Paranasal Computed Tomography Research Articles

Computed Tomography Evaluation of Frontal Sinus Volume in Migraine Patients.

This study aimed to assess the frontal sinus volume (FSV) on computed tomography (CT) scans in migraine patients. Cranial and paranasal CT images from 75 migraine patients (mean age: 39.14±13.63y) and 23 control cases (mean age: 38.78±13.32y) were analyzed retrospectively. Three-dimensionally reconstructed images of frontal sinuses were generated. Total FSV, anterolateral, and transverse diameters of the head were measured. The presence/absence and nature of supraorbital foramen and notches were evaluated. The total FSV was 8.02±5.97cm 3 in the migraine group and 8.38±4.83cm 3 in the control group, with no significant differences between them. Mean FSV values showed no statistically significant difference between females (7.79±5.85cm 3 ) and males (9.12±6.66cm 3 ) within and between the groups. Single notch was the most observed structure in both groups, with bilateral presence being the most common. Double foramen and notch were observed only in the migraine group, and the coexistence of both structures was higher in the migraine patients than in controls. There was no statistical difference in FSV between migraine and control groups, nor based on sex. Overall, the frontal region anatomy, particularly the exit locations of the supraorbital or supratrochlear foramen/notches, may be influenced by hyperplasia/hypoplasia of FSV. Therefore, assessing FSV using CT may be crucial for surgical planning in migraine patients undergoing open or endoscopic approaches to the frontal region.

Predicting Obstructive Sleep Apnea Based on Computed Tomography Scans Using Deep Learning Models.

Rationale: The incidence of clinically undiagnosed obstructive sleep apnea (OSA) is high among the general population because of limited access to polysomnography. Computed tomography (CT) of craniofacial regions obtained for other purposes can be beneficial in predicting OSA and its severity. Objectives: To predict OSA and its severity based on paranasal CT using a three-dimensional deep learning algorithm. Methods: One internal dataset (N = 798) and two external datasets (N = 135 and N = 85) were used in this study. In the internal dataset, 92 normal participants and 159 with mild, 201 with moderate, and 346 with severe OSA were enrolled to derive the deep learning model. A multimodal deep learning model was elicited from the connection between a three-dimensional convolutional neural network-based part treating unstructured data (CT images) and a multilayer perceptron-based part treating structured data (age, sex, and body mass index) to predict OSA and its severity. Measurements and Main Results: In a four-class classification for predicting the severity of OSA, the AirwayNet-MM-H model (multimodal model with airway-highlighting preprocessing algorithm) showed an average accuracy of 87.6% (95% confidence interval [CI], 86.8-88.6%) in the internal dataset and 84.0% (95% CI, 83.0-85.1%) and 86.3% (95% CI, 85.3-87.3%) in the two external datasets, respectively. In the two-class classification for predicting significant OSA (moderate to severe OSA), the area under the receiver operating characteristic curve, accuracy, sensitivity, specificity, and F1 score were 0.910 (95% CI, 0.899-0.922), 91.0% (95% CI, 90.1-91.9%), 89.9% (95% CI, 88.8-90.9%), 93.5% (95% CI, 92.7-94.3%), and 93.2% (95% CI, 92.5-93.9%), respectively, in the internal dataset. Furthermore, the diagnostic performance of the Airway Net-MM-H model outperformed that of the other six state-of-the-art deep learning models in terms of accuracy for both four- and two-class classifications and area under the receiver operating characteristic curve for two-class classification (P < 0.001). Conclusions: A novel deep learning model, including a multimodal deep learning model and an airway-highlighting preprocessing algorithm from CT images obtained for other purposes, can provide significantly precise outcomes for OSA diagnosis.

