scholarly journals Influence of anatomic variations of the middle nasal meathus on sinonasal diseases

2008 ◽  
Vol 61 (3-4) ◽  
pp. 135-141 ◽  
Author(s):  
Maja Buljcik-Cupic ◽  
Slobodan Savovic ◽  
Jasna Jovicevic
Keyword(s):  
Data Processing ◽  
Chronic Rhinosinusitis ◽  
Correlation Coefficient ◽  
Nasal Septum ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Lateral Nasal Wall ◽  
Anatomic Variations ◽  
Duration Of Symptoms ◽  
Middle Nasal Meatus

Introduction The most common anatomic variations of the structures of the middle nasal meatus are variations of agger nasi cells, variations of the middle turbinate, variations of uncinate process, variations of the ethmoidal bulla, deviations and deformations of nasal septum in the region of the middle nasal meatus, Haller's cell (orbitoethmoidal) and Onodi's cell(sphenoethmoidal cell). In 1997, the Otorhinolaryngology-Head Neck Surgery, Tasc Force on Chronic Rhinosinusitis defined chronic sinusitis and nasal disease initially by including sinusitis and rhinitis with one term-chronic rhinosinusitis. This was done because it was apparent to many that nasal disoders often affected the sinuses, and vice versa. Also they established baseline parameters, major and minor signs and symptoms, for definition of rhinosinusitis. Two major factors or one major factor and two minor factors constitute a strong history for rhinosinusitis. Material and methods The following methods were used in the study: 1. Anamnestic data processing about: disease symptoms that were recognired by American Academy for ENT as major and minor criteria in diagnosing nosinusitis; the duration of symptoms; the kind of sinonasal disorder and the secondary disorders. 2. Data processing obtained by anterior/posterior rhinoscopy. 3. Data processing obtained by endoscopic examination. 4. Data processing obtained by CT of paranasal cavities and the nose. The data about anatomic variations were statistically processed by Eives's correlation coefficient that indicates the degree of correlation between sinonasal disorders and anatomic variation. Results By analyzing the obtained data in the examined patients with sinonasal disorders, anatomic variations were present in over 50% of the patients and are defined by percentage. I. The deviation of nasal septum in 83.33% patients. 2. The variations of the form of the middle nasal chonha in 58.92% patients. 3. The presence of agger nasi cells in 50% patients. 4. Variations of the form of ethomoidal bulla in 50% patients. Eives's correlation coefficient i.e. the degree of correlation between sinonasal disorders and the presence of anatomic variation statistically significantly correlate at r >/= ft 05 of anatomic variation of the middle nasal chonha (r =0.23) and the presence of deviation/deformation of nasal septum (r = 0.6) with sinonasal disorders. Discussion and conclusion Anatomic variations of the structures of the middle nasal meatus can additionally complicate the anatomy of the lateral nasal wall and the conditions of the ostiomeatal unit. Therefore we must view these variations as factors predisposing to more rapid and frequent appearance and persistence of chronic inflammations. Also, familiary with the variations in sinonasal anatomy is a prerequisite to safe and effective surgical treatment of sinonasal disease. Recognition of this anatomic variation should minimize catastrophic violation of vital structures such as orbit or skull base.

scholarly journals Large Doubly Septated Concha Bullosa: An Unusual Anatomic Variation

2009 ◽  
Vol 52 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Aleksandar Perić ◽  
Svjetlana Matković-Jožin ◽  
Nenad Baletić
Keyword(s):  
Nasal Obstruction ◽  
Rare Case ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Lateral Nasal Wall ◽  
Middle Meatus ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Frontal Recess ◽  
Different Sources

Partial or total pneumatization of the middle turbinate is called concha bullosa. It’s one of the most common anatomic variations of the lateral nasal wall. The exact reason of such pneumatization is not known. It can originate from the frontal recess, middle meatus, sinus lateralis or, less frequently, from the posterior ethmoid cells. Concha bullosa remains usually asymptomatic. However, an extensively pneumatized middle turbinate may constitute space-occupying mass, and thus, it may cause nasal obstruction. We report an extremely rare case of a patient with a large, doubly septated concha bullosa with four different sources of aeration.

scholarly journals CT Evaluation of Anatomical Variations in Osteomeatal Complex in Patients with Deviated Nasal Septum

2016 ◽  
Vol 21 (2) ◽  
pp. 90-93
Author(s):  
Mirza Aneesa ◽  
Sajad Majid Qazi ◽  
Aijazul Haq
Keyword(s):  
Paranasal Sinuses ◽  
Nasal Septum ◽  
Complex Disease ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Inferior Turbinate ◽  
Anatomical Variations ◽  
Lateral Nasal Wall ◽  
Deviated Nasal Septum ◽  
Osteomeatal Complex

