Radiological Correlation Between Ethmoid Roof Asymmetry and Variations of Nasal Turbinates

Introduction: Etmoid roof and nasal turbinates have many anatomic variations that are important during endoscopic sinus surgery (ESS). During ESS, lateral nasal wall serving as anatomic marker, is intervened at the beginning of surgery. Knowledge of anatomic variations and interrelations with each other increase success of surgery and reduces complications. In this study, we assess the relation of skull base asymmetry with variations of turbinates of lateral nasal wall.

Materials and Methods: Paranasal sinus tomography images of 124 patients [(64 (62%) females and 60 (48%) males] were retrospectively analyzed. Statistical analysis of variations of lateral nasal wall (middle, superior, supreme turbinate and accessory and secondary turbinate) variations were made in association to measurements of bilateral lateral lamella of cribriform plate (LLCP).

Results: In the existance of bilateral bullous middle turbinate (BMT), unilateral accessory middle turbinate (AMT), bilateral secondary middle turbinate (SeMT), bilateral superior concha bullosa (SCB), unilateral and bilateral supreme turbinate (SuprT), mean of difference of right LLCP (RLLCP) and left LLCP (LLLCP) is statistically significant (p<0.05). It is determined that the vertical diameter of the superior turbinate was correlated with the vertical diameter of contralateral superior turbinate, as well as the LLCP of the ipsilateral and contralateral side (p<0.05).

Conclusion: This study suggests bilateral BMT, unilateral AMT, bilateral SeMT, bilateral SCB, unilateral and bilateral SuprT should be carefully evaluated in the presence of anterior skull base asymetry in order not to experience complications during ESC.