Paraseptal structural changes and chronic sinus disease in relation to the deviated septum

Abstract

Objective: This study was conducted to evaluate the use of computerized tomography in the delineation of the ostiomeatal complex to enhance the endoscopic surgeon's understanding of associated and contributing anatomic features.

Methods: The ostiomeatal complex region (OMC) was prospectively evaluated in 122 consecutive patients as a function of the degree of nasal-septal deviation. This data was correlated with paranasal sinus disease, lateral nasal-wall findings, and middle-turbinate abnormalities.

Results: Patients with increasing nasal-septal deviations were associated with a higher incidence of OMC obstruction (p < .05). OMC obstruction in the direction of septal angulation was attributable to nasal septal deformity. However, contralateral OMC obstruction was related to middle-turbinate and lateral nasal-wall abnormalities, which appeared with increased frequency on the side opposite to the septal deviation (p < .05). Furthermore, an increased incidence and severity of sinus disease was noted with increasing septal deviation (p < .05).

Conclusion: Increasing angles of septal deviation are associated with bilateral sinus disease and contralateral middle turbinate abnormalities and ethmoid bulla prominence.