Association of Deviated Nasal Septum and Sinusitis: A Radiological Study

Dr. Rudresh S Halawar, Dr. Sudhindraswamy V B, Dr. Bhimashankar SN, Dr. Manaswini Pol, Dr. Rajeshwari Odugoudar, Dr. Mahantesh Uppin

Abstract


Introduction: Deviation of nasal septum (DNS) is the most common anatomical variant in sinonasal region. It is usually asymptomatic, but it sometimes can cause different sinonasal symptoms. The severity of the symptoms is related to associate abnormalities like agger nasi cells, onodi cells, haller cells, concha bullosa and inferior turbinate hypertrophy. Methods: Patients were retrospectively selected by a computer-assisted search of all the reports of CT scans performed with a clinical symptom referable to the sinonasal region, headache, nasal obstruction, recurrent sinusitis, chronic sinusitis, acute sinusitis, allergic sinusitis in S, Nijalinagppa Medical College and Hanagal Shri Kumareshwar Hospital & Research Centre between December 1, 2016 and November 30, 2017 to detect the presence of deviated nasal septum. A total of 524 CT studies were identified. Of these cases, studies with malignancy, motion artifacts, Traumatic fractures, polyps, post-op status were excluded. The study design did not involve any patient contact hence no approval by the local ethics committee was required.

Results: The sinusitis was identified in 54 patients (10.4%). The age range was 8 to 75 years with a mean age of 33.5 years. Majority of the patients in our study belonged to 21 to 30 year age group (n=21). 36 were males, 18 were females. Midline nasal septum was seen in 31 patients, among them 14 had sinusitis and 17 showed clear sinuses. Right sided septal deviation was seen in 12 patients. Among them 11 had sinusitis and one patient showed clear sinuses. Left sided septal deviation was noted in 9 cases. Among them 6 had sinusitis and 3 showed no signs of sinusitis. S shaped septum was seen in 2 patients. Septal deviation with spur was seen in 3 patients. Sinusitis was seen in 14 patients with midline septum (45.1%). In 17 patients with midline septum there was no sinusitis (54.9%). Right sided septal deviation with associated sinusitis was seen in 11 of the total 12 cases. There was statistically significant association of septal deviation and sinusitis in our study.  

Conclusion: The association of midline nasal septum with sinusitis is seen in 44.1% of the cases in our study. The association of deviated nasal septum with sinusitis is seen in 81% of the cases in our study. There was statistically significant association of septal deviation with sinusitis (p value <0.05) in our study.


Keywords


Deviated Nasal Septum, Sinusitis, turbinate hypertrophy, sinonasal region.

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References


. Phillips CD, Platts-Mills TA. Chronic Sinusitis: Relationship between CT findings and clinical history of asthma, allergy, eosinophilia, and infection. AJR Am J Roentgenol. 1995; 164(1):185-187.

. Bhattacharyya N. The role of CT and MRI in the diagnosis of chronic rhinosinusitis. Curr Allergy Asthma Rep. 2010; 10(3):171-174.

. Kenny TJ, Duncavage J, Bracikowski J, Yildirim A, Murray JJ, Tanner SB. Prospective analysis of sinus symptoms and correlation with paranasal computed tomography scan. Otolaryngol Head Neck Surg. 2001; 125(1): 40- 43.

. Bhattacharyya T, Piccirillo J, Wippold FJ. Relationship between patient based descriptions of sinusitis and paranasal sinus CT. Arch Otolaryngol Head Neck Surg. 1997; 123(11):1189-1192.

. Stewart MG, Donovan DT, Parke RB, Bautista MH. Does the severity of sinus computed tomography findings predict outcome in chronic sinusitis. Otolaryngol Head Neck Surg. 2000; 123(1 pt 1):81-84.

. Ogunleye A O, Nwaorgu O G B, Lasisi A O, Ijaduola G T A. Trends of sinusitis in Ibadan, Nigeria. West Africa J Med. 1999; 18(4): 298-302.

. Kolo ES. The role of plain radiographs in the diagnosis of chronic maxillary rhinosinusitis in adults. Afr Health Sci. 2012; 12(4):459-463.

. Schwartz RH, Pitkaranta A, Winther B. Computed tomography imaging of the maxillary and ethmoid sinuses in children with short-duration purulent rhinorrhea. Otolaryngol Head Neck Surg. 2001; 124(2): 160-163.

. Nair S. Correlation between symptoms and radiological findings in patients of chronic rhinosinusitis: a modified radiological typing system. Rhinology. 2009; 47(2):181-186.

. Wang X J, Kim J, McWilliams R, Cutting G R. Increased prevalence of chronic rhinosinusitis in carriers of a cystic fibrosis mutation. Arch Otolaryngol Head Neck Surg. 2005; 131(3):237-240.

. Weir N, Golding-Wood D G. Infective rhinitis and sinusitis, in Scott-Brown's otolaryngology. 1997. London. Butterworth-Heinemann

. Lanza DC, Kennedy DW. Adult rhinosinusitis defined. Otolaryngol Head Neck Surg. 1997; 117(3 pt 2):S1-S7.

. Benninger MS, Ferguson BJ, Hadley JA. Adult chronic rhinosinusitis: definitions, diagnosis, epidemiology, and pathophysiology. Otolaryngol Head Neck Surg. 2003; 129(3 Suppl):S1-32.

. Jones NS, Strobl A, Holland I. A study of the CT findings in 100 patients with rhinosinusitis and 100 controls. Clin Otolaryngol. 1997; 22(1): 47-51.

. Bhattacharyya N, Fried MP. The accuracy of computed tomography in the diagnosis of chronic rhinosinusitis. Laryngoscope. 2003; 113(1):125-129.

. Buljcik-Cupic MM, Savovic SN. Endonasal endoscopy and computerized tomography in diagnosis of the middle nasal meatus pathology. Med Pregl. 2007; 60(7-8):327-332.

. Azila A, Irfan M, Rohaizan Y, et al. The prevalence of anatomical variations in osteomeatal unit in patients with chronic rhinosinusitis. Med J Malaysia 2011; 66:191–194

. Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. AJNR 2004; 25:1613–1618

. Fadda GL, Rosso S, Aversa S, et al. Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis. Acta Otorhinolaryngol Ital 2012; 32:244–251

. Beale TJ, Madani G, Morley SJ. Imaging of the paranasal sinuses and nasal cavity: normal anatomy and clinically relevant anatomical variants. Semin Ultrasound CT MR 2009; 30:2–16

. Smith KD, Edwards PC, Saini TS, Norton NS. The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent 2010; 2010: 404982.

. Stewart MG, Donovan DT, Parke RB, Bautista MH. Does the severity of sinus computed tomography findings predict outcome in chronic sinusitis. Otolaryngol Head Neck Surg. 2000 Jul; 123(1 Pt 1): 81-4.

. Kalogjera L. Rhinitis in adults. Acta Med Croatica. 2011; 65(2):181-187.

. Shin SH, Ye MK, Lee YH. Fungus culture of the nasal secretion of chronic rhinosinusitis patients: seasonal variations in Daegu, Korea. Am J Rhinol. 2007; 21(5):556-559

. Lund VJ, Mackay IS. Staging in rhinosinusitis. Rhinology. 1993; 31(4):183-184.




DOI: http://dx.doi.org/10.7439/ijbar.v8i11.4479

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