Evaluation of pneumatized structures and osteoma frequency in the paranasal region

Aims: The aim of our study was to evaluate the incidence of pneumatized structures in the paranasal region and the presence of osteomas. Methods: Paranasal CT images obtained with Multislice (Philips) 64-slice computed tomography (CT) at Kırıkkale University Hospital in 2023 were retrospectively analyzed. Pneumatized variations and the presence of osteoma were evaluated. Results: The images of 186 patients (93 female and 93 male) with paranasal CT were analyzed. The most common pneumatized variation was middle turbinate bullosa with 40.3%, and the least common was pneumatization of the nasal septum with 2.1%. Anterior clinoid pneumatization was observed in 23.1%, posterior clinoid pneumatization in 2.2%, pneumatization of the uncinate process in 4.9%, and crista galli pneumatization in 4.3%. The frequency of osteomas in the paranasal region was 3.2% (n=6). Conclusion: Our study will provide a better understanding of paranasal anatomy by providing information about the frequency of pneumatized paranasal variations and the presence of osteomas. This will guide the surgeon in surgical planning and at the time of surgery.

Relation between anterior ethmoidal artery course on computed tomography and supraorbital ethmoid cell and Keros classification.

The anterior ethmoidal artery (AEA) is an important risk area in endoscopic sinus surgery. This study aimed to evaluate the course of AEA according to the Keros classification and the presence of supraorbital ethmoid cell (SOEC) and to prevent possible complications by emphasizing the importance of preoperative paranasal computed tomography (CT) imaging. This approach will increase the effectiveness of endoscopic sinus surgery and improve patient safety. The paranasal CT scan images of patients aged > 18 years between October 2020 and November 2021 from our center were retrospectively analyzed. The images were primarily evaluated in the coronal plane, and the sagittal and axial planes were utilized to evaluate variations in AEA regarding the skull base. Furthermore, the relation of AEA course with Keros classification and SOEC was evaluated. The study included 1000 patients aged 18-80 years (right and left, a total of 2000 samples). Grade 3 AEA was the most common regarding the skull base. Keros Type 2 was the most common classification. Overall, 48.7% patients had SOEC. The incidence of Grade 3 AEA was higher among patients with SOEC and a higher Keros classification compared with those without SOEC and a lower Keros classification. Furthermore, Keros Type 3 was the most associated with SOEC presence. Consistent with the literature, the probability of Grade 3 AEA in patients with high Keros classification and SOEC was significantly higher in our study. Therefore, we consider that preoperative imaging according to Keros classification and SOEC presence can predict AEA course and guide surgery.

Relationship Between Nasal Septal Deviation Angles and Turbinates: A Computed Tomography Study.

Background This study aimed to evaluate inferior turbinate hypertrophy caused by nasal septum deviation, nasal septal deviation (SD) angles, and age differences with the help of paranasal computed tomography (CT) and to investigate the relationship between these parameters. Methodology The paranasal sinus CT images of 100 patients (50 males and 50 females) were retrieved from the hospital's picture archiving and communication system. In this retrospective study, patients were examined in two groups. There were 50 patients aged >35 years in group 1 and 50 patients aged <35 years in group 2. The SD side was determined using a coronal image and was mentioned as the ipsilateral side. The contralateral side of the SD side was mentioned as the contralateral side. Additionally, the SD curve angle (SDCA), superior SD angle (SSDA), and diameters and mucosal thicknesses of the inferior turbinates were measured. Concomitant ipsilateral sinusitis and ipsilateral concha bullosa (in the middle concha) were also noted as present or absent. Results In our study, the SDCA values of the ≥35-year age group were significantly higher than those of the <35-year age group (p < 0.05). Furthermore, the SSDA values of the ≥35-year age group were significantly lower than those ofthe <35-year age group (p < 0.05). In each of the age groups, ipsilateral inferior turbinate mucosal thickness and ipsilateral inferior turbinate diameter values were significantly higher than those of the contralateral sides (p < 0.05). Ipsilateral concha bullosa was present in 30.0% of the <35-year age group and 18.0% of the ≥35-year age group.Ipsilateral sinusitis was present in 34.0% of the <35-year age group and 52.0% of the ≥35-year age group. Conclusions SD and inferior turbinate hypertrophies should be evaluated together and measured with paranasal CT to provide more efficient nasal aeration. Studies with larger patient series are needed to elucidate the etiology.

The Role of Serum Galactomannan Assay as a Potential Surrogate Biomarker for Fungal Microinvasion in Allergic Fungal Rhinosinusitis.

