonly occurring symptom was nasal block 51(89.47%) followed by nasal discharge or nasal purulence 48(84.21%). DNE and CT scan of nose and paranasal sinuses (coronal and axial) were studied for the evaluation of concha bullosa in our patients of CRS. Concha bullosa was noted in 33(57.89%) patients having unilateral and bilateral presentations. Conclusion: Concha bullosa is one of the most common anatomical variations of the lateral wall of the nose. The presence of concha bullosa plays a significant role in the development of chronic rhinosinusitis particularly in chronic maxillary sinusitis.

CT SCAN EVALUATION OF CONCHA BULLOSA AND ITS CORRELATION WITH DEVIATED NASAL SEPTUM – A PROSPECTIVE STUDY

Introduction : Osteomeatal unit is a functional unit of the anterior ethmoid complex representing the final common pathway for the drainage and ventilation of the frontal, maxillary and anterior ethmoid cells .Osteomeatal complex has become an area of active radiologic and pathophysiologic investigation with the development of endoscopic sinus surgery for inflammatory sinus disease. The aim of this study was to investigate the anatomical vari Aim : ation of the middle turbinate concha bullosa , incidence of concha bullosa and its correlation with nasal septal deviation. based on paranasal sinus imaging. A prospective study was performed in the Department of ENT and Materials and Methods : Head Neck Surgery over a period of 5 years, to determine the prevalence of Concha bullosa in patients who presented to our out patient department with symptoms of nasal obstruction, headache, post nasal drainage and facial pain , and underwent CT scan of Paranasal sinuses. We evaluated 462 CT images both coronal and axial planes with a 1-3-mm slice thickness. Out of the CT scans studied of the nose and paranasal sinus of 462 patients, the prevalen Results : ce of concha bullosa was 25.5 % (118) patients .Male predominance was seen with 63 (53.3%) patients and 55 (46.6%) female patients. Concha bullosa was bilateral in 21 (17.7%) patients, and unilateral in 76 (64.4 %) patients. Mixed or extensive type of concha bullosa was seen in 56 (47.4%) patients followed by 35 (29.7%) patients having lamellar type and 27 (22.9%) patients with bulbous type.Out of 118 cases of CB, 43 (36.4%) were on left side of which 29 (67.4%) patients showed deviation of the nasal septum to right and 33 (27.9%) were on right side of which 21 (63.3%) patients had a nasal septal deviation to left. We found that there is a strong relationship between the presence of unila Conclusion : teral or dominant Concha bullosa and contralateral nasal deviation.

Analysis of conductive olfactory dysfunction using computational fluid dynamics.

Conductive olfactory dysfunction (COD) is caused by an obstruction in the nasal cavity and is characterized by changeable olfaction. COD can occur even when the olfactory cleft is anatomically normal, and therefore, the cause in these cases remains unclear. Herein, we used computational fluid dynamics to examine olfactory cleft airflow with a retrospective cohort study utilizing the cone beam computed tomography scan data of COD patients. By measuring nasal–nasopharynx pressure at maximum flow, we established a cut-off value at which nasal breathing can be differentiated from combined mouth breathing in COD patients. We found that increased nasal resistance led to mouth breathing and that the velocity and flow rate in the olfactory cleft at maximum flow were significantly reduced in COD patients with nasal breathing only compared to healthy olfactory subjects. In addition, we performed a detailed analysis of common morphological abnormalities associated with concha bullosa. Our study provides novel insights into the causes of COD, and therefore, it has important implications for surgical planning of COD, sleep apnea research, assessment of adenoid hyperplasia in children, and sports respiratory physiology.

The coexistence of concha bullosa and nasal septum deviation in adult Nigerians

BACKGROUND: Concha bullosa (CB) with an associated nasal septum deviation (NSD) compromises the paranasal sinus drainage through the osteomeatal complex hence predisposing to sinus disease. This study aimed at elucidating the concomitant existence of CB and NSD in adult Nigerians.MATERIALS AND METHODS: Following institutional ethical approval, brain computed tomography images of 336 patients (199 males and 137 females) aged ≥ 20 years were analyzed for CB and NSD in the Radiology Department of a Teaching Hospital. Using the Statistical Package for the Social Sciences software version 23, the prevalence of these variants was expressed in percentages, and their association was probed using the Chi-square test. The angle of septum deviation was summarized in means and standard deviations. The differences in deviation angle in the presence of either ipsilateral or contralateral CB were assessed using the independent t-test. P < 0.05 was considered statistically significant.RESULTS: The prevalence of coexisting CB and NSD was 77, 22.9%. There was a significant preponderance of NSD away from a unilateral or dominant CB (54, 84.4%) (P = 0.022). This deviation occurred at a significantly higher angle (11.82° ± 2.21°) than deviation toward a CB (9.86° ± 2.63°) (P = 0.036).CONCLUSION: The awareness of the association between CB and NSD in our population emphasizes on mandatory preoperative radiological evaluation to aid in planning for safe endoscopic surgeries through the nose.

Are of Osteomeatal Complex Variations Related to Nasolacrimal Canal Morphometry.

Introduction:Due to the close anatomic relationship between paranasal structures and NLC, the morphometric measure of the nasolacrimal canal (NLC) could be affected by the osteomeatal complex (OMC) anatomical variations. The present study aimed to assess the effect of OMC variations on the NLC morphometric features using cone-beam computed tomography (CBCT).Materials and Methods: This cross-sectional study consisted of CBCT images of 150 subjects in the case group with at least one OMC variation and 40 cases in the control group without any OMC variation within the age range of 18-50 years. The presence of the OMC variations, including agger nasi, nasal septum deviation, concha bullosa, Haller cells, paradoxical middle turbinate, and pneumatization of the uncinate process, was evaluated in each patient. The NLC morphometric measurements were performed and compared between the case and control groups.Results:The middle anteroposterior diameter and middle sectional area of NCL were significantly higher in patients with OMC variations, as compared to that in the control group. The NLC volume was significantly higher in patients with agger nasi, nasal septum deviation, concha bullosa, and pneumatization of the uncinate process, as compared to that in the control group. Nonetheless, no significant difference in NLC angulation with the nasal floor or Frankfurt horizontal plane was observed in the presence of each OMC variation.Conclusions:As evidenced by the obtained results, a higher volume of the canal was revealed in the presence of some of the OMC variations. Therefore, it can be suggested that OMC variations cannot be a predisposing factor in cases with primary acquired nasolacrimal duct obstruction.