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

Investigation of the relationship between nasal cavity variations and pathological conditions of maxillary sinuses in Cone Beam Computed Tomography | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Investigation of the relationship between nasal cavity variations and pathological conditions of maxillary sinuses in Cone Beam Computed Tomography Fatemeh Alizadeh, Mohammadreza Jamalpour, Abbas Shokri, Asal Ebrahimi, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4732532/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version 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. Cone Beam Computed Tomography Nasal cavity Anatomical variations Maxillary sinus Figures Figure 1 Introduction The paranasal sinuses are 4 pairs of air spaces located around the nasal cavity. The nasal cavity and the paranasal sinuses decrease the weight of the skull, warm and moisturize the inhaled air, regulate speech resonance and intranasal pressure, and improve the sense of smell (1,2). The formation of paranasal sinuses following depression of the nasal mucosa around the facial bones explains the high frequency of anatomical variations in this region (3).Anatomical variations of the paranasal sinuses are highly important since they may predict inflammatory changes in the paranasal sinuses. Such variations of the sinus can complicate clinical procedures, particularly functional endoscopic surgery, in which accurate assessment of the region plays a pivotal role in the success and safety of surgical procedures (4). Mucosal drainage in healthy tissue occurs via the osteomeatal complex(OMC). In normal drainage and ventilation, the mucus reaches the ostium (maxillary sinus opening) and passes through a small passage that communicates with the nasal cavity (infundibulum)(1,5). Variations that cause the narrowing of this passage have been shown to be responsible for the development of maxillary sinusitis (6).Local anatomic variations associated with nasal septal deviation, concha bullosa, and Haller cells could cause this obstruction and sinusitis (7). Several radiographic imaging techniques are used to study the maxillary sinus. Panoramic radiography is the most common two-dimensional imaging technique used by most dentists to evaluate the general condition of the orofacial complex (8).Although panoramic radiography is beneficial for achieving a general view of the orofacial area, it has some inherent limitations, including unequal magnification, and geometric distortion across the whole image layer. These limitations lead to incorrect anatomical and pathological evaluations, as well as unreliable measurement accuracy. Sometimes, the overlapping structures, such as the cervical spines, can lead to misdiagnosis. Obtaining a 3D view using computer tomography (CT) is a more precise method for evaluating the maxillary sinus. Although CT is the choice method for assessing maxillary sinuses, high cost, radiation dose, and access issues have limited its use in general dentistry(9). The recent introduction of CBCT has enabled dentists and ENT specialists to understand anatomical abnormalities and pathologic areas within the nasal cavity and paranasal sinuses surrounding them(10). Since the role of anatomical variations in relation to the pathological conditions of the maxillary sinus is controversial in different articles and there are still contradictions in the results of different articles (11,12,13); this study aimed to investigate the relationship of the anatomical variations of the nasal cavity with the pathological conditions of the maxillary sinuses in a more comprehensive way. Methods This cross-sectional study evaluated CBCT scans of the nasal cavity and maxillary sinuses retrieved from the archives of the Radiology Department of the School of Dentistry, Hamadan University of Medical Sciences, Iran from 2015 to 2021. Since the CBCT records had been previously prescribed for other medical purposes, no extra radiation was imposed on the patients. Personal information of all individuals was kept totally undisclosed. The survey and data use had obtained the informed consent of all participants that mentioned their images could be used in research project. The study design of this was reviewed and approved by the ethical committee of Hamadan University of Medical Sciences (IR.UMSHA.REC.1399.749).All methods were carried out in accordance with relevant guidelines and regulations.This study included images from 280 patients (112 males and 168 females) in the age range of 10–65 years. Patients with a history of surgical procedures in this area , trauma to the head or face, clefts or benign or malignant tumors of the sinonasal mucosa causing changes in the anatomy of the nasal cavity or ethmoidal sinuses and patients with periodontal disease or periapical inflammatory lesions in posterior maxillary teeth that could influence on maxillary sinuses were excluded. All images were captured with a New Tom 3G CBCT scanner (Quantitative Radiology, Verona, Italy) and evaluated in the axial, coronal, and sagittal planes by an oral and maxillofacial radiologist with 10 years of educational experience and a dentist using NNT Viewer software (New Tom, Verona, Italy). The device delivers a cone-beam x-ray, and has a flat panel detector, 1536×1920 pixels, 127×127-pixel size, 14-bit pixel depth, 360-degree rotation, 4.6-second scan duration, and a maximum voltage of 110. The initial and final reconstruction of the images were carried out with NNT viewer software version 17.2. The images were viewed on a 20-inch LG monitor (LG, Seoul, Korea) in partly dark conditions. The observers could change the optical density and contrast of images using rendering software. The results were documented using a checklist. If there was any conflict between the 2 observers, the final decision was made by consulting a third observer, who was an experienced oral and maxillofacial radiologist. All images were analyzed again by the observers after 2 weeks, and the results were documented. In this study, as similar to previous studies, (14,15) the following radiological findings were considered as sinusitis. Diffuse mucosal thickening with 5 mm or more than 5 mm, which was in the maxillary, frontal, and sphenoid sinuses Air-fluid level, with diffuse mucosal thickening <5 mm or without mucosal thickening, which was in the maxillary, frontal, and sphenoid sinuses Partial opacifications, more than 5 mm, were polypoid, without diffuse mucosal thickening or total opacification, which were in the maxillary, frontal, and sphenoid sinuses Partial and total opacifications of the ethmoid cells consisting of the ethmoid sinuses The reactive changes such as sclerosis, decalcification, and erosion leading to sinusitis on the sinus bones. We examined the anatomical variations in the nasal cavity and maxillary sinuses separately: 1-Nasal septal deviation: Septal deviation refers as a deviation of the nasal septum in the inner part of the nose, which is categorized as follows: Type I: A slight deviation in the vertical or horizontal plane that does not stretch through the vertical dimension of the septum. Type II: Vertical anterior deviation Type III: Vertical posterior deviation Type IV: S-shaped septum Type V: Horizontal spores on one side with or without huge distortion on the opposite side Type VI: Type V with a deep groove on the concave surface Type VII: Any combination of Types II to VI. (16) Septum deviation was defined as a deviation above 4 mm from the midline (17). To determine septal deviation, the lines being drawn downward from the Crista Galli and upward from the nasal eminence were connected, and all deviations were noted without taking the degree of deviation into consideration (11).[figure 1 A] 2-Concha bullosa: Concha bullosa which can occur in any part of the ethmoid bone complex that becomes pneumatized, is the most common anatomical variation that occurs in the middle turbinate. When it occurs, posterior ethmoidal air cells are pulled in to pneumatize the middle turbinate. The area of pneumatization of the turbinate can be small, medium, or large. Very large cases can cause nasal septal deviation and nasal obstruction (2). [figure1 D] 3- Paradoxical concha: Paradoxical concha is a rare situation of nasal obstructive developmental anomaly and refers to the inferomedial position of the medial concha. In this situation, the convex surface of the concha is placed towards the nasal septum and is usually bilateral (18). [figure 1 C] 4- Haller cell: Haller cells are considered as air cells located along the medial portion of the orbital floor and continuous with the ethmoid capsule (19). [figure 1 F] 5- Supraorbital air cell: supraorbital air cells are an anatomical variant of originating from the anterior ethmoid air cells extending posteriorly over the orbit from the frontal recess. (20) [figure 1 B] 6- Agger nasi cells: agger nasi cell, which reflects a clinically important pattern of the outward spread of air cells. Anterior ethmoidal cells can pneumatize the frontal process of the maxilla. These cells are known as agger nasi cells and are related to the lacrimal bone (20). 