We conducted this study to determine if serum galactomannan (GM) can be used as a marker to implicate the invasiveness of allergic fungal rhinosinusitis (AFRS), and correlate this value with the aggressiveness of disease documented via computed tomography (CT). All paranasal CT scans done for AFRS patients prospectively over a five-year period (2015-2019) were included. An indigenous 20-point score was used to document the extent of bone erosion seen on CT, wherein a higher score meant a greater extent of bone erosion. It was then correlated with serum GM scores. The median CT scores of galactomannan-positive (GM+) patients were compared with the median CT scores of galactomannan-negative (GM-) patients 3 using Mann-Whitney U test. The patients were divided into five groups based on the extent of disease-No bone erosion, erosion of only sinus wall/orbit, 3 erosion of orbit and skull base, erosion of only skull base and lateral extension of disease into infratemporal fossa (ITF). Subgroup analysis was conducted over mean GM values in these groups using ANOVA test. p-value < 0.05 was considered significant. Statistical analysis was performed using SPSS version 25.0. A total of 92 patients were included (56 males, 36 females). No statistically significant difference was found (p-value = 0.42) between the CT scores of galactomannan-positive (GM+) group and galactomannan-negative (GM-) group. The mean GM scores amongst the five sub-groups did not show a statistically significant difference. Serum galactomannan values correlate poorly with aggressiveness of disease quantified on non-contrast CT of paranasal sinuses.

P068 Computational fluid dynamic study in Obstructive Sleep Apnea patients

Abstract Introduction Obstructive sleep apnea (OSA) is a common disorder which may need surgery to widen the airway. However, the success rate of surgery is variable. Thus, it is necessary to predict the outcome of the surgery preoperatively. The purpose of this study is to evaluate the mechanical parameter of upper airway airflow in OSA patients using computational fluid dynamics (CFD) method. Method We conducted a study on the patients with snoring, underwent the full night polysomnograpny (PSG) and paranasal sinus computed tomography(CT). The patients with past history of previous trauma or surgery were excluded. Three-demensional reconstructions of the upper airway were created in the medical imaging software Mimics 16.0 using paranasal CT. The reconstructions extended from nasopharynx to hypopharynx. Steady-state, turbulent, inspiratory airflow simulations were conducted in Fluent 17.0 with following boundary conditions The mechanical parameters (wall shear stress, pressure, plane velocity) were calculated in the three levels of nasopharynx, retropalatal, retrolingual area. Results The maximum wall shear stress values were shown at the retropalatal plane in all patients. There is a tendency for the wall shear stress value of the retropalatal area to increase as the AHI increases. The maximum velocity values were shown at the retropalatal plane in all patients. The maximum pressure values were shown at the nasopharynx plane in all patients. Conclusion the maximum wall shear stress values were shown at the retropalatal plane and the wall shear stress value of the retropalatal area increased as the AHI increased. Thus, the palatal surgery might help the OSA patients.

Radiological evaluation of sella turcica dimensions in patients with empty sella

Empty Sella (ES) occurs when the subarachnoid space is herniated into the Sella Turcica (ST). ES may be radiologically determined randomly, and patients with ES are usually asymptomatic. However, approximately 20% of partial ES (PES) cases can be symptomatic. Therefore, it is essential to diagnose patients with ES accurately for treatment. We studied whether there was a difference in ST dimensions between patients with ES and healthy individuals using magnetic resonance imaging (MRI), and we compared a group of measurements using computed tomography (CT). 212 patients with ES and 98 healthy individuals participated in this study and underwent cranial 3T MRI. We divided the study population into three groups: the PES, total ES (TES), and control groups. We placed the patients who underwent both cranial MRI and paranasal CT in a separate group. The aperture, height, and length of the ST of all subjects were measured. MRI and CT showed that the length, height, and aperture diameters of the ST were statistically significantly different between the PES, TES, and control groups (p&lt;0.05). In receiver operating characteristic analysis, the cut-off values for the length, height, and aperture measurements were 12.05 mm, 8.35 mm, and 9.65 mm, respectively. The dimensions of the ST expand in patients with ES, and we found a reliable threshold value for this expansion. CT taken for unrelated reasons may be used in the diagnosis of ES by measuring the dimensions of the ST.

