Is preoperative paranasal sinus computed tomography necessary for every patient undergoing septoplasty?

SummaryBackgroundThe aim of the study was to assess if the presence of nasal septal deviation and concha bullosa is connected with the development of sinuses and the incidence of inflammation within them.Material/MethodsWe retrospectively analysed 214 patients who underwent paranasal sinus computed tomography. There were 125 females and 89 males, the mean age being 47.67±16.74 years (range 18–97). Exclusion criteria included: age under 18 years, prior sinonasal surgery and S-shaped septum.ResultsMean volume of the right maxillary sinus was 17.794 cm3, while for the left one it was 17.713 cm3. Nasal septal deviation was found in 79.9% of computed tomography examinations and concha bullosa was observed in 42.1% of the patients’ examinations. There was an association between the presence of unilateral or dominant concha bullosa and contralateral direction of septal deviation [right-sided (p=0.039), left-sided (p=0.003)]. There was higher incidence of bilateral maxillary sinusitis in patients with septal deviation (p=0.007). Bilateral concha bullosa did not influence the incidence of bilateral maxillary sinusitis (p=0.495). Neither septal deviation (right sided: p=0.962; left-sided: p=0.731), nor unilateral/dominant concha bullosa (right: p=0.512; left: p=0,430) affected the asymmetry in volumes of maxillary sinuses. Bilateral concha bullosa was connected with larger volume of maxillary sinuses (right sinus: p=0.005; left sinus: p=0.048).ConclusionsNasal septal deviation, contrary to concha bullosa, has influence on the development of maxillary sinusitis. There is a connection between the presence of concha bullosa and direction of septal deviation. Only bilateral concha bullosa affects maxillary sinus volumes.

show abstract

“…Gunbey also recommended performing preoperative paranasal sinus CTs in patients with chronic sinusitis in whom septoplasty is planned [58]. …”

Section: Discussionmentioning

confidence: 99%

Nasal Septal Deviation and Concha Bullosa – Do They Have an Impact on Maxillary Sinus Volumes and Prevalence of Maxillary Sinusitis?

et al. 2018

View full text Add to dashboard Cite

show abstract

“…7,8,29 In particular, cross-sectional images allow the correlation of patient symptoms to the airway anatomy of both the anterior and posterior nasal cavity before surgery. 10,30 In this study, we analysed 46 CBCT images belonging to dental patients whose otolaryngological diagnosis is Figure 2 Example of segmentation of the right (B) and left (C) side of the nasal airway and of the left and right maxillary sinuses (A and D, respectively). In the top image, the segmentation outcomes are represented in a posterior coronal CBCT slice.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8] In particular, pre-operative CT scan of the paranasal sinuses is often performed before septoplasty, in order to evaluate nasal anatomy, to find concomitant sinonasal pathologies and to reduce surgical failure. [8][9][10] Despite the fact that pre-operative CT scan of the paranasal sinuses can be recommended in case of obstructive middle turbinate hypertrophy, impossibility to evaluate the middle meatus and the posterior nasal cavity or in patients with chronic sinusitis, the high radiation dose and costs do not allow its usage routinely in patients undergoing septoplasty. 10 In the last decades, CBCT has been emerging, and now, it is widely used in dentistry, thanks to its high image resolution, low radiation dose and low costs.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10] Despite the fact that pre-operative CT scan of the paranasal sinuses can be recommended in case of obstructive middle turbinate hypertrophy, impossibility to evaluate the middle meatus and the posterior nasal cavity or in patients with chronic sinusitis, the high radiation dose and costs do not allow its usage routinely in patients undergoing septoplasty. 10 In the last decades, CBCT has been emerging, and now, it is widely used in dentistry, thanks to its high image resolution, low radiation dose and low costs. [11][12][13] Currently, its clinical use in other medical fields is limited and not widespread because of minor soft-tissue contrast; however, many studies confirm that CBCT could be a valid support in otolaryngology also.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The nasal septum deviation index (NSDI) based on CBCT data

Codari¹,

Zago²,

Guidugli³

et al. 2016

Dentomaxillofacial Radiology

View full text Add to dashboard Cite

Objective: To assess whether three-dimensional morphometric parameters could be useful in nasal septal deviation (NSD) diagnosis and, secondarily, whether CBCT could be considered an adequate imaging technique for the proposed task. Methods: We analysed images of 46 subjects who underwent CBCT for reasons not related to this study. Two experienced operators divided all the images into healthy and NSD subjects. Subsequently, the images were segmented using ITK Snap in order to obtain the three-dimensional model of the nasal airways and compute four morphological parameters: septal deviation angle (SDA), percentage of volume difference between right and left side of the nasal airways, nasal airway total volume and a new synthetic septal deviation index (SDI). Principal component analysis (PCA) was used to unveil relationships between each variable and the global nasal airway variability. Results: Differences between the groups were found in SDA (p , 0.001), in volume percentage difference (p , 0.05) and in SDI (p , 0.001). PCA showed high correlation between the SDI and the first principal component (0.97, p , 0.001). Conclusions: Among the analysed parameters, SDI seemed to be the most suitable for the quantitative assessment of NSD, and CBCT allowed accurate assessment of airway morphology.

show abstract

“…However, usually a CT scan is not performed in patients undergoing septoplasty alone without FESS. A recent study published in this issue by Günbey et al . showed that 24% of patients with nasal septal deviation had concomitant sinus mucosal thickening.…”

mentioning

confidence: 96%

Editorial

Han¹

2015

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

Is preoperative paranasal sinus computed tomography necessary for every patient undergoing septoplasty?

Cited by 29 publications

References 25 publications

Nasal Septal Deviation and Concha Bullosa – Do They Have an Impact on Maxillary Sinus Volumes and Prevalence of Maxillary Sinusitis?

Nasal Septal Deviation and Concha Bullosa – Do They Have an Impact on Maxillary Sinus Volumes and Prevalence of Maxillary Sinusitis?

The nasal septum deviation index (NSDI) based on CBCT data

Editorial

Contact Info

Product

Resources

About