7-Enlargement of uncinate process: The uncinate process of the ethmoid bone is a thin hook-like osseous structure of the wall of the lateral nasal cavity, which can be normal, atelectatic, inclusive of the lamina terminalis, pneumatized, or curved (20). enlargement of the uncinate process was considered as an increased length of the uncinate process beyond the lower rim of the orbit. 8- Maxillary sinus ostium: The maxillary sinus ostium was defined as the distance between the inferomedial aspect of the orbital rim and the uncinate process. Obviously, in the cases where Haller cells existed, the maxillary sinus ostium was quantified as the distance between the Haller cell at its most medial portion and the uncinate process (21). [figure 1A] 9- Length of the infundibulum: The length of the infundibulum was measured as the distance between the center of the ostium and the most upper point of the uncinate process in the coronal slice of the CBCT image (5). [figure 1E] Quantitative variables were reported as mean and standard deviation and classified variables as frequency and percentage. Chi-square test was used to examine the relationship between different anatomical variables of the nasal cavity and sinus mucosal thickening, polypoid mucosa, air-fluid presence in the sinus and any sclerosis . P values lower than 0.05 were considered to indicate statistical significance. All statistical analyses were performed using SPSS version 24 (IBM Corp., Armonk, NY, USA). Results In this study, CBCT images of 280 patients were evaluated. Of these, 112 (40%) were male and 168 (60%) were female and the mean age was 27.56. The frequency of each pathological condition of the maxillary sinus in the studied patients is shown in Table 1 . Among the pathological conditions, thickening of the sinus mucosa was the most common. Next, a variety of anatomical variations of the nasal cavity were examined. The frequency and percentage of each anatomical variation is shown in Table 2 . Then, the mean and standard deviation of some characteristics of maxillary sinus and nasal cavity were also calculated, the results of which are given in Table 3 . Table 1 Frequency and Percentage of Maxillary Sinus Pathological Conditions. Pathologic Conditions Frequency Percentage Thickening of Sinus Mucosa NO YES 160 120 57.14 42.86 The direction of thickening of sinus mucosa Left Right Left-Right 35 40 45 29.17 33.33 37.5 Polypoid mucosa NO YES 227 53 81,07 18,93 The direction of Polypoid mucosa Left Right Left- Right 15 25 13 28.3 47.17 24.53 Fluid-Air NO YES 279 1 99.64 0.36 Sclerosis NO YES 247 33 88.21 11.79 The direction of Sclerosis Left Right Left-Right 10 13 10 30.3 39.39 30.3 Table 2 Frequency of each Anatomical Variations Anatomic Variation Frequency Percentage Nasal septal deviation NO YES 170 110 60.71 39.29 Concha Bullosa NO YES 88 192 31.43 68.57 The direction of Concha Bullosa Left Right Left-Right 37 44 111 19.27 22.92 57.81 Haller Cells NO YES 151 129 53.93 46.07 The direction of Haller Cells Left Right Left-Right 32 38 59 24.81 29.46 45.74 Paradoxical Concha NO YES 222 58 79.29 20.71 The direction of Paradoxical Concha Left Right Left-Right 15 26 17 25.86 44.83 29.31 Supraorbital air cells NO YES 213 67 76.07 23.93 Agger Nasi Cells NO YES 96 184 34.29 65.71 Enlargement of Right Uncinate Process NO YES 55 225 19.64 80.36 Enlargement of Left Uncinate Process NO YES 38 242 13.57 86.43 Table 3 Average and Standard Deviation of some characteristics of Maxillary Sinus and Nasal Cavity. Variable Total Number of Observation Average (mm) Standard Deviation Minimum Maximum Nasal septal deviation 110 6.05 1.54 4 11.2 The diameter of right maxillary ostium 280 1.54 0.66 0.2 3.9 The diameter of left maxillary ostium 280 1.71 0.67 0.3 3.6 The Hight of right Infundibulum 280 10.40 2.95 2.1 20 The Hight of left Infundibulum 280 11.06 3.04 4.3 21 The association between each of the pathological conditions of the maxillary sinus with gender was examined. The results are shown in Table 4 . As the results show, the thickness of sinus mucosa and polypoid mucosa are significantly related to gender (P = 0.003 and P = 0.002, respectively) so that the prevalence of both variables was higher in men than women. However, fluid-air and sclerosis had no significant relationship with gender (P > 0.05). Table 4 The Relationship between Pathological Conditions of the Maxillary Sinus and Gender. Variable Frequency (Men) Frequency (Women) P-Value Thickening of Sinus Mucosa NO YES 52(46.43) 60(53.57) 198(64.29) 60(35.71) 0.003 Polypoid mucosa NO YES 81(72.32) 31(27.68) 146(86.9) 22(13.1) 0.002 Fluid-Air NO YES 112(100) 0(0) 167(99.4) 1(0.6) 0.413 Sclerosis NO YES 95(84.82) 17(15.18) 152(90.48) 16(9.52) 0.151 There was no relationship between pathological conditions of the maxillary sinus and anatomical variations of the nasal cavity and age. (P > 0.05) The relationship between pathological conditions and gender with nasal septal deviation was also examined, the results of which are shown in Table 5 . As the results show, there is no relationship between gender and any of the pathological conditions with nasal septal deviation (P > 0.05). Table 5 The Relationship between Pathological Conditions & Gender with the nasal septal deviation Variable Nasal septal deviation P- value Yes (%) NO (%) Gender MEN WOMEN 43(39. 09) 67(60.91) 69(40.59) 101(59.41) 0.803 Thickening of Sinus Mucosa NO YES 66(60) 44( 40 ) 94(55.29) 76(44.72) 0.437 Polypoid mucosa NO YES 92(83.64) 18(16.36) 135(79.41) 35(20.59) 0.378 Fluid-Air NO YES 110(100) 0(0) 169(99.41) 1(0.59) 0.420 Sclerosis NO YES 98(89.09) 12(10.91) 149(87.65) 21(12.35) 0.714 The relationship between pathological conditions and gender with concha bullosa was also examined, the results of which are shown in Table 6 . As the results show, there is no relationship between gender and any of the pathological conditions with concha bullosa (P > 0.05). Table 6 The Relationship between Pathological Conditions and gender with Concha Bullosa. Variable Nasal septal deviation P- value Yes (%) NO (%) Gender MEN WOMEN 77(40.1) 115(59.9) 35(39.77) 53(60.23) 0.958 Thickening of Sinus Mucosa NO YES 109(56.77) 83(43.23) 51(57.95) 37(42.05) 0.853 Polypoid mucosa NO YES 156(81.25) 36(18.75) 71(80.68) 17(19.32) 0.910 Fluid-Air NO YES 191(99.48) 1(0.52) 88(100) 0(0) 0.498 Sclerosis NO YES 171(89.06) 21(10.94) 76(86.36) 12(13.64) 0.516 The relationship between pathological conditions and gender with Haller cells was also examined, the results of which are shown in Table 7 . As the results show, there is no relationship between gender and any of the pathological conditions with Haller cells (P > 0.05). Table 7 The Relationship between Pathological Conditions and gender with Haller cells. Variable Nasal septal deviation P- value Yes (%) NO (%) Gender MEN WOMEN 55(42.64) 74(57.36) 57(37.75) 94(62.25) 0.405 Thickening of Sinus Mucosa NO YES 70(54.26) 59(45.74) 90(59.6) 61(40.4) 0.853 Polypoid mucosa NO YES 102(79.07) 27(20.93) 125(82.78) 26(17.22) 0.429 Fluid-Air NO YES 129(100) 0(0) 150(99.34) 1(0.66) 0.354 Sclerosis NO YES 110(85.27) 19(14.73) 137(90.73) 14(9.27) 0.158 The relationship between pathological conditions and gender with paradoxical concha was also examined, the results of which are shown in Table 8 . As the results show, there is only a significant relationship between sinus mucosal thickening and paradoxical concha (P = 0.0001). However, there was no association between gender and other pathological conditions with paradoxical concha (P > 0.05). Table 8 The Relationship between Pathological Conditions and gender with Paradoxical concha. Variable Nasal septal deviation P- value Yes (%) NO (%) Gender MEN WOMEN 24(41.38) 34(58.62) 88(39.64) 134(60.36) 0.810 Thickening of Sinus Mucosa NO YES 45(77.59) 13(22.41) 115(51.8) 107(48.2) 0.000 Polypoid mucosa NO YES 52(89.66) 6(10.34) 175(78.83) 47(21.17) 0.061 Fluid-Air NO YES 58(100) 0(0) 221(99.55) 1(0.45) 0.609 Sclerosis NO YES 52(89.66) 6(10.34) 195(87.84) 27(12.16) 0.702 The relationship between pathological conditions and gender with Supraorbital air cells was also examined, the results of which are shown in Table 9 . As the results show, there is no relationship between gender and any of the pathological conditions with Supraorbital air cells (P > 0.05). Table 9 The Relationship between Pathological Conditions and gender with supraorbital cells. Variable Nasal septal deviation P- value Yes (%) NO (%) Gender MEN WOMEN 30(44.78) 37(55.22) 82(38.5) 131(61.5) 0.360 Thickening of Sinus Mucosa NO YES 38(56.72) 29(43.28) 122(57.28) 91(42.72) 0.936 Polypoid mucosa NO YES 58(86.57) 9(13.43) 169(79.34) 44(20.66) 0.188 Fluid-Air NO