Investigation of the relationship between nasal cavity variations and pathological conditions of maxillary sinuses in Cone Beam Computed Tomography

Abstract Objective: Anatomical changes of the nasal cavities play an important role in ostiomeatal complex obstruction and can increase the risk of sinus diseases. It is important to know the prevalence of these anatomical changes and their effect on the occurrence of pathological conditions of the sinuses. The aim of this study was to determine the relationship between anatomical variations of the nasal cavity and pathological conditions of the maxillary sinus. Methods: This descriptive-analytical study was performed on Cone Beam Computed Tomography (CBCT) scans of the nasal cavity and maxillary sinuses taken from the archives of the Department of Radiology of Hamadan Dental School between 2015 and 2021. Frequency of pathological conditions of the maxillary sinus as well as anatomical variations of nasal cavity such as septal deviation, agger nasi cells, concha bullosa, paradoxical middle concha, Haller cells,enlargement of uncinate process, supraorbital ethmoidal cell, diameter of maxillary ostium and height of infundibulum were evaluated. Finally, the data were analyzed by Stata 14.2 software at a significance level of 0.05. Results: In this study, 280 CBCT images were collected and examined. Patients with maxillary sinus thickening have the highest frequency (42.86%) of pathological conditions. Also, among the anatomical variations, the size of unciate process on the right (80.36%) and left (86.43%) had the highest frequency. In addition, a significant correlation was observed between maxillary sinus mucosal thickening and paradoxical concha (P˂0.05). However, no association was found between nasal septal deviation, concha bullosa, unciate process size, diameter of maxillary sinus ostium and infundibulum height with maxillary sinus pathological conditions (P˃0.05). Conclusion: The CBCT imaging is a reliable method in evaluation of anatomical variations and pathological conditions of the paranasal sinus. According to this study, paradoxical concha is associated with mucosal thickening of the maxillary sinus., Basic knowledge of anatomical variations and their relationship to the maxillary mucosa is essential for sinus surgery as well as dental implants.