Long-term assessment of conventional and mini-screw–assisted rapid palatal expansion on the nasal cavity

ABSTRACT Objectives To evaluate the long-term effects of mini-screw–assisted rapid palatal expansion (MARPE), rapid palatal expansion (RPE), and controls on the nasal cavity with cone-beam computed tomography (CBCT). Materials and Methods A total of 180 CBCT scans that were part of a previous randomized trial were evaluated retrospectively for 60 patients at pretreatment (T1), postexpansion (T2), and posttreatment (T3). Patients were randomly assigned into 3 groups: MARPE, RPE, and controls (time period T1 to T3; MARPE: 2 years 8 months; RPE: 2 years 9 months; control: 2 years 7 months). Nasal height, nasal length, nasion–ANS height, ANS–PNS length, pyriform height, and nasal septal deviation angle were measured. The changes in alar width, alar base width, anterior nasal cavity width, posterior nasal cavity width, maxillary intermolar width, and maxillary intercanine width were also evaluated. Results The alar base width, posterior nasal cavity width, anterior nasal cavity width, maxillary intercanine width, and maxillary intermolar width significantly increased (P < .05), and the nasal septal deviation angle significantly decreased (P < .05) in both the MARPE and RPE groups as compared with controls in the short term. In the long term, the nasal septal deviation angle was significantly decreased (P < .05) in the MARPE and RPE groups as compared with controls, and the posterior nasal cavity width was significantly increased (P < .05) in the MARPE group compared with the RPE group and controls. Conclusions MARPE and RPE led to a significant increase in the nasal cavity and alar base width compared with controls in the short term. In the long term, a significant increase was observed only in the posterior nasal cavity width with MARPE. Both MARPE and RPE led to a minimal decrease in nasal septal deviation angle in comparison with controls.

Radiological study of the nasal septal body

Objectives The nasal septal body (NSB) is the thickened area of the septum located superior to the inferior turbinates and anterior to the middle turbinates. NSB contributes to nasal breathing via functionally and anatomically. The aim of the present study was to analyze NSB size and its association with such variables as age, septal deviation, and nasal turbinate size Material and Methods This retrospective study included 381 randomly selected patients that underwent paranasal sinus CT between 2014 and 2019. NSB size, septal deviation angle, and middle and inferior turbinate size were analyzed. Results NSB, inferior turbinate, middle turbinate, and inferior turbinate-P were significantly smaller on the deviated side. NSB, inferior turbinate, middle turbinate, and inferior turbinate-P size according to nasal septal angle was also significantly smaller on the deviated side. NSB and inferior turbinate size was positively correlated. Conclusion The NSB is an important structure for the regulation of air flow in the nose and should be evaluated in routine examination of the nose especially before the nasal surgery.

The effect of concha bullosa and nasal septal deviation on palatal dimensions: a cone beam computed tomography study

Introduction Nasal septal deviation (NSD) and concha bullosa (CB) are associated with airway obstruction in mouth breathers. Mouth breathing is associated with alterations in maxillary growth and palatal architecture. The aim of our study was to determine the effect of the presence of CB and NSD on the dimensions of the hard palate using cone-beam computed tomography (CBCT). Materials and methods A retrospective study was conducted using CBCT scans of 200 study subjects. The study subjects were divided into four groups based on the presence of CB and NSD. Septal deviation angle (SDA), palatal interalveolar length (PIL), palatal depth (PD) and maxillopalatal arch angle (MPAA) were measured in the study groups. Results The presence of NSD and CB was associated with significant (p < 0.001) differences in the palatal dimensions of the study subjects. The PIL and MPA (p < 0.001) were significantly reduced (p < 0.001), whereas the PD was significantly increased (p < 0.001) in study subjects with NSD and CB. There was no significant change in the palatal dimensions between the unilateral and bilateral types of CB. Among the palatal dimensions, the PIL had the most significant association (R2 = 0.53) with SDA and CB. There was a significant correlation between the palatal dimensions and SDA when CB was present along with NSD. Conclusion Based on the results of this study, it can be concluded that the presence of NSD and CB have a significant effect on the palatal dimensions and, therefore, they may be associated with skeletal malocclusion.

