The Prevalence of Concha Bullosa and Nasal Septal Deviation and Their Relationship to Maxillary Sinusitis by Volumetric Tomography

Abstract

The objective of this study was to determine the prevalence of concha bullosa and nasal septal deviation and their potential relationships to maxillary sinusitis. 883 CT scans taken at Creighton University School of Dentistry from 2005 to 2008 were retrospectively reviewed for the presence of concha bullosa, nasal septal deviation, and maxillary sinusitis. 67.5% of patients exhibited pneumatization of at least one concha, 19.4% of patients had a deviated septum, and 50.0% had mucosal thickening consistent with maxillary sinusitis. 49.3% of patients who had concha bullosa also had evidence of maxillary sinusitis. Only 19.5% of patients with concha bullosa also had nasal septal deviation, whereas 19.7% of patients with sinusitis also presented with nasal septal deviation. Although concha bullosa is a common occurrence in the nasal cavity, there did not appear to be a statistically significant relationship between the presence of concha bullosa or nasal septal deviation and maxillary sinusitis.

Prevalence of Variant Anatomy of Paranasal Sinuses in Computed Tomography and its Correlation to Sinusitis:

“…Perez et al reported it to be 80%. It was as low as 19.4% according to Smith et al (4) as they followed the strict criteria of deviation > 4mm. DNS causing a reduction in osteomeatal unit's critical area, impairing mucociliary activity and drainage is supposed to predispose to sinusitis.…”

Paranasal Sinus Anatomic Variations Accompanying Maxillary Sinus Retention Cysts: A Radiological Analysis

“…Concha bullosa, paradoxical concha, bifid concha, and NSD are common anatomical variants occurring in as much as 30%-70% of the population (15,23). The middle turbinate is important in the drainage of the maxillary sinus.…”

“…The middle turbinate is important in the drainage of the maxillary sinus. Extreme NSD can obstruct the osteomeatal unit, while the role of a minimally or moderately abnormal middle turbinate and NSD in the etiology of paranasal inflammation is controversial (23,24). These variations cause narrowing or obstruction of the osteomeatal unit, thereby reducing the normal airflow and mucociliary clearance of the sinuses.…”

CBCT Imaging of Paranasal Sinuses and Variations

“…This anatomic variation was divided into three groups according to extent of the pneumatization: lamellar type (pneumatization in the lamellar portion), bulbous type (pneumatization in the bulbous portion; Figure 5), and extensive type (pneumatization in the both vertical lamellar and inferior bulbous portion) [35]. The prevalence of the CB varies from 4.6 to 89.5% [17,[20][21][22][36][37][38][39]. This may be due to the different definition criteria for CB.…”

“…It is still debated in the literature whether CB has a role in sinusitis aetiology. However, in most of the studies, no statistical significant relationship is found between the CB and maxillary sinusitis [17,[20][21][22][36][37][38][39]. Pneumatization of the superior and inferior turbinate is also called superior and inferior concha bullosa.…”