YES 67(100) 0(0) 212(99.53) 1(0.47) 0.574 Sclerosis NO YES 62(92.54) 5(7.46) 185(86.85) 28(13.15) 0.208 The relationship between pathological conditions and gender with Agger nasi cells was also examined, the results of which are shown in Table 10 . As the results show, there is no relationship between gender and any of the pathological conditions with Agger nasi cells (P > 0.05). Table 10 The Relationship between Pathological Conditions and gender with Agger nasi cells. Variable Nasal septal deviation P- value Yes (%) NO (%) Gender MEN WOMEN 67(36.41) 117(63.59) 45(46.,88) 51(53.13) 0.090 Thickening of Sinus Mucosa NO YES 106(57.61) 78(42.39) 54(56.25) 42(43.75) 0.827 Polypoid mucosa NO YES 151(82.07) 33(17.93) 76(79.17) 20(20.83) 0.557 Fluid-Air NO YES 183(99.46) 1(0.54) 96(100) 0(0) 0.469 Sclerosis NO YES 168(91.3) 16(8.7) 79(82.29) 17(17.71) 0.056 The relationship between pathological conditions and gender with the Enlargement of unciate process on the right and left was also examined, the results of which are shown in Tables 11 and 12 . As the results show, there is no relationship between gender and any of the pathological conditions with the Enlargement of unciate process on the right and left (P > 0.05). Table 11 The Relationship between Pathological Conditions and gender with Enlargement of right uncinate process. Variable Nasal septal deviation P- value Yes (%) NO (%) Gender MEN WOMEN 90( 40 ) 135(60) 22( 40 ) 33(60) 1000 Thickening of Sinus Mucosa NO YES 129(57.33) 96(42.67) 31(56.36) 24(43.64) 0.896 Polypoid mucosa NO YES 185(82.22) 40(17.78) 42(76.36) 13(23.64) 0.320 Fluid-Air NO YES 244(99.56) 1(0.44) 55(100) 0(0) 0.620 Sclerosis NO YES 196(87.11) 29(12.89) 51(92.73) 4(7.27) 0.247 Table 12 The Relationship between Pathological Conditions and gender with Enlargement of left uncinate process. Variable Nasal septal deviation P- value Yes (%) NO (%) Gender MEN WOMEN 99(40.91) 143(59.09) 13(34.21) 25(65.79) 0.433 Thickening of Sinus Mucosa NO YES 138(57.02) 104(42.98) 22(57.89) 16(42.11) 0.920 Polypoid mucosa NO YES 197(81.4) 45(17.6) 30(78.95) 8(21.05) 0.719 Fluid-Air NO YES 241(99.59) 1(0.41) 38(100) 0(0) 0.691 Sclerosis NO YES 214(88.43) 28(11.57) 33(86.84) 5(13.16) 0.778 Finally, the relationship of some other characteristics of maxillary sinus and nasal cavity with gender was also investigated, the results of which are shown in Table 13 . Table 13 The Relationship Between Some Characteristics of Maxillary Sinus and Nasal Cavity and Gender Variable Gender Quantity Average Standard deviation P value The diameter of right maxillary ostium Male Female 112 168 1.591071 1.514286 0.6935421 0.6443012 0.344 The diameter of left maxillary ostium Male Female 112 168 1.685714 1.73631 0.6627621 0.6866935 0.540 The Hight of right Infundibulum Male Female 112 168 11,06518 9.960714 3.268129 2.65041 0.002 The Hight of left Infundibulum Male Female 112 168 11.55536 10.73512 3.249971 2.871627 0.027 As the results show, there is only a significant relationship between the height of the right and left infundibulum and gender (P = 0.002), so that their amount is higher in men than women. Discussion Anatomical variations of the sinonasal region should be carefully identified prior to surgical procedures. These anatomical variations are important for 2 reasons. First, anatomical variations have a direct correlation with the drainage and ventilation of the paranasal sinuses. Second, anatomical variations can significantly affect the safety of surgical procedures ( 22 ). According to the results of our study, thickening of the maxillary sinus mucosa was the most common pathological condition of the maxillary sinus, as seen in nearly 43% of CBCT images of this pathology. In the study of Lu et al., This rate was 46.2%, which is close to the prevalence obtained from our study ( 23 ). The prevalence of sinus thickening was 56% ( 24 ) in the study of Ritter et al. And 58% ( 25 ) in the study of Aksoy et al. As in our study, Akay et al. Showed that thickening of the maxillary sinus mucosa has the highest frequency among maxillary sinus pathological conditions ( 13 ). However, in the study of Akay et al., The prevalence of this pathology was 25%, which is much less than the frequency obtained from our study ( 13 ). In general, most studies have reported sinus thickening as the most common maxillary sinus pathology. In general, the prevalence of maxillary sinus mucosa thickening in previous studies varied from 25% in the study of Akay et al. ( 13 ) to 58% in the study of Aksoy et al. ( 25 ), and different studies have reported different prevalence. The difference in the pathology prevalence of maxillary sinus thickening in different studies may be due to differences in the size of the thickness that is considered as thickening. Some studies have considered an increase in mucosal thickness of more than 1 mm, some more than 2 mm, and some more than 3 mm as thickening. As a result, differences in this size have led to a different prevalence of this pathology being reported in previous studies ( 13 ). The maxillary sinus is directly connected to the roots of the maxillary teeth, which causes the sinus to be associated with inflammation of these teeth, and any inflammation in these teeth alters the contents of the sinus and its normal physiology ( 5 , 23 , 25 ); Therefore, in our study, patients with periapical inflammation and periodontal disease in the posterior maxillary teeth were excluded. The results of our study showed that the thickening of the maxillary sinus mucosa is significantly associated with paradoxical concha. The study by Kayalioglu et al. Also showed that paradoxical concha has a higher prevalence in people with sinusitis. The incidence of this disorder was reported in 12% of people with sinusitis and only 7% in people without sinusitis ( 26 ). In fact, paradoxical concha blocks the middle meatus and, as a result, increases the thickness of the sinus mucosa and causes sinusitis ( 26 ). Stammberger et al. Also considered paradoxical concha as a factor in sinus pathology and increased mucosal thickness. They suggested that paradoxical concha may cause complete destruction or change in the dynamics of the nasal airflow, resulting in a change in the maxillary sinus ( 27 ). In our study, the prevalence of Haller cells was 45%. This rate was 36% for Tonai and Baba ( 28 ) and 40% for Alkire and Bhattacharyya ( 29 ). In the study of Khojastepour et al., This rate was 42% ( 19 ). Also, in the study of Akay et al., The prevalence of Haller cells was reported to be about 37% ( 13 ). Also, as in our study, Akay et al. Did not find a significant association between Haller cells and maxillary sinus pathology ( 11 ). The presence of Haller cells is associated with inflammatory changes in the mouth and teeth. Therefore, in our study, people with periodontal disease and any inflammation at the site were excluded from the study. Therefore, differences in the characteristics of the study population have led to different prevalence of Haller cells in studies. Also, differences in the definition and consequent diagnosis of Haller cells in studies can be the cause of differences in the results of previous studies ( 11 ). For example, Bolger et al. Defined the Haller cell as any air cell located between the ethmoid bulla and the orbital floor ( 30 ). Kennedy et al., Like us, defined cells in the midline of the orbital floor above the maxillary sinus ostium that extend into the sinus as a haller cell ( 31 ). Kainz et al., However, defined the Haller cell as air cells in the orbital floor ( 32 ). Finally, the technique used can also affect the difference in results because CBCT has a higher resolution than CT methods such as Multislice CT and therefore has a higher diagnostic power in this method ( 19 ). In our study, a high prevalence of agger nasi cells was observed in patients (65.71%). In different studies, the prevalence of agger nasi cells has been reported between 10 and 100% ( 33 , 34 ). Also, in our study, no significant relationship was observed between agger nasi cells and maxillary sinus pathology. However, in the study of Kaya et al., The presence of agger nasi cells was significantly associated with maxillary sinusitis ( 11 ). Differences in results may be due to differences in the characteristics of the study population, racial differences, as well as different sample sizes in previous studies. The prevalence of supraorbital cells in our study was 24%. In the study of Kaya et al., This rate was 14%. In general, the prevalence of supraorbital air cells in previous studies varied from 10 to 98% ( 33 , 35 ). These differences can be due to differences in sample size, differences in population characteristics and differences in race. In this study, concha bullosa had a high prevalence as seen in 68% of the CBCT images. This rate was 44% ( 36 ) for the study of Stallman et al. And 42% for the study of Alkire et al. ( 29 ). However, Akay et al. Reported a relatively low prevalence of concha bullosa in their study population (36%), although they did not observe a significant association between concha bullosa and maxillary sinus pathology as in our study ( 13 ). Also, in the study of Kalaiarasi et al., No significant relationship was observed between concha bullosa and maxillary sinus pathology ( 21 ). Similar results were observed in the Tassoker study ( 12 ). In general, the difference in the prevalence of concha bullosa in previous studies is probably due to different entry and exit criteria (which makes the studied populations have different characteristics) as well as racial differences between populations ( 21 ). In this regard, Papadopoulos et al., In a recent systematic review study of more than 50 articles, showed that race is an important factor in anatomical variation ( 37 ). As in our study, Akay et al. Showed that there was no significant relationship between nasal septal deviation and Haller cells with maxillary pathological conditions ( 13 ). However, some studies have shown that nasal septal deviation is significantly associated with maxillary sinus because it causes swelling and edema of the middle concha and obstruction of the meatus, resulting in obstruction of mucosal flow in the sinus ( 38 – 40 ). In general, the incidence of septal deviation in the community in various studies has been reported between 9 and 80%. The reason for the difference in the results of our studies compared to other studies that have shown a significant relationship between septal deviation and maxillary pathology can also be due to differences in the incidence of this disorder in different communities ( 40 , 41 ). In our study, sinus and polypoid mucosal thickening were significantly associated with gender, so that the frequency of these pathological conditions was higher in men than women. Consistent with our study, Akay et al. ( 13 ) as well as Janner et al. Reported a significant relationship between gender and mucosal thickening. They also showed that sinus mucosal thickening was more common in men ( 42 ). This finding is also consistent with the findings of a study by Sheikhi et al. ( 43 ). In addition, the results of our study showed that the height of the infundibulum had a significant relationship with gender and its rate was higher in men. Akay et al. Showed that the height of the infundibulum and the diameter of the maxilla ostomy are higher in men than women ( 13 ). However, de Carvalho et al. did not observe a significant relationship between infundibulum height and maxillary ostium diameter and gender ( 5 ). The reason for the difference in the results of previous studies can be the difference in exclusion criteria, measurement technique and also the difference in the race population ( 13 ). In our study, no significant relationship was observed between maxillary pathological conditions and anatomical variations of the nasal cavity with age, and only the size of the uncinate process was directly related to age. The results of Akay et al.'s study also showed that there is no significant relationship between age and pathological conditions of maxillary sinus and its anatomical variations. Although they showed that the incidence of maxillary sinus pathology increases with age, but this increase was not significant ( 13 ). Conclusion The results of this study showed that maxillary sinus thickening has the highest frequency of pathological conditions in patients. Also, among the anatomical variations of the nasal cavity, the size of the uncinate process on the right and left was the most frequent. In addition, in this study, a significant relationship was observed between the thickening of the maxillary sinus mucosa and paradoxical concha. However, no association was found between nasal septal deviation, concha bullosa, uncinate process size, diameter of maxillary sinus ostium and infundibulum height with maxillary sinus pathological conditions. Finally, the CBCT method seems to be a reliable method in the study of anatomical variations and its relationship with the pathological conditions of the maxillary sinus. Basic knowledge of anatomical variations and their relationship to the maxillary sinus mucosa is essential for sinus surgery as well as dental implants’. Abbreviations CBCT Cone-beam computed tomography Declarations Acknowledgements The Vice-Chancellor of Research and Technology of Hamadan University of Medical Sciences provided funding for this study (14000131766). Authors’ contributions FA were principal investigators; MJ were secondary investigators tooth collection and data measurements during imaging; ASH imaging and writing the original draft and following submission, NHS was involved in the statistical analysis. All authors read and approved the final manuscript Funding The Vice-Chancellor of Research and Technology of Hamadan University of Medical Sciences provided funding for this study (14000131766). Availability of data and materials The complete documentation of all patients enrolled in this study belongs to the authors, and are available only upon reasonable request. Ethics approval and consent to participate The study was approved by the ethics committee of Hamadan University of Medical Sciences (IR.UMSHA.REC. 1399.749). All patients consented to the use of their extracted teeth for research purposes prior to extraction at the department of oral and maxillofacial surgery, and signed an informed consent form for this purpose. Consent for Publication Not applicable. Competing interests The authors declare that they have no competing interests in relation to the present study. Author details 1Dental School, Hamadan University of Medical Sciences, Hamadan, Iran. 2Department of oral and maxillofacial surgery Hamadan, Iran. 3Dental Implants Research Center, Department of Oral and Maxillofacial Radiology, Hamadan, Iran.4Department of epidemiology, Hamadan University of Medical Sciences, Shahid Fahmideh Blvd, 65166474 References Parks ET. Cone beam computed tomography for the nasal cavity and paranasal sinuses. Dental Clinics. 2014;58(3):627-51. Koo SK, Kim JD, Moon JS, Jung SH, Lee SH. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: a retrospective radiologic study. Auris Nasus Larynx. 2017;44(5):561-70. Güldner C, Ningo A, Voigt J, Diogo I, Heinrichs J, Weber R, et al. Potential of dosage reduction in cone-beam-computed tomography (CBCT) for radiological diagnostics of the paranasal sinuses. Eur Arch Otorhinolaryngology 2013; 270:1307–1315. Roman RA, Hedeşiu M, Gersak M, Fidan F, Băciuţ G, Băciuţ M. Assessing the prevalence of paranasal sinuses anatomical variants in patients with sinusitis using cone beam computer tomography. Clujul Medical. 2016;89(3):423. de Carvalho ABG, Costa ALF, Fuziy A, de Assis ACS, Veloso JRC, Junior LRCM, et al. Investigation on the relationship of dimensions of the maxillary sinus drainage system with the presence of sinusopathies: a cone beam computed tomography study. Archives of oral biology. 2018;94:78-83. Bell G, Joshi B, Macleod R. 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International archives of otorhinolaryngology. 2018;22(3):297-302 Aramani A, Karadi R, Kumar S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients-CT findings. Journal of clinical and diagnostic research: JCDR. 2014;8(10):KC01. Lu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X, et al. Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. Journal of endodontics. 2012;38(8):1069-74. Ritter L, Lutz J, Neugebauer J, Scheer M, Dreiseidler T, Zinser MJ, et al. Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;111(5):634-40. Aksoy U, Orhan K. Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study. Clinical oral investigations. 2019;23(1):123-31. Kayalioglu G, Oyar O, Govsa F. Nasal cavity and paranasal sinus bony variations: a computed tomographic study. Rhinology. 2000;38(3):108-13. Stammberger H, Wolf G. Headaches and sinus disease: the endoscopic approach. Annals of Otology, Rhinology & Laryngology. 1988;97(5_suppl):3-23. Tonai A, Baba S. Anatomic variations of the bone in sinonasal CT. Acta oto-laryngologica Supplementum. 1996;525:9-13. Alkire BC, Bhattacharyya N. An assessment of sinonasal anatomic variants potentially associated with recurrent acute rhinosinusitis. The Laryngoscope. 2010;120(3):631-4. Bolger WE, Parsons DS, Butzin CA. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. The Laryngoscope. 1991;101(1):56-64. Kennedy DW, Zinreich SJ. The functional endoscopic approach to inflammatory sinus disease: current perspectives and technique modifications. American Journal of Rhinology. 1988;2(3):89-96. Kainz J, Braun H, Genser P. Haller's cells: morphologic evaluation and clinico-surgical relevance. Laryngo-rhino-otologie. 1993;72(12):599-604. Perez‐Pinas I, Sabate J, Carmona A, Catalina‐Herrera C, Jimenez‐Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. Journal of anatomy. 