Department of Otolaryngology, Head and Neck Surgery, Bozok University Medical Faculty, Adnan Menderes Bulvarı No. 42, Yozgat, Turkey,
Eur Arch Otorhinolaryngol. 2013 Nov;270(12):3069-73. doi: 10.1007/s00405-013-2435-y. Epub 2013 Mar 20.
The purpose of this study was to determine the possible role of nasal septal deviation on volume of maxillary sinuses and its relationship with development of maxillary sinusitis.
Between May 2010 and September 2012, paranasal sinus computed tomography (CT) findings of 825 patients (470 males, 355 females), who admitted to Ear Nose and Throat Department of Bozok University Medical Faculty were retrospectively analyzed. By excluding the other co-existent sino nasal pathologies, 109 consecutive patients (47 males, 62 females mean age 36 ± 13.4 years; range 18-71 years) with isolated nasal septal deviations were recruited for the study. The convex side of the septal curvature was accepted as the direction of deviation. The findings were grouped according to the radiologically measured angle of nasal septal deviations. The deviation angle of the nasal septum was described as; mild (<9°), moderate (the angle between 9° and 15°), or severe (15° and up). The volume of each maxillary sinus (ipsi- and contralateral to the deviation side) was also calculated using the computer program. Sinusitis was defined as any evident thickening of the maxillary sinus mucosa.
There were 62 females and 47 males with a mean age of 36 ± 13.4. Nasal septal deviation angles were found to range between 5° and 27.2° (mean 13° ± 3.4°). The right sided deviations included 19 mild (<9°, Group I), 16 moderate (9°-15°, Group II), and 16 severe (15° and up, Group III) cases. The left sided deviations included 19 mild (<9°, Group I), 19 moderate (9°-15°, Group II), and 20 severe (15° and up, Group III) subjects. Maxillary sinus volumes were compared between right and left sided deviation groups. We could not demonstrate a statistically significant difference between the right maxillary sinus volumes of Groups I and II in left sided deviation cases (p = 0.77). In the same side, comparison of Groups I-III and Groups II-III, the maxillary sinus volume differences were found to be significantly meaningful (p = 0.001 and p = 0.013, respectively). Identical results were yielded in the right sided septal deviation group related to the maxillary sinus volumes of Groups I and II and Groups I-III and Groups II-III compartments (p = 0.99, p = 0.004 and p = 0.003, respectively). In both right and left deviation groups, ipsi and contralateral maxillary sinus volume comparements produced statistically significant results (p = 0.002 and p = 0.04, respectively). The presence of maxillary sinusitis findings were significantly increased in both group (p = 0.00). Statistical significance was set at p < 0.05.
Our findings suggest that maxillary sinus volumes tend to be higher at the contralateral side of the severe septum deviations. In addition, the chance of finding maxillary sinusitis findings on ipsilateral to the severe septum deviation was significantly increased.
本研究旨在确定鼻中隔偏曲对上颌窦容积的可能作用及其与上颌窦炎发展的关系。
回顾性分析 2010 年 5 月至 2012 年 9 月博兹大学医学院耳鼻喉科收治的 825 例患者（470 例男性，355 例女性）的鼻窦计算机断层扫描（CT）结果。排除其他并存的鼻-鼻窦病变后，招募了 109 例连续的鼻中隔偏曲患者（47 例男性，62 例女性，平均年龄 36±13.4 岁；年龄范围 18-71 岁）进行研究。鼻中隔弯曲的凸侧被认为是偏曲的方向。根据影像学测量的鼻中隔偏曲角度将发现进行分组。鼻中隔偏曲角度描述为：轻度（<9°）、中度（9°-15°之间）或重度（15°及以上）。使用计算机程序还计算了每个上颌窦（偏曲侧的同侧和对侧）的容积。将上颌窦黏膜任何明显增厚定义为鼻窦炎。
62 例女性和 47 例男性，平均年龄 36±13.4。鼻中隔偏曲角度在 5°至 27.2°之间（平均 13°±3.4°）。右侧偏曲包括 19 例轻度（<9°，第 I 组）、16 例中度（9°-15°，第 II 组）和 16 例重度（15°及以上，第 III 组）病例。左侧偏曲包括 19 例轻度（<9°，第 I 组）、19 例中度（9°-15°，第 II 组）和 20 例重度（15°及以上，第 III 组）病例。比较右侧和左侧偏曲组的上颌窦容积。我们不能证明左侧偏曲情况下右侧上颌窦容积在第 I 组和第 II 组之间存在统计学上的显著差异（p=0.77）。在同侧，第 I-III 组和第 II-III 组之间的上颌窦容积差异有统计学意义（p=0.001 和 p=0.013）。在右侧鼻中隔偏曲组中，第 I 组和第 II 组与第 I-III 组和第 II-III 组之间的上颌窦容积差异也有统计学意义（p=0.99、p=0.004 和 p=0.003）。在右侧和左侧偏曲组中，同侧和对侧上颌窦容积比较均产生统计学意义（p=0.002 和 p=0.04）。两组上颌窦炎的发现均明显增加（p=0.00）。统计学显著性水平设为 p<0.05。
我们的研究结果表明，上颌窦容积在严重鼻中隔偏曲的对侧往往较高。此外，严重鼻中隔偏曲同侧发生上颌窦炎的几率显著增加。