Lamina papyracea position in patients with allergic nasal polypi

Objective: This study aimed to describe the variations of the position of lamina papyracea (LP) in patients with allergic nasal polyposis candidate for functional endoscopic sinus surgery (FESS), by computed tomography (CT) analysis. Méthod: Paranasal CT scan of patients diagnosed to have allergic nasal polypi were included in this study and positions of lamina papyracea were registered then analyzed in relation to allergic sinonasal polypi grading. Results: fifty subjects (100 nasal sides) were included in the current study. Grade of nasal polypi was not necessarily associated with certain grade of lamina payracea. Conclusion: This study improves surgeons’ awareness of LP position in different grades of allergic sinonasal polypi and highlights that meticulous preoperative reading of every CT is the key to avoid LP injury during FESS.

C61 MULTIDISCIPLINARY MANAGEMENT IN A CASE OF EOSINOPHILIC MYOCARDITIS WITH CHURG STRAUSS SYNDROME: FROM ECG TO ENDOMYOCARDIAL BIOPSY

Abstract Background Eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg–Strauss, is a rare multisystem disorder characterized by chronic rhinosinusitis, asthma, and prominent peripheral blood eosinophilia (PE). Cardiac involvement may include eosinophilic myocarditis and it is a serious manifestation of EGPA. Case Presentation A 67–year–old woman presented to the emergency department with 2–weeks history of dyspnea, orthopnea and asthenia. She had history of asthma, PE, adjuvant radiotherapy after right mastectomy (July 2021). The patient was diagnosed with new onset atrial fibrillation in the previous month. At admission, the patient was hemodynamically stable and with signs of congestion. Complementary exams showed sinus rhythm and T–wave inversion on lateral leads; PE (2010/uL), elevated troponin and BNP values; and severe biventricular systolic dysfunction with diffuse hypokinesia and apical akinesia. The patient was admitted to the ICU and was treated with intravenous diuretics and levosimendan. Optimal HF therapy was introduced. Serial echocardiography revealed partial recovery of LVEF and blood analysis showed a decrease in troponin levels, with persistent eosinophilia (6330/uL). Computed tomography (CT) excluded significant coronary disease, and showed bilateral basal ground–glass opacities, areas of air–space consolidation and bilateral reticular–nodular pattern. Cardiac magnetic resonance revealed increased T2 values/signs of myocardial edema in anterior wall, interventricular septum and apex and no late gadolinium enhancement, compatible with myocarditis. An endomyocardial biopsy (EMB) was performed and confirmed the diagnosis of eosinophilic myocarditis. Oral corticosteroids were started. Paranasal CT scan showed signs of chronic sinusitis, without polyposis, and antineutrophil cytoplasmic antibodies were positive, making the diagnosis of EGPA, according to ACR criteria. Discussion In a patient presenting with new onset heart failure and with history of asthma and eosinophilia, it is important to suspect eosinophilic myocarditis, as this is a rare but reversible life–threatening condition. EMB plays an important role in the diagnosis and should be done promptly. Conclusion We described a multidisciplinary management of a case of a patient with eosinophilic myocarditis and EGPA, presenting with severe acute biventricular dysfunction.

Posterior ethmoid sinus: a computed tomography analysis and classification

BackgroundThe CT details of the dimensions of the posterior ethmoid sinus are not fully covered in the literature, so building up for a base for the CT measurements and description of that area is important. Preoperative details of the posterior ethmoid sinuses are mandatory before any approach or procedure involving this area.ObjectiveTo determine the different dimensions, measurements, and grading of the posterior ethmoid sinus by computed tomography (CT) that were not previously published.MethodsTwo hundred paranasal CT scans (400 sides) were included in the study. Axial images were acquired with multiplanar reformats to obtain delicate details in coronal and sagittal planes for all subjects.ResultsWithin 200 CTs (400 sides), the mean anteroposterior dimension of the posterior ethmoid was 13.62± 1.75 mm (range= 9.5–19.5), the mean posterior ethmoid transverse diameter was 12.15+1.6 mm (range= 8–16.2) and the mean posterior ethmoid height was 44.64±3.83 mm (range= 35.8–56) without reported significant differences between both sides in all posterior ethmoid dimensions. The mean width of the posterior ethmoid sinus and its height from the orbital roof and nasal floor was significantly more in males than in females. There was significantly lower fovea ethmoidalis in males than females as we go posterior.ConclusionThis study improves surgeons’ awareness and orientation of posterior ethmoid sinus variations in the endoscopic sinus surgery and can be of help to residents in training.