2000;197(2):221-7. Messerklinger W. On the drainage of the normal frontal sinus of man. Acta oto-laryngologica. 1967;63(2-3):176-81. Meyers RM, Valvassori G. Interpretation of anatomic variations of computed tomography scans of the sinuses: a surgeon's perspective. The Laryngoscope. 1998;108(3):422-5. Stallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. American Journal of Neuroradiology. 2004;25(9):1613-8. Papadopoulou A-M, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical Variations of the Nasal Cavities and Paranasal Sinuses: A Systematic Review. Cureus. 2021;13(1). Holton NE, Yokley TR, Figueroa A. Nasal septal and craniofacial form in European‐and African‐derived populations. Journal of anatomy. 2012;221(3):263-74. Aramani A, Karadi R, Kumar S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients-CT findings. Journal of clinical and diagnostic research: JCDR. 2014;8(10):KC01. Bayrak S, Ustaoglu G, Demiralp KÖ, Çakmak ESK. Evaluation of the characteristics and association between schneiderian membrane thickness and nasal septum deviation. Journal of Craniofacial Surgery. 2018;29(3):683-7. Kucybała I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal septal deviation and concha bullosa–do they have an impact on maxillary sinus volumes and prevalence of maxillary sinusitis? Polish journal of radiology. 2017;82:126. Janner SF, Caversaccio MD, Dubach P, Sendi P, Buser D, Bornstein MM. Characteristics and dimensions of the Schneiderian membrane: a radiographic analysis using cone beam computed tomography in patients referred for dental implant surgery in the posterior maxilla. Clinical oral implants research. 2011;22(12):1446-53. Sheikhi M, Pozve NJ, Khorrami L. Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus. Dental research journal. 2014;11(4):495. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4732532","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":327610538,"identity":"649b969f-227f-4bd6-a292-ed965071149a","order_by":0,"name":"Fatemeh Alizadeh","email":"","orcid":"","institution":"Hamedan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Fatemeh","middleName":"","lastName":"Alizadeh","suffix":""},{"id":327610539,"identity":"5f517522-94d2-4bea-861e-06e90c57eaf4","order_by":1,"name":"Mohammadreza Jamalpour","email":"","orcid":"","institution":"Hamedan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mohammadreza","middleName":"","lastName":"Jamalpour","suffix":""},{"id":327610540,"identity":"9fcbcebd-a8ae-4abc-89df-5e7d68729eb0","order_by":2,"name":"Abbas Shokri","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4UlEQVRIie3PvQrCMBDA8TsCcQl1Taj6DEIXJ30Vi6ubkzioFDL5BgUfI7OQwaU4C3WwCs7tIFToYPyYHFq7CeY/HDfcDxIAm+0X27wnB1wezcacOiToPgitQYDyx1pJnHiDKRSHjgi1nF7H/RYFkpz2JUTshoSjvHiu48u4rUbmYdTzxiWkGwFwXGh/zVDGQhFDGHUrCMmheJGJUPOviPk11X5oCGZKVxMRoez5UntihYGLassoqfiLExG9Twvd4VEjyW5qNmg2guRcRgBwAcP3Sthzlp5/6rzOtc1ms/1Nd/VeRG+zXrk3AAAAAElFTkSuQmCC","orcid":"","institution":"Hamedan University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Abbas","middleName":"","lastName":"Shokri","suffix":""},{"id":327610541,"identity":"21d994fd-0910-4814-a357-abf0bb417d6a","order_by":3,"name":"Asal Ebrahimi","email":"","orcid":"","institution":"Hamedan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Asal","middleName":"","lastName":"Ebrahimi","suffix":""},{"id":327610542,"identity":"1e51811b-e164-47a4-afd3-37181a61f300","order_by":4,"name":"Amin Dousti Irani","email":"","orcid":"","institution":"Hamedan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Amin","middleName":"Dousti","lastName":"Irani","suffix":""}],"badges":[],"createdAt":"2024-07-12 20:31:53","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4732532/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4732532/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":62222959,"identity":"984da059-c226-42d6-a041-5d9f016ec946","added_by":"auto","created_at":"2024-08-11 12:41:12","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":769475,"visible":true,"origin":"","legend":"\u003cp\u003eAnatomical variations in the nasal cavity and pathologic condition of maxillary sinuses.A. Nasal septal deviation, B.Supraorbital air cell, C.Paradoxical concha, D.Concha bullosa, E.Length of the infundibulum,F.Haller cell.\u003c/p\u003e","description":"","filename":"fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-4732532/v1/134812708e704be81a52e30f.png"},{"id":62865290,"identity":"2c6c1cc6-2b51-40fe-bfd1-91a7ca207c3a","added_by":"auto","created_at":"2024-08-20 11:30:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1724465,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4732532/v1/4a182665-4c70-4283-9061-18689000b068.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Investigation of the relationship between nasal cavity variations and pathological conditions of maxillary sinuses in Cone Beam Computed Tomography","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe paranasal sinuses are 4 pairs of air spaces located around the nasal cavity. The nasal cavity and the paranasal sinuses decrease the weight of the skull, warm and moisturize the inhaled air, regulate speech resonance and intranasal pressure, and improve the sense of smell\u0026nbsp;(1,2).\u003c/p\u003e\n\u003cp\u003eThe formation of paranasal sinuses following depression of the nasal mucosa around the facial bones explains the high frequency of anatomical variations in this region\u0026nbsp;(3).Anatomical variations of the paranasal sinuses are highly important since they may predict inflammatory changes in the paranasal sinuses. Such variations of the sinus can complicate clinical procedures, particularly functional endoscopic surgery, in which accurate assessment of the region plays a pivotal role in the success and safety of surgical procedures\u0026nbsp;(4).\u003c/p\u003e\n\u003cp\u003eMucosal drainage in healthy tissue occurs via the\u0026nbsp;osteomeatal complex(OMC). In normal drainage and ventilation, the mucus reaches the ostium (maxillary sinus opening) and passes through a small passage that communicates with the nasal cavity (infundibulum)(1,5).\u0026nbsp;Variations that cause the narrowing of this passage have been shown to be responsible for the development of maxillary sinusitis\u0026nbsp;(6).Local anatomic variations associated with nasal septal deviation, concha bullosa, and Haller cells could cause this obstruction and sinusitis\u0026nbsp;(7).\u003c/p\u003e\n\u003cp\u003eSeveral radiographic imaging techniques are used to study the maxillary sinus. Panoramic radiography is the most common two-dimensional imaging technique used by most dentists to evaluate the general condition of the orofacial complex\u0026nbsp;(8).Although panoramic radiography is beneficial for achieving a general view of the orofacial area, it has some inherent limitations, including unequal magnification, and geometric distortion across the whole image layer. These limitations lead to incorrect anatomical and pathological evaluations, as well as unreliable measurement accuracy. Sometimes, the overlapping structures, such as the cervical spines, can lead to misdiagnosis. Obtaining a 3D view using computer tomography (CT) is a more precise method for evaluating the maxillary sinus. Although CT is the choice method for assessing maxillary sinuses, high cost, radiation dose, and access issues have limited its use in general dentistry(9).\u0026nbsp;The recent introduction of CBCT has enabled dentists and ENT specialists to understand anatomical abnormalities and pathologic areas within the nasal cavity and paranasal sinuses surrounding them(10).\u003c/p\u003e\n\u003cp\u003eSince the role of anatomical variations in relation to the pathological conditions of the maxillary sinus is controversial in different articles and there are still contradictions in the results of different articles (11,12,13); this study aimed to investigate the relationship of the anatomical variations of the nasal cavity with the pathological conditions of the maxillary sinuses in a more comprehensive way.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis cross-sectional study evaluated CBCT scans of the nasal cavity and maxillary sinuses retrieved from the archives of the Radiology Department of the School of Dentistry, Hamadan University of Medical Sciences, Iran from 2015\u0026nbsp;to 2021. Since the CBCT records had been previously prescribed for other medical purposes, no extra radiation was imposed on the patients. Personal information of all individuals was kept totally undisclosed. The survey and data use had obtained the informed consent of all participants that mentioned their images\u0026nbsp;could be used in research project. The\u0026nbsp;study design\u0026nbsp;of this was reviewed and approved by the ethical committee of Hamadan University of Medical Sciences (IR.UMSHA.REC.1399.749).All methods were carried out in accordance with relevant guidelines and regulations.This study included images from 280 patients (112 males and 168 females) in the age range of 10–65 years. Patients with a history of surgical procedures in this\u0026nbsp;area\u0026nbsp;, trauma to the head or face, clefts or benign or malignant tumors of the sinonasal mucosa causing changes in the anatomy of the nasal cavity or ethmoidal sinuses and\u0026nbsp;patients with periodontal disease \u0026nbsp;or periapical inflammatory lesions in posterior maxillary teeth that could influence on maxillary sinuses\u0026nbsp;were excluded.