Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Does Nasal Septal Deviation and Concha Bullosa Have Effect on Maxillary Sinus Volume and Maxillary Sinusitis?: A Retrospective Study

비중격 만곡증과 수포성 비갑개는 상악동 부피와 상악골 부비동염에 있어 관련성을 지니는가?: 후향적 연구

  • Juyeon Lee (Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital) ;
  • Sang Man Park (Department of Otorhinolaryngology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital) ;
  • Seung-Whan Cha (Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital) ;
  • Jin Sil Moon (Department of Biostatistics, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital) ;
  • Myung Soon Kim (Department of Radiology, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital)
  • 이주연 (연세대학교 원주의과대학 원주세브란스 기독병원 영상의학과) ;
  • 박상만 (연세대학교 원주의과대학 원주세브란스 기독병원 이비인후과) ;
  • 차승환 (연세대학교 원주의과대학 원주세브란스 기독병원 영상의학과) ;
  • 문진실 (연세대학교 원주의과대학 원주세브란스 기독병원 생물통계학과) ;
  • 김명순 (연세대학교 원주의과대학 원주세브란스 기독병원 영상의학과)
  • Received : 2019.10.10
  • Accepted : 2020.04.15
  • Published : 2020.11.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose This study aimed to determine whether nasal septal deviation and concha bullosa affect the maxillary sinus volume, and whether this effect is associated with the prevalence of chronic sinusitis. Materials and Methods This study retrospectively reviewed 209 paranasal sinus CT (PNS CT) images of patients with sinonasal symptoms from January 2017 to December 2018. The maxillary sinus volume was measured twice by a radiologist, and statistical analysis was performed using SAS 9.4. Results Intersex comparison of the maxillary sinus volume (on left and right sides) revealed that the volume was significantly larger on both the sides (p < 0.0001) in men compared with that in women. Concha bullosa was found to occur mainly in the concave cavity of the septal deviation (p < 0.0001). No significant association was found between nasal septal deviation and maxillary sinusitis (p = 0.8756) as well as between concha bullosa and maxillary sinusitis prevalence (p = 0.3401) or maxillary sinus volume (both: p = 0.6289, Rt.: p = 0.9522, Lt.: p = 0.9201). Conclusion Although nasal septal deviation and the location of concha bullosa may affect each other, maxillary sinus volume and maxillary sinusitis were neither associated with nasal septal deviation nor concha bullosa.

목적 본 연구의 목적은 비중격 만곡증과 수포성 비갑개가 상악동 부피에 영향을 미치는지 그리고 만성 부비동염의 유병률과 관련성 여부를 분석해보는 것이다. 대상과 방법 이 연구는 2017년 1월부터 2년 동안 부비동 증상을 호소하며 본원 이비인후과를 내원한 환자 중 부비동 컴퓨터단층촬영술을 시행한 209명의 환자들을 후향적으로 분석하였다. 부비동의 부피 측정을 포함한 컴퓨터단층촬영술에 대한 판독은 1명의 영상의학과 의사가 2번 반복하여 시행하였고, 통계적 분석은 SAS 9.4를 사용되었다. 결과 상악동 부피는 우측, 좌측 모두 남자가 여자보다 의미 있게 컸다(p < 0.0001). 또한 수포성 비갑개는 비중격 만곡증의 오목한 부분에서 유의하게 많이 존재하였다(p < 0.0001). 그러나 비중격 만곡증이나 상악동 부비동염과의 관련성은 방향성을 나누어 분석했을 시 서로 유의하지 않았다(p = 0.8756). 또한 수포성 비갑개는 상악동 부비동염(p = 0.3401)이나 상악동 부피와(양측: p = 0.6289, 우측: p = 0.9522, 좌측: p = 0.9201) 연관성이 없었다. 결론 수포성 비갑개는 만곡된 비중격의 반대편에 주로 존재하였다. 그러나 해당 관련성 이외에는, 비중격 만곡증과 수포성 비갑개는 상악동의 부피나 부비동염과는 큰 연관이 없다.

