Modification of the maxillary bone in adults with nasal polyposis: a CT morphometric study

Abstract

Chronic nasal obstruction is a common complaint in otorhinolaryngology outpatient practice (1, 2). Causes of nasal obstruction, conditioning mouth breathing, include nasoseptal deviation, hypertrophied lower turbinates, adenoids and tonsils, chronic or especially allergic rhinitis, nasal trauma, congenital nasal deformities, foreign bodies, nasal polyps, and tumors (3). One of the most common causes of nasal obstruction in adults is nasal polyposis (NP) (1, 2). Computed tomography (CT) is the ideal imaging method to investigate nasal and paranasal sinus diseases (4, 5).In paranasal sinus CT scans, we have recently observed that the plane angle between the maxillary alveolar process (MAP) and palatine bone (PB) is increased and the depth of maxillary arch is decreased in many cases with NP.Pediatric orthodontics literature concerning how nasal obstruction relates to dentofacial development is extensive and whether a cause-effect relationship exists has been debated for over a century (6)(7)(8). Although recent studies suggest a relationship between chronic nasal obstruction and dentofacial deformities, many questions remain unanswered (9, 10). However, there is very limited data on the morphometry of the maxillary arch in adults with nasal obstruction.The objectives of the present study are to correlate the airway variables obtained by paranasal sinus CT findings of both patients with chronic nasal airway obstruction and a control group in adult population, and to investigate whether the bony structure of the airway is affected or not. Materials and methodsForty NP cases that were followed up by an otorhinolaryngologist at least for 1 year were included in this retrospective study. The control group consisted of 40 subjects that were randomly selected from our CT database. Control subjects had normal findings or trivial pathologies, which did not cause any nasal airway obstruction (e.g., minimal mucosal thickening, small retention cyst) reported in paranasal CT scans. Both groups were similar regarding the age and weight. The diagnosis of NP was established by direct visualization via nasal endoscopy.Paranasal sinus CT scans of all subjects were performed with the same parameters. A single slice spiral unit (Siemens Emotion, Siemens, Erlangen, Germany) was used for imaging. Unenhanced, 3 mm thick coronal and axial contiguous slices (pitch, 1.5) were obtained in the prone position with the head hyperextended. Although images were originally obtained with soft tissue and bone windows, we made the calculations on a single set of images obtained in the bone algorithm (window width, 2000-3000; window level, 400-760). The maxillary and palatine bones were evaluated on coronal images. The plane angle between MAP and There is yet no study in the literature measuring the morphometry of maxillary bone in NP. The objectives of this study are to correlate the airway variables obtained by CT findings of both chronic nasal airway obstruction and control group in an adult population, and to investigate whether the bony structur...

Assessment of the Relationship Between Palatum Durum and Maxillary Bone in Patients with Nasal Polyp, Chronic Sinusitis or Septum Deviation

“…In the study on patients with NP and healthy subjects, Serter et al [2] found that there was an increase in IAD and decrease in palatal bone depth in NP similar to our findings. In addition to these findings, we found that IAD was decreased; palatal bone depth was increased and these values were more prominent in patients with CS than those with SD.…”

“…There is an increased interalveolar distance (IAD) as a result of enlarged maxillary bone due to expansion of nasal cavity caused by polyps. This causes flatting of palatal curve [2]. On the other hand, dome-like palatal bone curve and decreased IAD develop in patients with septum deviation due to mouth breathing.…”

“…Nasal obstruction most commonly results from adenoid vegetation (AV) in children [1,2]. However, most common causes include SD, NP, CS, concha bullosa and concha hypertrophy in adults [3].…”

“…However, most common causes include SD, NP, CS, concha bullosa and concha hypertrophy in adults [3]. Orofacial deformities may occur due to breathing from mouth because of the nasal obstruction [2]. Growth at lower parts of face is striking in the deformities caused by AV at childhood [4].…”

Peculiarities of organometric parameters of the hard palate in the second and third trimester of the intrauterine development and newborns

“…Finding anatomical variability of organs, structures and their parts at all the stages of human development is rather topical [2]. Defects of the dentoalveolar system rank one of the main places among pathology of the maxillary-facial region, and according to the data of certain authors their occurrence is from 70 to 80% [1,3,4,16]. One of the common congenital developmental defects of the maxillaryfacial region is cleft of the lip and hard palate named "harelip" and "cleft palate".…”