Correlation between Nasal Septal Deviation and Paranasal Sinus Mucosal Thickening in Chronic Rhinosinusitis on CT-Scan
DOI:
https://doi.org/10.15850/ijihs.v14n1.4932Keywords:
Chronic rhinosinusitis, Computed tomography, Nasal septum, Paranasal sinuses, Sinus mucosaAbstract
Background: Nasal septal deviation is a common structural anomaly of the nasal cavity and a potential risk factor for obstruction of the ostiomeatal complex, which may compromise ventilation and drainage of the paranasal sinuses. Consequently, patients with septal deviation may be at increased risk of developing chronic rhinosinusitis (CRS).
Objective: To examine the association between nasal septal deviation and paranasal sinus mucosal thickening in patients with CRS using CT imaging. Methods: An analytic cross-sectional study was conducted at Dr. Zainoel Abidin Regional General Hospital (RSUDZA), Banda Aceh. Medical records and paranasal sinus CT scans of patients with CRS from January 2021 to December 2023 were retrospectively reviewed during a four-month study period (August–November 2024). A total of 46 eligible patients were included, and the association was analyzed using Fisher's exact test.
Results: Among 46 patients with CRS, nasal septal deviation was identified in 30 (65.2%): 17 (37.0%) had rightward deviation and 13 (28.3%) had leftward deviation, whereas 16 (34.8%) had no deviation. Mucosal thickening was detected in 32 patients (69.6%), most commonly in the maxillary sinus (36.95%), followed by the ethmoid sinus (19.56%). Nasal septal deviation was significantly associated with paranasal sinus mucosal thickening (p=0.002; odds ratio, 10.83; 95% CI, 2.60–45.16).
Conclusion: Nasal septal deviation was significantly associated with paranasal sinus mucosal thickening in patients with CRS undergoing paranasal sinus CT examination at RSUDZA, Banda Aceh. Given the cross-sectional design, this finding indicates an association rather than causation.
Downloads
References
Juniati SH, Desihartati BD, Kristyono I. Relationship between nasal septal deviation type and changes in severity of nasal obstruction in post-septoplasty patients. New Armen Med J. 2024;18(2):114–20. doi: 10.56936/18290825-2024.18.2-114.
Ashwinirani SR, Kumbhare S, Suragimath G, Sande A. Prevalence of nasal septum deviation and its association with chronic maxillary sinusitis. J Oral Med Oral Surg Oral Pathol Oral Radiol. 2022;8(1):16–9. doi: 10.18231/j.jooo.2022.004.
Alghamdi FS, Albogami D, Alsurayhi AS, Alshibely AY, Alkaabi TH, Alqurashi LM, et al. Nasal septal deviation: a comprehensive narrative review. Cureus. 2022;14(11):e31317. doi: 10.7759/cureus.31317.
Wardani RS, Wardhana A, Mangunkusumo E, Wulani V, Senior BA. Radiological anatomy analysis of uncinate process, concha bullosa, and deviated septum in chronic rhinosinusitis. Oto Rhino Laryngol Indones. 2017;47(1):16–24. doi: 10.32637/orli.v47i1.191.
Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, et al. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 2020;58(Suppl 29):1–464. doi: 10.4193/Rhin20.600.
Kim DH, Kim SW, Basurrah MA, Hwang SH. Global incidence and prevalence of chronic rhinosinusitis: a systematic review. Clin Exp Otorhinolaryngol. 2024;17(4):302–15. doi: 10.21053/ceo.2024.00388.
Zhang L, Zhang R, Pang K, Liao J, Liao C, Tian L. Prevalence and risk factors of chronic rhinosinusitis among Chinese: a systematic review and meta-analysis. Front Public Health. 2023;10:986026. doi: 10.3389/fpubh.2022.986026.
Putra TRI, Husni TR, Sariningrum HA, Endalif D. Characteristics of chronic sinusitis based on non-contrast CT scan at the ENT-Head and Neck Surgery Polyclinic of Regional General Hospital Dr. Zainoel Abidin Banda Aceh. Indones J Trop Infect Dis. 2022;10(1):55–61. doi: 10.20473/ijtid.v10i1.27468.
Amelia NL, Zuleika P, Utama DS. Prevalensi rinosinusitis kronik di RSUP Dr. Mohammad Hoesin Palembang. Maj Kedokt Sriwij. 2017;49(2):76–84. doi: 10.32539/mks.v49i2.6851.
Papadopoulou AM, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical variations of the nasal cavities and paranasal sinuses: a systematic review. Cureus. 2021;13(1):e12727. doi: 10.7759/cureus.12727.
