A PROSPECTIVE STUDY ON ASSOCIATION BETWEEN DEVIATED NASAL SEPTUM AND SINUSITIS AT ENT DEPARTMENT OF SKMCH, MUZAFFARPUR, BIHAR

Background: Chronic sinusitis (CS) is an extremely prevalent disorder. It affects up to two percent of the world population. It has a significant impact on the quality of life of people. Basically, the word “sinusitis‟ refers to a group of disorders characterized by inflammation of mucosa of nose and paranasal sinuses. Deviated Nasal septum is one of the most common disorder that presents up to 62% of the population. Its role in the pathogenesis of chronic sinusitis remains uncertain. Methods: Two groups were included in this study.Each group had 30 cases with Midline nasal septum & Deviated nasal septum. This study conducted in the Department. of ENT, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. The duration of the study was over a period of six months from August 2019 to January 2020. Results: We were studied two groups, 30 cases involved in group I of Midline nasal septum and in group II 30 cases involved with Deviated nasal septum. In this study we showed symptom & sign of rhinoscopy. In the group I, 14 cases had congested nasal mucosa followed by 10 cases of nasal discharge, 4 cases of inferior turbinate hypertrophy & 2 cases of Middle turbinate hypertrophy. Conclusions: that management of chronic maxillary sinusitis should include simultaneous treatment of any anatomical variation. For treating chronic sinusitis along with deviated nasal septum, nowadays treatment of choice is Septoplasty along with Functional Endoscopic Sinus Surgery (FESS). FESS technique is used for managing sinus infection and ostial obstruction.

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Anatomical variations in patients with chronic sinusitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180702 ◽

2018 ◽

Vol 4 (2) ◽

pp. 428 ◽

Cited By ~ 1

Author(s):

Pragadeeswaran Kumarasekaran ◽

Rajprakash Dharmapuri Yadhava krishnan ◽

Gurumani Sriraman

Keyword(s):

Nasal Septum ◽

Chronic Sinusitis ◽

Anatomical Variation ◽

Middle Turbinate ◽

Anatomical Variations ◽

Uncinate Process ◽

Sinus Surgery ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Anatomical Variant

Background: Chronic sinusitis is repeated bouts of acute infection or persistent inflammation of the sinuses. The range of anatomic variants that can interfere with the mucociliary drainage of osteomeatal complex including concha bullosa, deviated nasal septum, uncinate process variations, ethmoid bulla, paradoxical middle turbinate, agger nasi and Haller cells. This is also important in surgeon point of view to know about detail knowledge of lateral nasal wall, paranasal sinuses, surrounding vital structures and anatomical variation. Methods: Observational case series study in which 90 cases of chronic rhinosinusitis patients attending the ENT outpatient department from November-2015 to November-2016 in Shri Sathya Sai Medical college and Hospital, who had chronic sinusitis for more than three months duration not responding to the medical line treatment and who are willing to undergo functional endoscopic sinus surgery are studied and statistically analysed. Results: In our study we found anatomical variation in 93% of chronic sinusitis patients. In our study it was observed that 52% of patients with two anatomical variation, 41% patients presented with single anatomical variation and 7% patients presented with no anatomical variation. In our study deviated nasal septum was the most common anatomical variant noted followed by unilateral concha bullosa, medialized uncinate process, paradoxical middle turbinate, haller cell and agger nasi. Conclusions: In our study it was concluded that presence of anatomical variations is common in patients with chronic sinusitis. Presence of more than one anatomical variations significantly contributes to disease process. Deviated nasal septum is the most common anatomical variation in our study followed by concha bullosa, medialized uncinate process.

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The Impact of Middle Turbinate Concha Bullosa on the Severity of Inferior Turbinate Hypertrophy in Patients with a Deviated Nasal Septum

American Journal of Neuroradiology ◽

10.3174/ajnr.a4705 ◽

2016 ◽

Vol 37 (7) ◽

pp. 1324-1330 ◽

Cited By ~ 8

Author(s):

C. M. Tomblinson ◽

M.- R. Cheng ◽

D. Lal ◽

J. M. Hoxworth

Keyword(s):

Nasal Septum ◽

Middle Turbinate ◽

Inferior Turbinate ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy ◽

The Impact

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Study to Determine the Incidence of Allergic Fungal Sinusitis among Patients with Nasal Polyps and Its Related Risk Factors

10.53350/pjmhs211571860 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1860-1863

Author(s):

Bakht Zada ◽

Ejaz Ahmed ◽

Muhammad Habib ◽

Zafar Iqbal ◽

Rehan Saleem ◽

...