\u003c/p\u003e\n\u003cp\u003eAll images were captured with a New Tom 3G CBCT scanner (Quantitative Radiology, Verona, Italy) and evaluated in the axial, coronal, and sagittal planes by an oral and maxillofacial radiologist with 10 years of educational experience and a dentist using NNT Viewer software (New Tom, Verona, Italy). The device delivers a cone-beam x-ray, and has a flat panel detector, 1536×1920 pixels, 127×127-pixel size, 14-bit pixel depth, 360-degree rotation, 4.6-second scan duration, and a maximum voltage of 110. The initial and final reconstruction of the images were carried out with NNT viewer software version 17.2.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The images were viewed on a 20-inch LG monitor (LG, Seoul, Korea) in partly dark conditions. The observers could change the optical density and contrast of images using rendering software. The results were documented using a checklist. If there was any conflict between the 2 observers, the final decision was made by consulting a third observer, who was an experienced oral and maxillofacial radiologist. All images were analyzed again by the observers after 2 weeks, and the results were documented.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn this study, as similar to previous studies, (14,15) the following radiological findings were considered as sinusitis.\u003c/p\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eDiffuse mucosal thickening with 5 mm or more than 5 mm, which was in the maxillary, frontal, and sphenoid sinuses\u003c/li\u003e\n \u003cli\u003eAir-fluid level, with diffuse mucosal thickening \u0026lt;5 mm or without mucosal thickening, which was in the maxillary, frontal, and sphenoid sinuses\u003c/li\u003e\n \u003cli\u003ePartial opacifications, more than 5 mm, were polypoid, without diffuse mucosal thickening or total opacification, which were in the maxillary, frontal, and sphenoid sinuses\u003c/li\u003e\n \u003cli\u003ePartial and total opacifications of the ethmoid cells consisting of the ethmoid sinuses\u003c/li\u003e\n \u003cli\u003eThe reactive changes such as sclerosis, decalcification, and erosion leading to sinusitis on the sinus bones.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eWe examined the anatomical variations in the nasal cavity and maxillary sinuses separately:\u003c/p\u003e\n\u003cp\u003e1-Nasal septal deviation: Septal deviation refers as a deviation of the nasal septum in the inner part of the nose, which is categorized as follows:\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eType I: A slight deviation in the vertical or horizontal plane that does not stretch through the vertical dimension of the septum.\u003c/li\u003e\n \u003cli\u003eType II: Vertical anterior deviation\u003c/li\u003e\n \u003cli\u003eType III: Vertical posterior deviation\u003c/li\u003e\n \u003cli\u003eType IV: S-shaped septum\u003c/li\u003e\n \u003cli\u003eType V: Horizontal spores on one side with or without huge distortion on the opposite side\u003c/li\u003e\n \u003cli\u003eType VI: Type V with a deep groove on the concave surface\u003c/li\u003e\n \u003cli\u003eType VII: Any combination of Types II to VI. (16)\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eSeptum deviation was defined as a deviation above 4 mm from the midline (17). To determine septal deviation, the lines being drawn downward from the Crista Galli and upward from the nasal eminence were connected, and all deviations were noted without taking the degree of deviation into consideration (11).[figure 1 A]\u003c/p\u003e\n\u003cp\u003e2-Concha bullosa: Concha bullosa which can occur in any part of the ethmoid bone complex that becomes pneumatized, is the most common anatomical variation that occurs in the middle turbinate. When it occurs, posterior ethmoidal air cells are pulled in to pneumatize the middle turbinate. The area of pneumatization of the turbinate can be small, medium, or large. Very large cases can cause nasal septal deviation and nasal obstruction (2). [figure1 D]\u003c/p\u003e\n\u003cp\u003e3- Paradoxical concha: Paradoxical concha is a rare situation of nasal obstructive developmental anomaly and refers to the inferomedial position of the medial concha. In this situation, the convex surface of the concha is placed towards the nasal septum and is usually bilateral (18). [figure 1 C]\u003c/p\u003e\n\u003cp\u003e4-\u0026nbsp;Haller cell:\u0026nbsp;Haller cells are considered as air cells located along the medial portion of the orbital floor and continuous with the ethmoid capsule (19). [figure 1 F]\u003c/p\u003e\n\u003cp\u003e5-\u0026nbsp;Supraorbital air cell: supraorbital air cells are an anatomical variant of originating from the anterior ethmoid air cells extending posteriorly over the orbit from the frontal recess. (20) [figure 1 B]\u003c/p\u003e\n\u003cp\u003e6-\u0026nbsp;Agger nasi cells:\u0026nbsp;agger nasi cell, which reflects a clinically important pattern of the outward spread of air cells. Anterior ethmoidal cells can pneumatize the frontal process of the maxilla. These cells are known as agger nasi cells and are related to the lacrimal bone (20).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e7-Enlargement of uncinate process:\u0026nbsp;The uncinate process of the ethmoid bone is a thin hook-like osseous structure of the wall of the lateral nasal cavity, which can be normal, atelectatic, inclusive of the lamina terminalis, pneumatized, or curved (20).\u0026nbsp;enlargement of the uncinate process was considered as an increased length of the uncinate process beyond the lower rim of the orbit.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e8-\u0026nbsp;Maxillary sinus ostium: The maxillary sinus ostium was defined as the distance between the inferomedial aspect of the orbital rim and the uncinate process. Obviously, in the cases where Haller cells existed, the maxillary sinus ostium was quantified as the distance between the Haller cell at its most medial portion and the uncinate process (21). [figure 1A]\u003c/p\u003e\n\u003cp\u003e9- Length of the infundibulum: The length of the infundibulum was measured as the distance between the center of the ostium and the most upper point of the uncinate process in the coronal slice of the CBCT image (5). [figure 1E]\u003c/p\u003e\n\u003cp\u003eQuantitative variables were reported as mean and standard deviation and classified variables as frequency and percentage.\u0026nbsp;Chi-square test was used to examine the relationship between different anatomical variables of the nasal cavity and sinus mucosal thickening, polypoid mucosa, air-fluid presence in the sinus and any sclerosis\u003cem\u003e.\u003c/em\u003e\u003cem\u003e\u0026nbsp;P\u003c/em\u003e values lower than 0.05 were considered to indicate statistical significance. All statistical analyses were performed using SPSS version 24 (IBM Corp., Armonk, NY, USA).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn this study, CBCT images of 280 patients were evaluated. Of these, 112 (40%) were male and 168 (60%) were female and the mean age was 27.56. The frequency of each pathological condition of the maxillary sinus in the studied patients is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. Among the pathological conditions, thickening of the sinus mucosa was the most common. Next, a variety of anatomical variations of the nasal cavity were examined. The frequency and percentage of each anatomical variation is shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Then, the mean and standard deviation of some characteristics of maxillary sinus and nasal cavity were also calculated, the results of which are given in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency and Percentage of Maxillary Sinus Pathological Conditions.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathologic Conditions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e160\u003c/p\u003e \u003cp\u003e120\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57.14\u003c/p\u003e \u003cp\u003e42.86\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe direction of thickening of sinus mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003cp\u003eRight\u003c/p\u003e \u003cp\u003eLeft-Right\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35\u003c/p\u003e \u003cp\u003e40\u003c/p\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.17\u003c/p\u003e \u003cp\u003e33.33\u003c/p\u003e \u003cp\u003e37.