Cebula M, Nowak MD, Modlińska S, Tyrakowski M. Impact of window computed tomography (CT) parameters on measurement of inflammatory changes in paranasal sinuses. Pol J Radiol. 2017;82:567–70. doi: 10.12659/PJR.902828.
Fouladvand T, Pirzadeh A, Isazadehfar K, Alipour A. Evaluating diagnostic value of clinical symptoms and signs for chronic sinusitis by CT-scan in patients admitted to Ardabil city hospital, Iran. Int J Adv Med. 2019;6(3):590–6. doi: 10.18203/2349-3933.ijam20192049.
Leland EM, Vohra V, Seal SM, Zhang Z, Ramanathan M Jr. Environmental air pollution and chronic rhinosinusitis: a systematic review. Laryngoscope Investig Otolaryngol. 2022;7(2):349–60. doi: 10.1002/lio2.774.
Sogebi OA, Oyewole EA. Trends in the clinical pattern, diagnosis and management of rhinosinusitis in a sub-urban tertiary health centre. Ann Health Res. 2015;1(2):74–80.
Sedaghat AR, Kuan EC, Scadding GK. Epidemiology of chronic rhinosinusitis: prevalence and risk factors. J Allergy Clin Immunol Pract. 2022;10(6):1395–403. doi: 10.1016/j.jaip.2022.01.016.
Romoozi E, Molaee M, Rahimi H, Karimian A. The prevalence of nasal septum deviation and its association with maxillary sinus mucosal thickening using cone-beam computed tomography. Int J Health Sci. 2022;6(Suppl 7):6258–70. doi: 10.53730/ijhs.v6nS7.13513.
Alsaggaf ZH, Almadfaa AO, Marouf AA, Alfawaz KS, Niyazi RA, Ibrahim NK, et al. Sinusitis and its association with deviated nasal septum at a tertiary hospital: a retrospective study. J Taibah Univ Med Sci. 2022;17(6):1065–9. doi: 10.1016/j.jtumed.2022.06.001.
Malpani SN, Deshmukh P. Deviated nasal septum a risk factor for the occurrence of chronic rhinosinusitis. Cureus. 2022;14(10):e30261. doi: 10.7759/cureus.30261.
Poorey VK, Gupta N. Endoscopic and computed tomographic evaluation of influence of nasal septal deviation on lateral wall of nose and its relation to sinus diseases. Indian J Otolaryngol Head Neck Surg. 2014;66(3):330–5. doi: 10.1007/s12070-014-0726-2.
Whyte A, Boeddinghaus R. The maxillary sinus: physiology, development and imaging anatomy. Dentomaxillofac Radiol. 2019;48(8):20190205. doi: 10.1259/dmfr.20190205.
Kim SM. Definition and management of odontogenic maxillary sinusitis. Maxillofac Plast Reconstr Surg. 2019;41:13. doi: 10.1186/s40902-019-0196-2.
Husni TR, Ridwan A, Machillah N, Fitri EM, Mutawakkil AF. The correlation between nasal and paranasal sinus anatomical variations with severity of chronic rhinosinusitis based on CT scan examination at Dr. Zainoel Abidin Hospital Banda Aceh. Magna Sci Adv Biol Pharm. 2023;9(1):39–53. doi: 10.30574/msabp.2023.9.1.0040.
Temur KT, Evlice B, Öztunç H. Evaluation of paranasal sinus anatomic variations and mucosal changes with cone beam computed tomography. Balk J Dent Med. 2022;26(1):27–32. doi: 10.2478/bjdm-2022-0005.
He Y, Fu Y, Wu Y, Zhu T, Li H. Pathogenesis and treatment of chronic rhinosinusitis from the perspective of sinonasal epithelial dysfunction. Front Med (Lausanne). 2023;10:1139240. doi: 10.3389/fmed.2023.1139240.
Chegini Z, Noei M, Hemmati J, Arabestani MR, Shariati A. The destruction of mucosal barriers, epithelial remodeling, and impaired mucociliary clearance: possible pathogenic mechanisms of Pseudomonas aeruginosa and Staphylococcus aureus in chronic rhinosinusitis. Cell Commun Signal. 2023;21:306. doi: 10.1186/s12964-023-01347-2.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 International Journal of Integrated Health Sciences

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors retain copyright and grant International Journal of Integrated Health Sciences right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to freely share and remix the work with an acknowledgement of the work's authorship and initial publication in International Journal of Integrated Health Sciences.