Value of Hounsfield Units in the Evaluation of Isolated Sphenoid Sinus Lesions.

Radiologic findings of fungal sinus disease are generally opacification in paranasal computed tomography (CT) images. The Hounsfield unit (HU) is a standardized objective unit that is also suitable for measuring remodeling and opacifications on CT scans of bone sections of patients with chronic rhinosinusitis. We hypothesized that HU values could provide valuable information in isolated sphenoid sinus lesions before surgery. Between 2012 and 2019, 35 patients underwent functional endoscopic sinus surgery for sphenoid sinus lesions. Tissues obtained from the sphenoid sinus were divided into two groups, fungal and nonfungal, according to the findings of histopathologic examinations. HU values were measured in sphenoid sinus sections on paranasal CT scans of these two groups. Differences in mean and maximum HU values between the two groups were statistically significant (p < .05). The maximum HU values calculated from the sphenoid sinus were 435.08 and 196.23 (p ≤ .05) in the fungal group and nonfungal group, respectively. The mean HU values calculated from the sphenoid sinus were 64.31 and 29 (p ≤ .05) in the fungal and nonfungal groups, respectively. At the maximum cutoff value of 241, the sensitivity and specificity of the HU maximum were 84.6% and 77.3%, respectively. At the mean cutoff value of 41.5, the sensitivity and specificity of the HU mean were 76.9% and 86.4%, respectively. HU is an objective value used in radiographic density measurement. The HU values were higher in fungal lesions than in nonfungal inflammations, and they are useful in preoperative measurement.

Radiologic analysis of correlations between sinonasal anatomical variations in patients with nasal septal deviation

Objective: This study aims to analyze the sinonasal anatomical variations accompanying the nasal septal deviation, the correlations between these variations, and their relationship with the septal deviation angle.Methods: In this retrospective study, preoperative paranasal computed tomography (CT) scans of 206 patients who underwent septoplasty between January 2015 and December 2019 were examined. In CT scans, different nasal septal deviation types, Keros classification, optic nerve type, ethmoid air cell variants, nasal concha variants, paranasal sinus pneumatization variants, and the correlation between accessory pneumatization variants and their relationship with the septal deviation angle were analyzed.Results: In patients with nasal septal deviation, supraorbital ethmoid cell, anterior clinoid process pneumatization and onodi cell were more frequent compared to the literature. Any significant correlation between the nasal septal deviation angle and the presence of sinonasal variants was not detected (p &amp;gt; 0.05). Correlations were significant between the presence of Frontal sinus hypoplasia and Haller cell (ϕ = -0.142, p = 0.042), Supraorbital Ethmoid cell (ϕ = -0.173, p = 0.013) and Paradoxal middle concha (ϕ = 0.152, p = 0.029).Conclusion: Careful examination of paranasal CTs before craniomaxillofacial surgeries is important to determine sinonasal anatomic variants, to determine the appropriate treatment plan and to prevent possible complications peroperatively.

Sinonasal anatomic variations and relationship with sinonasal inflammatory mucosal disease: a computed tomography study

Objective: To evaluate sinonasal anatomic variations on the paranasal computed tomography (CT) scans and to investigate association with sinonasal inflammatory mucosal disease.&#x0D; &#x0D; Materials and Methods: Between January 2019 and December 2019, paranasal CT scans of 279 adult patients were retrospectively analyzed. Patients data were obtained from medical and imaging records. On CT examinations, each anatomic variation was evaluated with respect to side and bilaterality. We investigated statistically coexistence between anatomic variations and presence of sinonasal inflammatory mucosal disease.&#x0D; &#x0D; Results: Our results showed high prevalence of sinonasal anatomic variations. The most common anatomic variation was nasal septal deviation (65.2 %), followed by concha bullosa (41.6 %)and septal spur (28.7 %). We found a statistically significant relationship between concha bullosa and sinonasal inflammatory mucosal disease (p=0.009) which was observed especially in bulbous (p=0.048) and extensive types(p=0.017). No significant association was noted with the other anatomic variations.&#x0D; &#x0D; Conclusion: &#x0D; Concha bullosa, particularly bulbous and extensive types have a tendency to cause sinonasal inflammatory mucosal disease. &#x0D; Key words: Sinonasal cavity, anatomic variation, computed tomography, mucosal disease, rhinosinusitis