Keywords

References

  1. Momeni AK, Roberts CC, Chew FS. Imaging of chronic and exotic sinonasal disease: review. AJR Am J Roentgenol 2007;189:S35-S45  https://doi.org/10.2214/AJR.07.7031
  2. Koo SK, Kim JD, Moon JS, Jung SH, Lee SH. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: a retrospective radiologic study. Auris Nasus Larynx 2017;44:561-570  https://doi.org/10.1016/j.anl.2017.01.003
  3. Polat C, Dostbil Z. Evaluation of the nasal mucociliary transport rate by rhinoscintigraphy before and after surgery in patients with deviated nasal septum. Eur Arch Otorhinolaryngol 2010;267:529-535  https://doi.org/10.1007/s00405-009-1116-3
  4. Tassoker M, Magat G, Lale B, Gulec M, Ozcan S, Orhan K. Is the maxillary sinus volume affected by concha bullosa, nasal septal deviation, and impacted teeth? A CBCT study. Eur Arch Otorhinolaryngol 2020;277:227-233  https://doi.org/10.1007/s00405-019-05651-x
  5. Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 1991;101:56-64  https://doi.org/10.1288/00005537-199101000-00010
  6. Hatipoglu HG, Cetin MA, Yuksel E. Concha bullosa types: their relationship with sinusitis, ostiomeatal and frontal recess disease. Diagn Interv Radiol 2005;11:145-149 
  7. Zinreich SJ, Kennedy DW, Rosenbaum AE, Gayler BW, Kumar AJ, Stammberger H. Paranasal sinuses: CT imaging requirements for endoscopic surgery. Radiology 1987;163:769-775  https://doi.org/10.1148/radiology.163.3.3575731
  8. Rak KM, Newell JD 2nd, Yakes WF, Damiano MA, Luethke JM. Paranasal sinuses on MR images of the brain: significance of mucosal thickening. AJR Am J Roentgenol 1991;156:381-384  https://doi.org/10.2214/ajr.156.2.1898819
  9. Leonard S, Reiter A, Sinha A, Ishii M, Taylor RH, Hager GD. Image-based navigation for functional endoscopic sinus surgery using structure from motion. Proc SPIE Int Soc Opt Eng 2016;9784:97840V 
  10. Carter BL, Bankoff MS, Fisk JD. Computed tomographic detection of sinusitis responsible for intracranial and extracranial infections. Radiology 1983;147:739-742  https://doi.org/10.1148/radiology.147.3.6844609
  11. Beck TJ, Rosenbaum AE, Miller NR. Orbital computed tomography: technical aspects. Int Ophthalmol Clin 1982;22:7-43  https://doi.org/10.1097/00004397-198202240-00004
  12. Earwaker J. Anatomic variants in sinonasal CT. Radiographics 1993;13:381-415  https://doi.org/10.1148/radiographics.13.2.8460226
  13. Wee JH, Kim DW, Lee JE, Rhee CS, Lee CH, Min YG, et al. Classification and prevalence of nasal septal deformity in Koreans according to two classification systems. Acta Otolaryngol 2012;132 Suppl 1:S52-S57  https://doi.org/10.3109/00016489.2012.661077
  14. Al-Rawi NH, Uthman AT, Abdulhameed E, Al Nuaimi AS, Seraj Z. Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: a cone-beam computed tomography study. Imaging Sci Dent 2019;49:45-51  https://doi.org/10.5624/isd.2019.49.1.45
  15. Zinreich S, Albayram S, Benson M, Oliverio P. The ostiomeatal complex and functional endoscopic surgery. Head and neck imaging. 4th ed. St Louis: Mosby 2003:149-173 
  16. Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR Am J Neuroradiol 2004;25:1613-1618 
  17. Balikci HH, Gurdal MM, Celebi S, Ozbay I, Karakas M. Relationships among concha bullosa, nasal septal deviation, and sinusitis: retrospective analysis of 296 cases. Ear Nose Throat J 2016;95:487-491  https://doi.org/10.1177/014556131609501209
  18. Kapusuz Gencer Z, OzkIrI,s M, Okur A, Karacavu,s S, Saydam L. The effect of nasal septal deviation on maxillary sinus volumes and development of maxillary sinusitis. Eur Arch Otorhinolaryngol 2013;270:3069-3073  https://doi.org/10.1007/s00405-013-2435-y
  19. Lorkiewicz-Muszynska D, Kociemba W, Rewekant A, Sroka A, Jonczyk-Potoczna K, Patelska-Banaszewska M, et al. Development of the maxillary sinus from birth to age 18. Postnatal growth pattern. Int J Pediatr Otorhinolaryngol 2015;79:1393-1400  https://doi.org/10.1016/j.ijporl.2015.05.032
  20. Orlandi RR, Kingdom TT, Hwang PH, Smith TL, Alt JA, Baroody FM, et al. International consensus statement on allergy and rhinology: rhinosinusitis. Int Forum Allergy Rhinol 2016;6 Suppl 1:S22-S209  https://doi.org/10.1002/alr.21694
  21. Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ. CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg 1991;104:480-483  https://doi.org/10.1177/019459989110400409
  22. Jones NS, Strobl A, Holland I. A study of the CT findings in 100 patients with rhinosinusitis and 100 controls. Clin Otolaryngol Allied Sci 1997;22:47-51  https://doi.org/10.1046/j.1365-2273.1997.00862.x
  23. Kucybala I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal septal deviation and concha bullosa - do they have an impact on maxillary sinus volumes and prevalence of maxillary sinusitis? Pol J Radiol 2017;82:126-133 https://doi.org/10.12659/PJR.900634