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e227\u003c/p\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81,07\u003c/p\u003e \u003cp\u003e18,93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe direction of Polypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003cp\u003eRight\u003c/p\u003e \u003cp\u003eLeft- Right\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003cp\u003e25\u003c/p\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28.3\u003c/p\u003e \u003cp\u003e47.17\u003c/p\u003e \u003cp\u003e24.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e279\u003c/p\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e99.64\u003c/p\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e247\u003c/p\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.21\u003c/p\u003e \u003cp\u003e11.79\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe direction of Sclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003cp\u003eRight\u003c/p\u003e \u003cp\u003eLeft-Right\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003cp\u003e13\u003c/p\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30.3\u003c/p\u003e \u003cp\u003e39.39\u003c/p\u003e \u003cp\u003e30.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of each Anatomical Variations\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnatomic Variation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e170\u003c/p\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.71\u003c/p\u003e \u003cp\u003e39.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConcha Bullosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e88\u003c/p\u003e \u003cp\u003e192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31.43\u003c/p\u003e \u003cp\u003e68.57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe direction of Concha Bullosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003cp\u003eRight\u003c/p\u003e \u003cp\u003eLeft-Right\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003cp\u003e44\u003c/p\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.27\u003c/p\u003e \u003cp\u003e22.92\u003c/p\u003e \u003cp\u003e57.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaller Cells\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e151\u003c/p\u003e \u003cp\u003e129\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.93\u003c/p\u003e \u003cp\u003e46.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe direction of Haller Cells\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003cp\u003eRight\u003c/p\u003e \u003cp\u003eLeft-Right\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32\u003c/p\u003e \u003cp\u003e38\u003c/p\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e24.81\u003c/p\u003e \u003cp\u003e29.46\u003c/p\u003e \u003cp\u003e45.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParadoxical Concha\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e222\u003c/p\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79.29\u003c/p\u003e \u003cp\u003e20.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe direction of Paradoxical Concha\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLeft\u003c/p\u003e \u003cp\u003eRight\u003c/p\u003e \u003cp\u003eLeft-Right\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003cp\u003e26\u003c/p\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.86\u003c/p\u003e \u003cp\u003e44.83\u003c/p\u003e \u003cp\u003e29.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSupraorbital air cells\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e213\u003c/p\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.07\u003c/p\u003e \u003cp\u003e23.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAgger Nasi Cells\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e96\u003c/p\u003e \u003cp\u003e184\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.29\u003c/p\u003e \u003cp\u003e65.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnlargement of Right Uncinate Process\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003cp\u003e225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.64\u003c/p\u003e \u003cp\u003e80.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnlargement of Left Uncinate Process\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003cp\u003e242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.57\u003c/p\u003e \u003cp\u003e86.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAverage and Standard Deviation of some characteristics of Maxillary Sinus and Nasal Cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal Number of Observation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003cp\u003e(mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStandard Deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMinimum\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMaximum\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe diameter of right maxillary ostium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe diameter of left maxillary ostium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe Hight of right Infundibulum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe Hight of left Infundibulum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e280\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe association between each of the pathological conditions of the maxillary sinus with gender was examined. The results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e. As the results show, the thickness of sinus mucosa and polypoid mucosa are significantly related to gender (P\u0026thinsp;=\u0026thinsp;0.003 and P\u0026thinsp;=\u0026thinsp;0.002, respectively) so that the prevalence of both variables was higher in men than women. However, fluid-air and sclerosis had no significant relationship with gender (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions of the Maxillary Sinus and Gender.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003cp\u003e(Men)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFrequency (Women)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(46.43)\u003c/p\u003e \u003cp\u003e60(53.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e198(64.29)\u003c/p\u003e \u003cp\u003e60(35.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81(72.32)\u003c/p\u003e \u003cp\u003e31(27.68)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e146(86.9)\u003c/p\u003e \u003cp\u003e22(13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e167(99.4)\u003c/p\u003e \u003cp\u003e1(0.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.413\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95(84.82)\u003c/p\u003e \u003cp\u003e17(15.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e152(90.48)\u003c/p\u003e \u003cp\u003e16(9.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.151\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThere was no relationship between pathological conditions of the maxillary sinus and anatomical variations of the nasal cavity and age. (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05)\u003c/p\u003e \u003cp\u003eThe relationship between pathological conditions and gender with nasal septal deviation was also examined, the results of which are shown in Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. As the results show, there is no relationship between gender and any of the pathological conditions with nasal septal deviation (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions \u0026amp; Gender with the nasal septal deviation\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEN\u003c/p\u003e \u003cp\u003eWOMEN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43(39. 09)\u003c/p\u003e \u003cp\u003e67(60.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e69(40.59)\u003c/p\u003e \u003cp\u003e101(59.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.803\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e66(60)\u003c/p\u003e \u003cp\u003e44(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e94(55.29)\u003c/p\u003e \u003cp\u003e76(44.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.437\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92(83.64)\u003c/p\u003e \u003cp\u003e18(16.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e135(79.41)\u003c/p\u003e \u003cp\u003e35(20.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.378\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e110(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e169(99.41)\u003c/p\u003e \u003cp\u003e1(0.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.420\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98(89.09)\u003c/p\u003e \u003cp\u003e12(10.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e149(87.65)\u003c/p\u003e \u003cp\u003e21(12.