Background:The presence of septal deviation has been positively associated with sinus disease, especially osteomeatal complex disease and anterior and posterior ethmoid disease.Computerized tomographic imaging (CT) of the paranasal sinuses has become a widely accepted tool for assessing the paranasal sinuses (PNS) and providing a detailed anatomy of the lateral nasal wall.Objective:The objective of the study was to identify the anatomical variations of lateral nasal wall and paranasal sinuses in patients with Deviated nasal septum.Methods:Computerized tomographic (CT) examination was carried out using the bone algorithm in the coronal plane in 40 patients who met the inclusion criteriain the Postgraduate Department of Otorhinolaryngology and Head and Neck Surgery, SMHS Hospital an associated Hospital of Government Medical College, Srinagar from March 2011 to May 2012.Results:In our study, CT Nose and PNS revealed Deviated nasal septum in 40 (100%) patients, Hypertrophied Inferior turbinate in 11 (27.50%) patients, Concha bullosa in 5 (12.50%) patients, Paradoxical Middle turbinate in 8 (20%) patients, Everted Hypertrophied Uncinate in 2 (5%) patients, Aggernasi cells in 4 (10%) patients, Haller cells in 3 (7.50%) patients and Onodi cells in 2 (5%) patients.Conclusion:The most common anatomical variation associated with deviated nasal septum was Hypertrophied Inferior turbinate and the least encountered variation was Everted Hypertrophied Uncinate and Onodi cells. The CT scan provides supplementary clinical data to the history and endoscopic examination and assists in directing surgical treatment to the affected areas.Bangladesh J Otorhinolaryngol; October 2015; 21(2): 90-93

scholarly journals Retroverted Uncinate Process: An Anatomic Variation

2009 ◽  
Vol 24 (2) ◽  
pp. 40 ◽  
Author(s):  
Armando T. Isla ◽  
Josefino G. Hernandez
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Uncinate Process ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Anatomic Variations ◽  
Intelligent Decision Making ◽  
Intelligent Decision ◽  
Ct Analysis

Considerable attention has been directed toward analysis of paranasal sinus anatomy through coronal plane computerized tomographic (CT) imaging in this age of functional endoscopic sinus surgery.  Recently, it has become apparent that anatomic variations are also evident on CT analysis of patients.  Subtle anatomic features can now be imaged through CT, with a level of clarity previously not afforded by standard sinus radiographs.1         The key to a successful endoscopic sinus surgery is the proper identification of landmarks, and intelligent decision-making should there be any doubts as to what structure lies ahead.  The middle turbinate is the main landmark in the region and should be preserved if possible.  Attention to the limits of the middle turbinate landmark is one of the keys to uncomplicated surgery.2   The presence of a retroverted uncinate process, wherein the uncinate process ( rather than the middle turbinate) is the first bone to encountered, can be misleading to the rhinologic surgeon and lead to inadequate surgery.  Familiarity with anatomic variations such as the retroverted uncinate process should increase the safety and effectiveness of functional endoscopic sinus surgery.  

scholarly journals Concha Bullosa in Paradoxical Middle Turbinate: A New Variation

2016 ◽  
Vol 9 (3) ◽  
pp. 141-142 ◽  
Author(s):  
Mohammad W El-Anwar ◽  
Ahmed I Ali
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Laboratory Tests ◽  
Anatomic Variation ◽  
Middle Turbinate ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Normal Limits ◽  
Osteomeatal Complex ◽  
The Right

ABSTRACT Introduction Concha bullosa is the most common anatomic variation of osteomeatal complex region that is generally seen in the middle turbinate (MT). Materials and methods A 25-year-old male presented with headache and nasal obstruction. Computed tomography (CT) scan documented right paradoxical MT. The right MT also showed aerated concha bullosa with narrow right osteomeatal area. Routine preoperative laboratory tests were within normal limits. Results This case of concha bullosa in paradoxically bent MT was reported, described, and could be safely managed endoscopically. Patient was symptom free up to date without any complication, recurrence, or other pathology. Conclusion Computed tomography may easily identify such uncommon anatomic variations of the osteomeatal region. This directs the surgeon attention to these variations as a cause of headache and osteomeatal area obstruction. How to cite this article El-Anwar MW, Ali AI. Concha Bullosa in Paradoxical Middle Turbinate: A New Variation. Clin Rhinol An Int J 2016;9(3):141-142.

