There Is No Structural Relationship between Nasal Septal Deviation, Concha Bullosa, and Paranasal Sinus Fungus Balls

Abstract

This study aims to determine the relationship between nasal septal deviation, concha bullosa, and chronic rhinosinusitis by using a definitive pathological and simplified model. Fifty-two consecutive sinus computed tomography scans were performed on patients who received endoscopic sinus surgery and whose final diagnosis was paranasal sinus fungus balls. The incidences of nasal septal deviation and concha bullosa for patients diagnosed with paranasal sinus fungus balls among the study group were 42.3% and 25%, respectively. About 63.6% sinuses with fungus balls were located on the ipsilateral side of the nasal septal deviation, and 46.2% were located on the ipsilateral side of the concha bullosa. When examined by Pearson's chi-square test and the chi-squared goodness-of-fit test, no significant statistical difference for the presence of paranasal sinus fungus balls between ipsilateral and contralateral sides of nasal septal deviation and concha bullosa was noted (P = 0.292 and P = 0.593, resp.). In conclusion, we could not demonstrate any statistically significant correlation between the location of infected paranasal sinus, the direction of nasal septal deviation, and the location of concha bullosa, in location-limited rhinosinusitis lesions such as paranasal sinus fungal balls. We conclude that the anatomical variants discussed herein do not predispose patients to rhinosinusitis.

Headache Secondary to Isolated Sphenoid Sinus Fungus Ball: Retrospective Analysis of 6 Cases First Diagnosed in the Neurology Department

“…Hwang et al observed that the middle meatus bears the major part of the inspiratory nasal airflow, and the relatively larger volume of the middle meatus was associated with the localization of the FB ( 22 ). In contrast, Tsai et al ( 23 ) reported that the anatomical variants do not predispose patients to paranasal sinus FB. Additionally, dentogenic factors may correlate with the presence of maxillary sinus fungus ball ( 24 ).…”

The frequencies of different types of nasal septum deviation and their effect on increasing the thickness of maxillary sinus mucosa

“…Overall, 31.76% of males and 56.67% of females had increased maxillary sinus mucosa thickness, including mucositis and sinusitis. 11 Tung-Lung 29 used the CT scan technique in the coronal and sagittal planes in their study. The criteria to determine nasal septum deviation included any angles of septal deviation >10º in the osteomeatal complex.…”

Concha Bullosa: A Shield against Allergens?

“…Multiple infectious, inflammatory, and anatomic factors may contribute singly or jointly to triggering and sustaining the persistent inflammation in CRS [15]. However, while one study has shown an association between CB and CRS [3], others have observed a connection only when CB is bilateral [4], and a large number of studies have found no association [5,6,7,8,9]. Similarly, this study found no association between CB and CRS.…”

“…An overly large CB causes increased contact between the turbinate and the adjacent nasal structures, which may drive nasal obstruction and impair sinus drainage [2,3]. However, the association between chronic rhinosinusitis (CRS) and CB remains controversial [3,4,5,6,7,8,9]. While several hypotheses describe the aberrant formation of this anatomic variant, ranging from expansive sinus pneumatization and abnormal chondral lamella fusion in utero [10] to conchal microfractures and mucosal invagination in late puberty [11,12], it is unclear if CB imparts any physiologic benefit.…”