Keyword(s):

Risk Factors ◽

Nasal Septum ◽

Nasal Polyps ◽

Bone Erosion ◽

Histopathological Examination ◽

Sinus Surgery ◽

Fungal Sinusitis ◽

Deviated Nasal Septum ◽

Allergic Fungal Sinusitis ◽

Turbinate Hypertrophy

Aim: To govern the incidence of allergic fungal sinusitis in patients with nasal polyposis. Various anatomical risk factors were also investigated, including turbinate hypertrophy, deviated nasal septum and comorbidities such as asthma and diabetes. Study Design: This is a Descriptive cross-sectional study. Place and duration of study:The study was conducted at ENT Head &Neck Surgery department, Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for the duration of six months from May 2020 to October 2020. Methods: 110 patients with nasal polyps were evaluated and operated on. Samples were sent for histopathological examination and culture. All patients were assessed with clinical examination and detailed history. Laboratory tests were performed including complete blood counts, urea, electrolytes, ECG and chest radiographs for the suitability of general anesthesia as a prerequisite for surgery. In 95% of cases, computed tomography was recommended to check for sinus involvement, bone erosion, osteo-hypertrophic complex, turbinate hypertrophy, nasal septal deviation, and intracranial and intra-orbital enlargement. MRI examinations were also recommended in cases of suspected intraocular and intracranial disease (5%). Data was scrutinized on a computer using SPSS version 22.0. Results:Of the 110 patients, 65 were male and 45 were female, with a mean age of 1and ranged from 7 to 80 years. All patients had nasal polyps. The incidence of AFS was approximately 29.1% and the remaining 78 had a different pathology. Major deviation of the nasal septum and bilateral hypertrophy of the inferior turbinate’s were observed in 6 (18.7%) and 4 (12.5%) patients, respectively. Unilateral nasal polyps were observed in 7 (21.9%) patients and bilateral nasal polyps in 18 (52.3%). 19/32 (59.4%) of the cases underwent functional endoscopic surgery of the paranasal sinuses, and in 6 (18.7%) external fronto-ethmoidectomy. Two patients underwent nasal ethmoidectomy. Septoplasty and endoscopic sinus surgery were performed in a total of 3 (9.37%) cases. Key words:Allergic bronchopulmonary aspergillosis (ABPA), Allergic fungal sinusitis (AFS).

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Radiological significance of the sinonasal anatomical variants in recurrent acute rhinosinusitis patients

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20172121 ◽

2017 ◽

Vol 5 (6) ◽

pp. 2379

Author(s):

Niranjan Sahu ◽

Satya Sundar G. Mohapatra ◽

Siba N. Rath ◽

Rabindra N. Padhy

Keyword(s):

Nasal Septum ◽

Middle Turbinate ◽

Uncinate Process ◽

Sinus Surgery ◽

Concha Bullosa ◽

Deviated Nasal Septum ◽

Anatomical Variants ◽

Acute Rhinosinusitis ◽

Computed Tomography Images ◽

Osteomeatal Complex

Background: Recurrent acute rhinosinusitis (RARS), a low form chronic rhinosinusitis is frequently under evaluated. The significance of sinonasal anatomical variants of osteomeatal complex (OMC) and spheno-ethmoidal (SE) recess regions in patients of RARS is assessed.Methods: Retrospective analysis of coronal sinonasal computed tomography images of 120 RARS patients presented with sinonasal anatomical variants during November 2013 to October 2016 was carried out. Patients with acute and expansile sinonasal lesions are excluded.Results: Sinonasal anatomical variants in the regions of OMC and SE recess are responsible for obstruction of normal mucociliary drainage of corresponding paranasal sinuses in presence of inflammation predisposing to RARS. Anatomical variants of nasal septum were, deviated nasal septum (DNS) in 86 (72%) and septal spur in 58 (48%) patients. Anatomical variants in OMC region were, pneumatized middle turbinate (concha bullosa) in 50 (48%), paradoxical middle turbinate in 38 (28%), giant ethmoid bulla in 35 (32%), agger nasi cell in 29 (38%), Haller cell in 23 (15%), pneumatised uncinate process in 20 (18%), medialized uncinate process in 18 (22%) and septated maxillary sinus in 5 (4%) patients. Anatomical variants in SE recess were superior concha bullosa in 14 (12%) and septal bullosa in 11 (9%) patients.Conclusions: OMC pattern of recurrent rhinosinusitis is often prevalent in patients of RARS due to abundance of anatomical variants in the OMC region. DNS or ethmoid bulla when gets associated with concha bullosa increased the incidence of RARS. Present analysis would help surgeons to evaluate RARS patients for selective endoscopic sinus surgery.