Septal Deviation and Chronic Sinus Disease

2000 ◽  
Vol 14 (3) ◽  
pp. 175-180 ◽  
Author(s):  
Mohammed M Elahi ◽  
Saul Frenkiel
Keyword(s):  
Paranasal Sinus ◽  
Computerized Tomography ◽  
Nasal Septum ◽  
Middle Turbinate ◽  
Septal Deviation ◽  
Lateral Nasal Wall ◽  
Sinus Disease ◽  
Ostiomeatal Complex ◽  
Anatomic Variants ◽  
Paranasal Sinus Disease

The introduction of computerized tomography in the identification of sinonasal pathology and associated anatomic variants has contributed to a greater understanding of the factors leading to ostiomeatal complex (OMC) obstruction and chronic sinus disease. The OMC and paranasal sinus regions were prospectively evaluated in 150 consecutive patients as a function of the degree of nasal septal deviation and compared with matched controls. These data were correlated with paranasal sinus disease, lateral nasal wall findings, and middle turbinate abnormalities. An increased incidence and severity of bilateral chronic sinus disease was present with increasing septal deviations (p < 0.05). Similarly, patients with increasing nasal septum deviations were noted to have a higher incidence of OMC obstruction (p < 0.05). Ostiomeatal complex obstruction in the direction of septal angulation was associated with nasal septal deformity; however, contralateral OMC obstruction was associated with middle turbinate and lateral nasal wall abnormalities (p < 0.05). The evaluation of the degree of septal angulation has helped better understand the factors contributing to chronic sinus disease and OMC obstruction.

scholarly journals ANATOMIC VARIATION OF CT SCAN IN CHRONIC RHINOSINUSITIS PATIENTS IN SANGLAH PROVINCIAL GENERAL HOSPITAL

2019 ◽  
Vol 12 (04) ◽  
pp. 2083-2086
Author(s):  
Luh Made Ratnawati ◽  
I Putu Yupindra Pradiptha
Keyword(s):  
General Hospital ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Anatomic Variation ◽  
Anatomical Variation ◽  
Operative Procedure ◽  
Septal Deviation ◽  
Anatomic Variations ◽  
Ostiomeatal Complex ◽  
Nose And Paranasal Sinuses

The anatomical abnormalities of the nose and paranasal sinuses are the most common causes of rhinosinusitis. These anatomical variations can cause obstruction of the ostiomeatal complex (OMC) and interfere with the mucociliary clearance which allows the occurrence of chronic rhinosinusitis. Knowing the anatomic variations of the nose and paranasal sinuses in rhinosinusitis patients whose undergo operative procedure at Sanglah Provincial General Hospital is important because it can be used as a reference for proper intervention to treat rhinosinusitis. This research is a descriptive study in the Ear Nose Throat - Head Neck Departement, Udayana University Medical School / Sanglah Provincial General Hospital Denpasar, from January 2018 to December 2018. The research location is at the ENT clinic, Sanglah Hospital, Denpasar. This research will be conducted in approximately 2 months (January 2019 to February 2019). The sample from this study was all rhinosinusitis patients who underwent operative procedure, both male and female for the period of 1 January – 31 December 2018. Based on the results of the research data, it was found that the most anatomic variation was septal deviation which was 24 people Anatomic variations cause chronic sinusitis by causing obstruction in the ostiomeatal complex (OMC) and affecting the mucociliary transport pattern. The most anatomical variation in this study is septal deviation.

scholarly journals Nasal endoscopic evaluation of patients presenting with frontal headache

2019 ◽  
Vol 6 (1) ◽  
pp. 137
Author(s):  
Lakshmi Menon Ravunniarth ◽  
G. K. Narayana
Keyword(s):  
Nasal Septum ◽  
Mucociliary Clearance ◽  
Chronic Sinusitis ◽  
Middle Turbinate ◽  
Anatomic Variations ◽  
Concha Bullosa ◽  
Endoscopic Evaluation ◽  
Deviated Nasal Septum ◽  
Common Cause ◽  
Ethmoidal Bulla