Analysis of anatomical variation of the inclination of lamellas attached to the skull base and its correlation with the anterior ethmoidal artery floating in the ethmoid sinus for use in endoscopic sinus surgery.

Attention to the inclination of lamellas attached to the skull base, including the basal lamella of the middle turbinate, facilitates the intraoperative identification of each lamella without requiring the use of a navigation system. We classified the inclination between the lamella and the skull base in preoperative computed tomography (CT) images and examined the relationship between the lamellas attached to the skull base, including the basal lamella of the middle turbinate, and the position of the anterior ethmoidal artery (AEA). We aimed to develop a preoperative classification to help prevent intraoperative injury of the AEA. We retrospectively investigated the paranasal sinus sagittal section CT slices of 366 sides of 183 patients to assess the inclination of lamellas attached to the skull base and the AEA location. We also reviewed the AEA position, its correlation with the supraorbital ethmoid cell, and the lateral lamella of the cribriform plate. We classified the lamella inclination at the skull base as the anterior direction, perpendicular direction, and posterior direction types. Lamellas containing a floating AEA inclined in the anterior direction toward the skull base were observed in 68.9% of sides, inclination in the perpendicular direction was noted in 30.5% of sides, and inclination in the posterior direction was noted in 0.5% of sides. It is easier to identify the AEA intraoperatively when the lamella inclination of the skull base attachment is recognized based on preoperative CT findings. This approach could be applied to all paranasal sinus lamellas and assist in identifying the AEA and other nearby structures.

Anterior Ethmoidal Artery: A Computed Tomography Analysis and New Classifications.

Objective to determine the anterior ethmoidal artery (AEA) anatomy and variations by computed tomography (CT) in adult and their relations to and presents new AEA classifications. Methods One hundred and fifty paranasal CT scans (300 sides) were included. Axial images were acquired with multiplanar reformates to obtain delicate details in coronal and sagittal planes. Results One hundred and forty-four AEAs canal (48%), 293 AEAs foramen (97.7%), and 229 AEAs sulcus could be detected (76.3%). The mean AEA intranasal length was 6.7 ± 1.27 mm (range: 4.24-10.6 mm). The mean angle between AEA and lamina papyracea was 105.49 ± 9.28 degrees (range: 76.41-129.76 degrees). Of them, 95.8% AEAs had an angle with lamina >90 degrees, while 4.2% had angle <90 degrees. The mean angle between AEA and lateral lamella of cribriform plate was 103.95 ± 13.08 degrees (range: 65.57-141.36 degrees). Of them, 87.5% AEAs had an angle >90 degrees and 12.5% had an angle <90 degrees. The mean distance between AEA and skull base was 1.37 ± 1.98 mm (range: 0-8.35 mm). The AEA types in relation to skull base was type 1 (0-2 mm from skull base; 64.6%), type 2 (2-4 mm; 22.2%), type 3 (4-6 mm; 11.1%), and type 4 (>6 mm; 2.1%). The mean distance between the AEA and frontal sinus ostium was 9.17 ± 4.72 mm (range: 0-25.36 mm). AEA classification according to distance from AEA to frontal sinus ostium was 17.4% type 1 (<5 mm), 41.7% type 2 (5-10 mm), 31.9% type 3 (10-15 mm), and 9% type 4 (>15 mm). Conclusion Provided AEA details improve surgeons' awareness of AEA variations in the endoscopic field and can help residents in training.

An Analysis of Association Between Nasal Bone Morphology and Sinonasal Anatomical Variations.