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

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v21i2.27646 ◽

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

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Prospective evaluation of chronic rhinosinusitis with reference to anatomical variation

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200145 ◽

2020 ◽

Vol 6 (2) ◽

pp. 326

Author(s):

Sindhura . ◽

Mamatha Devi Kandipilli ◽

Ali Shaik ◽

Venkata Ramana

Keyword(s):

Chronic Rhinosinusitis ◽

Anatomical Variation ◽

Medical Science ◽

Middle Turbinate ◽

Anatomical Variations ◽

Final Diagnosis ◽

Sinus Surgery ◽

Nasal Endoscopy ◽

Deviated Nasal Septum ◽

A Prospective Study

Background: Rhinosinusitis is one of the commonest sinonasal condition with chronic Rhinosinusitis affecting 10% of population worldwide. Although the diagnosis of chronic rhinosinusitis is clinical, the final diagnosis should be confirmed by objective measures like radiography and nasal endoscopy. Though anatomical variations in sinonasal region are rare, they have significant impact in the causation of sinonasal diseases and pose difficulties during surgery.Methods: This was a prospective study conducted on 60 patients who attended to the Department of ENT and HNS, Konaseema Institute of Medical Science, Amalapuram between December 2017 to July 2019. By considering AAO-HNS criteria patients were selected and subjected to high resolution computerized tomography para nasal sinuses and diagnostic nasal endoscopy. Results: As per study, 60% patients are having deviated nasal septum, followed by aggar nasi in 58.3%, concha bullosa in 26.8%, Haller cells in 11.7%, paradoxical middle turbinate in 11.7%, uncinate pneumatisation in 5%, and onodi cells in 5% of cases.Conclusions: Anatomical variations in sinonasal cavity predispose to chronic rhinosinusitis and hence require correction. Also, detecting these variations preoperatively by computed tomography of paranasal sinus helps in avoiding complications during functional endoscopic sinus surgery.

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Bilateral Antrochoanal Polyps: An Analysis from Four Cases

Journal of Postgraduate Medicine Education and Research ◽

10.5005/jp-journals-10028-1213 ◽

2016 ◽

Vol 50 (4) ◽

pp. 173-175

Author(s):

Prachi Jain ◽

Lokesh K Penubarthi ◽

Eshaan Kaushik

Keyword(s):

Nasal Septum ◽

Close Association ◽

Inferior Turbinate ◽

Sinus Surgery ◽

Easy Access ◽

Rare Entity ◽

Deviated Nasal Septum ◽

Turbinate Hypertrophy ◽

Inferior Turbinate Hypertrophy

ABSTRACT Bilateral antrochoanal polyps (ACPs) are a rare entity. We studied four cases of bilateral ACPs that presented to us. We found a close association of allergy (75%) and chronic rhinosinusitis (CRS) (50%) as etiological factors. The anatomical factors like deviated nasal septum (75%), inferior turbinate hypertrophy (50%), and concha bullosa (25%) are also commonly associated with bilateral ACPs. Endoscopic sinus surgery was performed in all the patients with special emphasis to correct the anatomical factors. Inferior meatal antrostomy was performed in two cases to allow easy access of the angled microdebrider blade for clearing the polyp from the anterolateral and anterosuperior limits of the antrum. After a mean follow-up period of 23 months, no recurrence was found. How to cite this article Virk RS, Penubarthi LK, Gupta AK, Jain P, Kaushik E. Bilateral Antrochoanal Polyps: An Analysis from Four Cases. J Postgrad Med Edu Res 2016;50(4):173-175.

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Nasal endoscopic evaluation of patients presenting with frontal headache

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195704 ◽

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

Background: 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.Methods: 100 patients with frontal headache underwent diagnostic nasal endoscopy and all anatomic variations and pathological abnormalities were notedResults: 83% cases had a diagnosis of deviated nasal septum or rhinosinusitis, and the rest 17% had non sinonasal cause for headacheConclusions: 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.

