EFFECT OF SEPTAL DEVIATION ON PARANASAL SINUS ANATOMY

Objective: To investigate the effect of septal deviation on the important paranasal structures and sinus volumes. Methods: Paranasal computed tomography (CT) scans of 133 patients with septum deviation (67 males, 66 females; age over 18 years) were retrospectively evaluated. Frontal, ethmoid and maxillary sinus volumes, ostiomeatal complex, sphenoethmoid recess and frontoethmoid recess diameters in deviated side contralateral side were compared and concha bullosa(CB) formation was evaluated. Results: Deviation angles varied between 2,7 and 21,5 degrees with a mean value of 9,7±4,1.The mean wide of osteomeatal complex and frontoethmoideal recess diameter diameter was significantly smaller in deviated side than contralateral side (p< 0,001). The mean ethmoid sinus volume was significantly smaller in deviated side than contralateral side (p<0,001).Wide of sphenoethmoideal recess, maxillary sinus volume, frontal sinus volume were not significantly different between deviated and contralateral side(p>0,001).CB were found in 90 (67%) cases, of which 55 (61%) were bilateral and 35 (39%) were unilateral. 43 CB were found in the deviated side and 47 (53%) CB were found in contralateral side (p>0,001). The presence of concha bullosa in deviated side did not have a significant effect on the volume of frontal sinus and frontoethmoid recess diameter (p> 0,001). Conclusion: The ostiomeatal complex diameter, frontoethmoid recess diameter and ethmoid cell volume were found to be smaller in deviated side of the septum.Therefore rhinologic surgeons should be aware of the increased risk of surgical approach in deviated side.

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