Computed Tomography Analysis of the Nasal Septal Deviation and Related Paranasal Sinus Pathologies

Dayan  Amanian; Shekoofeh  Yaghmaei; Mansoureh  Jalilpour; Mohammad Hossein  Taziki; Amir  Soltaniesmaeili

doi:10.18502/fbt.v11i4.16511

Dayan Amanian Department of Radiology, Golestan University of Medical Sciences, Golestan, Iran
Shekoofeh Yaghmaei General Practitioner, Shiraz University of Medical Science, Shiarz, Iran
Mansoureh Jalilpour Radiologist, Shiraz University of Medical Sciences, Shiraz, Iran
Mohammad Hossein Taziki ENT Department, Golestan University of Medical Sciences, Golestan, Iran
Amir Soltaniesmaeili Otorhinolaryngologist, Otolaryngology Research Center, Department of Otolaryngology, Shiraz University of Medical Science, Shiraz, Iran

DOI: https://doi.org/10.18502/fbt.v11i4.16511

Keywords: Nasal Septal Deviation; Paranasal Sinuses; Paranasal Sinus Computed Tomography.

Abstract

Purpose: Nasal Septum Deviation (NSD), which is defined as a dislocated septum, is a prevalent condition that is mostly asymptomatic; however, it can cause difficulties such as nasal obstruction and rhinosinusitis symptoms. Other Paranasal Sinuses (PNS) disorders, e.g., Osteo Meatal Complex (OMC) obstruction, have been assumed to be correlated with NSD. This study investigates the possible correlation of specific radiological findings of PNS pathologies in patients with or without the existence and direction of NSD. We also discussed the different types of NSD and their incidence among different groups stored by age, gender, etc.

Materials and Methods: This is a cross-sectional study conducted at multiple imaging centers in Iran between July 2019 and February 2020 to estimate the prevalence of deviated nasal septum and correlate between NSD and other findings using paranasal sinus scans. All the individuals who met the inclusion and exclusion criteria were included in the study. NSD types have been classified based on Mladina's method.

Results: We prospectively reviewed PNS Computed Tomography (CT) scans obtained from 254 cases (82 men and 172 women), aged 18 to 81 years (mean: 35.53), evaluated over seven months. Out of 254 cases, 135 (53 %) patients had NSD, without any direction predominance (right-sided vs. left-sided), and equally distributed between genders. The most common NSD types were type V with a frequency of 42.22% and type III with a frequency of 24.44%. Other PNS CT findings were also investigated in our patients, like OMC obstruction, pansinusitis, mucocele, air-fluid level, mucosal thickening, and concha bullosa. There was no statistically significant correlation between any of these pathologies and NSD (P-value > 0.05).

Conclusion: Although NSD was observed in more than half of our cases' PNS CTs, there was no significant correlation between NSD and other findings in most subjects. This reveals that the effectiveness of septal repair surgeries in relieving patients' symptoms might not be as high as expected.