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COMPUTED TOMOGRAPHIC EVALUATION OF INFERIOR TURBINATE HYPERTROPHY IN ADULT INDO-DRAVIDIAN PATIENTS WITH DEVIATED NASAL SEPTUM

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2017.v10i7.18083 ◽

2017 ◽

Vol 10 (7) ◽

pp. 342

Author(s):

Niranjan Sahu ◽

Satyasundar G Mohapatra ◽

Siba Narayan Rath ◽

Rabindra Nath Padhy

Keyword(s):

Nasal Septum ◽

Inferior Turbinate ◽

Septal Deviation ◽

Total Width ◽

Deviated Nasal Septum ◽

Maximum Width ◽

Turbinate Hypertrophy ◽

Group I ◽

Group Ii ◽

Inferior Turbinate Hypertrophy

Objective: Aim of the study was to evaluate the prevalence and significance of inferior turbinate hypertrophy (ITH) in adult indo-dravidian patients with deviated nasal septum (DNS). Methods: Analysis of sinonasal computerized tomography (CT) images of 86 patients having DNS was done during October 2015-December 2016 for evaluation of severity of the associated ITH. Values of maximum width of medial mucosa, bone and total width of the turbinate were measured. Patients with inflammatory or expansile sinonasal masses were excluded. Results: Total 86 patients with varying degrees of septal deviation with ages ranging from 18 to 72 years (mean age of 42.8 years) were distributed as: Group I, mild cases and Group II, moderate and severe DNS cases. Patients having ITH on the contralateral side of deviation were included in the study group. The dimensions of the ITH were evaluated. The medial mucosal component of the ITH underwent maximum hypertrophy as compared to bone and lateral mucosa components. The average medial mucosa, bone and total turbinate widths of the inferior nasal concha as well as lateral offset in Group II DNS cases were 5.21 mm, 1.76 mm, 9.96 mm and 8.74 mm, respectively. Total width and width of medial mucosa of ITH in relation to the severity of septal deviation was statistically significant (p=0.0001 and 0.0098). Conclusion: Present study evaluated the relationship between DNS and compensatory ITH. The findings support the decision to excise the inferior turbinate at the time of septoplasty, because of the significant mucosal expansion.

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Significance of relationship between anatomical variants of middle turbinate and nasal septum in recurrent acute rhinosinusitis patients

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20172075 ◽

2017 ◽

Vol 3 (3) ◽

pp. 569

Author(s):

Satya Sundar G. Mohapatra ◽

Niranjan Sahu ◽

Siba N. Rath ◽

Mahesh C. Sahu ◽

Rabindra N. Padhy

Keyword(s):

Nasal Septum ◽

Tertiary Care ◽

Middle Turbinate ◽

Septal Deviation ◽

Transverse Diameter ◽

Deviated Nasal Septum ◽

Anatomical Variants ◽

Acute Rhinosinusitis ◽

Group I ◽

History Of

Background: Aim of the study was to evaluate the significance of relationship between anatomical variants of middle turbinate and nasal septum, and role for the causation of recurrent acute rhinosinusitis (RARS) in a tertiary care teaching hospital.Methods: Retrospective analysis of sinonasal computerized tomography (CT) images of 160 patients with history of RARS during August 2015 to December 2016 was done for evaluation of concha bullosa (CB) and paradoxical middle turbinate (PMT) associated with deviated nasal septum (DNS). Measurements of CB, PMT and septal deviation angles were recorded. Patients with acute and expansile paranasal sinus diseases were excluded.Results: Of the total 160 RARS cases with DNS, 120 cases had unilateral (contralateral and ipsilateral) and bilateral (dominant and similar sized) CB, and were distributed into group I (contralateral and dominant) and group II (ipsilateral and similar sized bilateral) basing on the direction of septal convexity. Maximum transverse diameter of CB (MTDCB) and septal deviation angle values were highly significant (p =0.0001) in group I CB cases. Direction of septal convexity had no significance (58 to right and 62 to left) in relation to CB pneumatization. Septal deviation severity in group I CB cases was highly significant (p =0.0001). The fraction of 40 unilateral and bilateral PMT cases revealed no significance (p =0.45) with severity of DNS.Conclusions: Anatomical variants of middle turbinate associated with DNS caused increased prevalence of OMC pattern RARS. Contralateral and dominant CBs had shown relationship in direct proportion to the severity of septal deviation contributing to recurrent rhinosinusitis.

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