The goal of this study was to investigate the association between various sinonasal anatomical variations and the morphological features of lateral nasal bone, using paranasal computerized tomography (PNCT) sections. Two hundred and fifty patients who underwent a PNCT scan because of a prediagnosis of nasal septum deviation or sinusitis were included in the study. For each patient, presence of the following anatomical variations was determined on CT sections: length and thickness of nasal bone, thickness of intermediate nasal bone, pneumatized middle turbinate, paradox middle turbinate, Agger nasi cell, Haller cell, Onodi cell, supraorbital cell, pneumatized uncinate process, and nasal septal deviation. The effect of each anatomical variation on the length and thickness of the lateral nasal bone was investigated. The patients with bilateral pneumatized middle turbinate and the patients with bilateral Agger nasi cell had a thinner lateral nasal bone both on the right and the left sides compared to those without. The patients with bilateral Onodi cell and Agger nasi cell had a longer lateral nasal bone both on the right and the left sides compared to those without. The nasal bone thickness was significantly thicker on the deviation side than the contralateral nasal bone. The nasal bone length was significantly longer on the side of the septum deviation. In this study, we found that sex, presence of Agger nasi and Onodi cells, pneumatization of middle turbinate, and direction of nasal septal deviation influenced the morphology of the nasal bone. For successful nasal surgery, careful examination of preoperative anatomical variations is very important.

Micro-dose Paranasal Computed Tomography is Valuable When Evaluating Diseases of the Paranasal Sinuses

Micro-dose Paranasal Computed Tomography is Valuable When Evaluating Diseases of the Paranasal Sinuses

Examining the relation between Concha Bullosa types and Septum Deviation and Maxillary Sinusitis: Analysis of 293 Paranasal Computed Tomography

Amaç: Bu çalışmanın amacı orta konka pnömatizasyonunun 3 tipi olan lamellar, bülböz ve ekspensive tip konka büllöza (KB) ile maksiller sinüzit ve septum deviasyonu (SD) arasındaki ilişkiyi araştırmaktır. Hastalar ve Yöntem: Bu retrospektif çalışmada Tokat Devlet Hastanesinde 1 ocak 2017 ile 1 temmuz 2017 arasında başvurmuş ve sinonazal patoloji şüphesi ile Paranazal BT tetkiki yapılmış 293 (586 taraf) hastanın Bilgisayarlı Tomografi (BT) görüntüleri değerlendirilmiştir. KB tipleri ile maksiller sinüzit ve SD arasındaki ilişki istatistiksel yöntemlerle araştırılmıştır. Bulgular: Bilateral KB 74 (%61,66) hastada tespit edilirken unilateral KB 56 (%38,33) hastada tespit edilmiştir. Lamellar tipin bulunduğu hastalarla, bulunmadığı hastalar arasında, bülböz tipin bulunduğu hastalarla, bulunmadığı hastalar arasında, ekstensiv tipin bulunduğu hastalarla, bulunmadığı hastalar arasında maksiller sinüzit varlığı açısından istatistiksel fark bulunamamıştır (sırasıyla, p&amp;gt;0,05; p&amp;gt;0,05; p&amp;gt;0,05). Lamellar tip KB’si bulunanlarda SD diğer tiplere göre istatistiksel olarak anlamlı derecede daha az bulunmuştur (p&amp;lt;0,05). Bülböz tipin ve ekstensivin tipin bulunduğu hastalarla bulunmadığı hastalar arasında SD varlığı açısından istatistiksel fark yoktur (sırasıyla, p&amp;gt;0,05;p&amp;gt;0,05). Sonuç: KB nin tiplerine göre maksiller sinüzit varlığının sıklığı arasında ilişki bulunmazken SD bülböz ve ekstensiv tipte lamellar tipe göre daha fazla bulunmuştur.

Preoperative Evaluation of Paranasal Computed Tomography Reports of Patients Requesting Rhinoplasty for the Presence of Septal Deviation and Inferior Turbinate Hypertrophy: Retrospective Clinical Case Series Study

Preoperative Evaluation of Paranasal Computed Tomography Reports of Patients Requesting Rhinoplasty for the Presence of Septal Deviation and Inferior Turbinate Hypertrophy: Retrospective Clinical Case Series Study