<p class="abstract"><strong>Background:</strong> Headache is a universal symptom affecting most people at some point in their lifetime. The most common cause of headache in ENT is acute sinusitis or an acute exacerbation of chronic sinusitis. Anatomic variations like a massive concha bullosa, enlarged ethmoidal bulla, laterally rotated uncinate can interfere with mucociliary clearance. Thus, a thorough nasal endoscopic evaluation will help us to detect any anatomic abnormality which may predispose to sinogenic headache.</p><p class="abstract"><strong>Methods:</strong> 100 patients with frontal headache underwent diagnostic nasal endoscopy and all anatomic variations and pathological abnormalities were noted</p><p class="abstract"><strong>Results:</strong> 83% cases had a diagnosis of deviated nasal septum or rhinosinusitis, and the rest 17% had non sinonasal cause for headache</p><p class="abstract"><strong>Conclusions:</strong> Anatomic abnormalities like middle turbinate anomaly, spur, enlarged bulla, hyperplastic uncinate and pathological abnormality like mucopurulent discharge, polypi can be diagnostic of sinogenic cause for frontal headache.</p>

scholarly journals A computed tomography and endoscopy assisted study of the anatomical variations of lateral wall of nose in patients of chronic rhinosinusitis- our experience at a tertiary care centre

2017 ◽  
Vol 3 (2) ◽  
pp. 327
Author(s):  
Shashidhar S. Suligavi ◽  
Afshan Fathima ◽  
Mallikarjun N. Patil ◽  
S. S. Doddamani
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Chronic Rhinosinusitis ◽  
Task Force ◽  
Anatomic Variation ◽  
Intraoperative Complications ◽  
Tertiary Care ◽  
Middle Turbinate ◽  
Lateral Wall ◽  
Anatomical Variations

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Chronic rhinosinusitis (CRS) is a common and persistent illness that ENT surgeons encounter in their day to day practice. The lateral wall of the nose contains the ostiomeatal unit which is the key area targeted in the management of CRS. The lateral wall of nose shows several variations which can alter the course of the disease. It is of utmost importance for the ENT surgeon to be aware of these variations as they decide the overall line of management. The objectives of the study was to study the anatomical variations of the lateral wall of nose using computed tomography (CT) scans and nasal endoscopy in patients of chronic rhinosinusitis.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A one year study from April 2015 to March 2016 involving 50 patients attending the ENT outpatient department clinically diagnosed as CRS using the criteria of task force on rhinosinusitis were included in the present study. Patients underwent a CT scan and DNE and the anatomical variations of the lateral wall of nose were studied.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Concha bullosa was the most common anatomic variation noted in 20 (40%) of the total 50 patients. The other anatomic variations noted were uncinate process variations in 15(30%) patients, agger nasi cells in 3 (6%) patients, hypoplastic middle turbinate in 1 (2%) patient, paradoxical middle turbinate in 2(4%) patients, bulla ethmoidalis in 4 (8%) patients and Haller cells in 1 (2%) patient. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The lateral wall of nose is made up of several structures showing variations which can lead to the development CRS and affect the overall management. They should be evaluated pre-operatively in order to avoid intraoperative complications. CT scan and DNE both complement each other and effectively evaluate the anatomical variations of the lateral wall of nose.</span></p>

Anatomic Variations of the Lateral Nasal Wall in the Computed Tomography Scans of Patients with Chronic Rhinosinusitis

2001 ◽  
Vol 15 (6) ◽  
pp. 371-375 ◽  
Author(s):  
Antoni Krzeski ◽  
Ewa Tomaszewska ◽  
Iwona Jakubczyk ◽  
Anna Galewicz–Zielińska
Keyword(s):  
Computed Tomography ◽  
Chronic Rhinosinusitis ◽  
Lateral Nasal Wall ◽  
Anatomic Variations ◽  
Computed Tomography Scans

scholarly journals Bilateral Triple Concha Bullosa: A Very Rare Anatomical Variation of Intranasal Turbinates

2014 ◽  
Vol 2014 ◽  
pp. 1-2 ◽  
Author(s):  
Turhan San ◽  
Selma San ◽  
Emre Gürkan ◽  
Barış Erdoğan
Keyword(s):  
Paranasal Sinus ◽  
Anatomic Variation ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Etiologic Factor ◽  
Lateral Nasal Wall ◽  
Concha Bullosa ◽  
Superior Turbinate ◽  
Negative Effect ◽  
Air Cells

Pneumatization of the intranasal turbinates or concha bullosa is an anatomic variation of the lateral nasal wall. Concha bullosa is defined as the presence of air cells in turbinates. It can be best diagnosed with paranasal sinus computed tomography. Concha bullosa is a possible etiologic factor for recurrent sinusitis due to its negative effect on paranasal sinus ventilation and mucociliary clearance. Concha bullosa is most commonly seen in the middle turbinate and less frequently in the inferior or superior turbinate. Pneumatization of all turbinates is very rare. To our knowledge, there are only two publications about a case with concha bullosa in all turbinates in the current literature. Here, we present a woman with bilateral pneumatization in all three intranasal turbinates.

Sign in / Sign up

Export Citation Format

Share Document