Association of nasal septal deviation with the incidence of anxiety, depression, and migraine: A national population-based study

Background & aims Nasal obstruction caused by nasal septal deviation is very bothersome and, therefore, can affect the patient’s emotional state. However, little is known about the effect of nasal septal deviation (NSD) on the neuropsychiatric aspects of patients. Therefore, this study aims to verify the higher incidence of anxiety, depression, and migraine in patients diagnosed with NSD compared to general populations using big data. Methods This retrospective cohort study collected subjects from the Korean National Health Insurance Service (NHIS) database. Adjustments were made to minimize the confounding of variables for age, sex, residence type, income levels, hypertension, diabetes, dyslipidemia, rhinitis, and chronic rhinosinusitis between the two groups. The primary endpoint of this study was newly diagnosed anxiety, depression, and migraine between January 2009 and December 2018. Kaplan-Meier survival curves, logarithmic rank test, and Cox proportional regression test were used for statistical analysis. Results Among a total of 135,769 subjects in the NHIS database, 48,495 patients with NSD (NSD group) and 54,475 control subjects (control group) were selected. Patients with NSD had an increased risk of anxiety, depression, and migraine compared to the control group. In the NSD group, the adjusted hazard ratios (HR) were 1.236 (95% CI, 1.198–1.276) for anxiety, 1.289 (95% CI, 1.238–1.343) for depression, and 1.251 (95% CI, 1.214–1.290) for migraine. Conclusion NSD is associated with a higher incidence of anxiety, depression, and migraine. Therefore, it is suggested that physicians carefully consider psychoneurological distress and employ therapeutic strategies to minimize these conditions.

Otological Presentation of Obstructive Nasal Lesions: A Study of 50 Cases

Purpose: To analyze and realize the importance of the Eustachian tube dysfunction (ETD) in the pathogenesis of the middle ear infections as to raise the awareness amongst the Otolaryngologists consider the tubal dysfunctions in the management of the otitis media. Materials and methods: 50 patients of aural discharge, aural fullness, aural pain, hearing loss and tinnitus along with nasal obstruction were selected from July 2013 upto December 2013 in the outpatient department (OPD) of Otorhinolaryngology - Head and Neck Surgery dept. of Dhaka Medical College Hospital under a specific prospective study protocol. All patients of aural fullness, hearing loss, aural pain, tinnitus, aural discharge along with nasal obstruction with or without sore throat were included; patients of sensorineural hearing loss, primary external ear pathology, ear malignancy and congenital ear diseaseswere excluded. Results: 58% patients were below 20 years, 50% were children, 64% were male and 36% female. 62% patients got aural fullness, 60% hearing loss 40% mild, 14% moderate, 6% severe conductive and 8% mixed), 26% tinnitus, 32% aural discharge and 30% aural pain and amongst the patients of otitis media with effusion (OME), 100% got hearing loss, 73% aural fullness, 33% tinnitus, 27% aural pain and 13% dizziness. 78% patients got septal deviation, 58% hypertrophied inferior turbinates (HIT), 32% enlarged adenoids (EA), 62% allergic rhinitis, 26% acute upper respiratory tract infection (URTI), 4% nasal polyps and 48% sinusitis/mucosal thickening and amongst the children, 64% got enlarged adenoids, 56% HIT, 76% septal deviation (SD), 24% acute URTI, 4% antrochoanal polyp, 20% adenoid with HIT and 44% adenoid with SD. Regarding findings in the patients of enlarged adenoid, 37.5% patients got eustachian tube dysfunction (ETD) and 62.5% got hearing loss due to OME as well as acute otitis media (AOM), chronic otitis media (COM) and it showed that mild adenoid caused ETD occasionally on URTI but mild adenoid with HIT caused OME. Conclusion: The obstructive nasal lesions are intermingled with otitis media, so this association should be sought out and underlying nasal lesions must be managed if any as a part of treatment of the otitis media. Bangladesh J Otorhinolaryngol 2021; 27(2): 159-169