The Impact of Middle Turbinate Concha Bullosa on the Severity of Inferior Turbinate Hypertrophy in Patients with a Deviated Nasal Septum

C.M. Tomblinson; M.-R. Cheng; D. Lal; J.M. Hoxworth

doi:10.3174/ajnr.A4705

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Fig 1.
Coronal reformatted image from noncontrast sinus CT demonstrates the measurements of NSD. The midline is defined by a dashed line extending from the crista galli to the nasal crest. NSD severity (solid line) is measured to the point of maximal NSD orthogonal to the midline. NSD height is determined by measuring the distance from the point of maximal NSD to the floor of the nasal cavity parallel to the midline (dotted line).
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Fig 2.
Coronal reformatted image from noncontrast sinus CT demonstrates the measurements of inferior turbinate size. A, The maximum transverse distance from the most medial aspect of the inferior turbinate conchal bone to the lateral nasal wall (lateral offset) is defined by the dotted line. The maximum transverse width of the pendulous portion of the inferior turbinate inclusive of soft tissue and bone (width) is depicted by the solid line. B, The greatest width of the inferior turbinate bone (bone width) is demarcated with a solid line, while the thickest transverse dimension of the soft tissue along the medial aspect of the inferior turbinate (medial mucosa width) is identified with a dotted line.

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Table 1:

Comparison between CB groups for patient characteristics and measurements^{^a}

Variable	CB− (n = 100)	CB+ (n = 100)	Entire Cohort (N = 200)	P Value
Age (yr)	52.6 (16.6)	54.2 (17.4)	53.4 (17.0)	.50^{^b}
Sex (female)	54 (54.0%)	59 (59.0%)	113 (56.5%)	.48^{^c}
NSD severity (mm)	7.1 (1.6)	7.3 (2.0)	7.2 (1.8)	.25^{^b}
NSD height (mm)	13.5 (4.1)	19.1 (4.3)	16.3 (5.1)	<.001^{^b}
ΔLateral offset (mm)	2.7 (1.8)	1.9 (2.0)	2.3 (1.9)	<.01^{^b}
ΔWidth (mm)	3.4 (2.0)	2.5 (2.3)	2.9 (2.2)	<.01^{^b}
ΔBone width (mm)	1.3 (0.7)	0.9 (0.8)	1.1 (0.8)	<.01^{^b}
ΔMedial mucosa width (mm)	1.0 (1.5)	0.7 (1.5)	0.8 (1.5)	.13^{^b}

↵a All values are displayed as mean (SD) except for sex, which is presented as count (%).
↵b Two-sample t test was used to compare the CB+ and CB− groups.
↵c χ² tests were used to compare the CB+ and CB− groups.

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Table 2:

Pearson correlation coefficients (P value) between side-to-side differences in inferior turbinate measurements and risk factors by concha bullosa group

Variable	CB− (n = 100)		CB+ (n = 100)		Entire Cohort (N = 200)
Variable	Septal Deviation Severity	Septal Deviation Height	Septal Deviation Severity	Septal Deviation Height	Septal Deviation Severity	Septal Deviation Height
ΔLateral offset	0.31^{^a} (<.01)	−0.13 (.20)	0.36^{^a} (<.001)	−0.17 (.10)	0.31^{^a} (<.001)	−0.24^{^a} (<.001)
ΔWidth	0.23^{^a} (.02)	−0.22^{^a} (.03)	0.23^{^a} (.02)	−0.13 (.21)	0.20^{^a} (<.01)	−0.26^{^a} (<.001)
ΔBone width	0.43^{^a} (<.001)	−0.24^{^a} (.02)	0.56^{^a} (<.001)	−0.31^{^a} (<.01)	0.47^{^a} (<.001)	−0.35^{^a} (<.001)
ΔMedial mucosa width	−0.03 (.76)	−0.21^{^a} (.04)	−0.08 (.43)	−0.03 (.79)	−0.07 (.35)	−0.16^{^a} (.03)

↵a Pearson correlation coefficients that were significant at the P < .05 level.

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Table 3:

Multiple linear regression models predicting side-to-side inferior turbinate measurement differences

Dependent Variable/Predictor	β Coefficient (Standard Error)	P Value
ΔLateral offset		<.001^{^a}
NSD height	−0.10 (0.02)	<.001
NSD severity	0.36 (0.07)	<.001
ΔWidth		<.001^{^a}
NSD height	−0.12 (0.03)	<.001
NSD severity	0.28 (0.08)	<.001
ΔBone width		<.001^{^a}
NSD height	−0.06 (0.01)	<.001
NSD severity	0.22 (0.02)	<.001
ΔMedial mucosa width		.06^{^a}
NSD height	−0.05 (0.02)	.03
NSD severity	−0.04 (0.06)	.45