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.714\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe relationship between pathological conditions and gender with concha bullosa was also examined, the results of which are shown in Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e. As the results show, there is no relationship between gender and any of the pathological conditions with concha bullosa (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions and gender with Concha Bullosa.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEN\u003c/p\u003e \u003cp\u003eWOMEN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77(40.1)\u003c/p\u003e \u003cp\u003e115(59.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35(39.77)\u003c/p\u003e \u003cp\u003e53(60.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.958\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e109(56.77)\u003c/p\u003e \u003cp\u003e83(43.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51(57.95)\u003c/p\u003e \u003cp\u003e37(42.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.853\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e156(81.25)\u003c/p\u003e \u003cp\u003e36(18.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e71(80.68)\u003c/p\u003e \u003cp\u003e17(19.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.910\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e191(99.48)\u003c/p\u003e \u003cp\u003e1(0.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.498\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e171(89.06)\u003c/p\u003e \u003cp\u003e21(10.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76(86.36)\u003c/p\u003e \u003cp\u003e12(13.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.516\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe relationship between pathological conditions and gender with Haller cells was also examined, the results of which are shown in Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e. As the results show, there is no relationship between gender and any of the pathological conditions with Haller cells (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions and gender with Haller cells.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEN\u003c/p\u003e \u003cp\u003eWOMEN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55(42.64)\u003c/p\u003e \u003cp\u003e74(57.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e57(37.75)\u003c/p\u003e \u003cp\u003e94(62.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.405\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70(54.26)\u003c/p\u003e \u003cp\u003e59(45.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90(59.6)\u003c/p\u003e \u003cp\u003e61(40.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.853\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e102(79.07)\u003c/p\u003e \u003cp\u003e27(20.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e125(82.78)\u003c/p\u003e \u003cp\u003e26(17.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.429\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e129(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e150(99.34)\u003c/p\u003e \u003cp\u003e1(0.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.354\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e110(85.27)\u003c/p\u003e \u003cp\u003e19(14.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e137(90.73)\u003c/p\u003e \u003cp\u003e14(9.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.158\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe relationship between pathological conditions and gender with paradoxical concha was also examined, the results of which are shown in Table\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e. As the results show, there is only a significant relationship between sinus mucosal thickening and paradoxical concha (P\u0026thinsp;=\u0026thinsp;0.0001). However, there was no association between gender and other pathological conditions with paradoxical concha (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions and gender with Paradoxical concha.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEN\u003c/p\u003e \u003cp\u003eWOMEN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24(41.38)\u003c/p\u003e \u003cp\u003e34(58.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88(39.64)\u003c/p\u003e \u003cp\u003e134(60.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.810\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45(77.59)\u003c/p\u003e \u003cp\u003e13(22.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e115(51.8)\u003c/p\u003e \u003cp\u003e107(48.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(89.66)\u003c/p\u003e \u003cp\u003e6(10.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e175(78.83)\u003c/p\u003e \u003cp\u003e47(21.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e221(99.55)\u003c/p\u003e \u003cp\u003e1(0.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.609\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52(89.66)\u003c/p\u003e \u003cp\u003e6(10.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e195(87.84)\u003c/p\u003e \u003cp\u003e27(12.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.702\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe relationship between pathological conditions and gender with Supraorbital air cells was also examined, the results of which are shown in Table\u0026nbsp;\u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e. As the results show, there is no relationship between gender and any of the pathological conditions with Supraorbital air cells (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions and gender with supraorbital cells.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEN\u003c/p\u003e \u003cp\u003eWOMEN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30(44.78)\u003c/p\u003e \u003cp\u003e37(55.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e82(38.5)\u003c/p\u003e \u003cp\u003e131(61.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.360\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38(56.72)\u003c/p\u003e \u003cp\u003e29(43.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e122(57.28)\u003c/p\u003e \u003cp\u003e91(42.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.936\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e58(86.57)\u003c/p\u003e \u003cp\u003e9(13.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e169(79.34)\u003c/p\u003e \u003cp\u003e44(20.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.188\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e212(99.53)\u003c/p\u003e \u003cp\u003e1(0.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.574\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62(92.54)\u003c/p\u003e \u003cp\u003e5(7.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e185(86.85)\u003c/p\u003e \u003cp\u003e28(13.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.208\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe relationship between pathological conditions and gender with Agger nasi cells was also examined, the results of which are shown in Table\u0026nbsp;\u003cspan refid=\"Tab10\" class=\"InternalRef\"\u003e10\u003c/span\u003e. As the results show, there is no relationship between gender and any of the pathological conditions with Agger nasi cells (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab10\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 10\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions and gender with Agger nasi cells.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEN\u003c/p\u003e \u003cp\u003eWOMEN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67(36.41)\u003c/p\u003e \u003cp\u003e117(63.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e45(46.,88)\u003c/p\u003e \u003cp\u003e51(53.13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.090\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e106(57.61)\u003c/p\u003e \u003cp\u003e78(42.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54(56.25)\u003c/p\u003e \u003cp\u003e42(43.75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.827\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e151(82.07)\u003c/p\u003e \u003cp\u003e33(17.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76(79.17)\u003c/p\u003e \u003cp\u003e20(20.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.557\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e183(99.46)\u003c/p\u003e \u003cp\u003e1(0.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e96(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.469\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e168(91.3)\u003c/p\u003e \u003cp\u003e16(8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e79(82.29)\u003c/p\u003e \u003cp\u003e17(17.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe relationship between pathological conditions and gender with the Enlargement of unciate process on the right and left was also examined, the results of which are shown in Tables\u0026nbsp;\u003cspan refid=\"Tab11\" class=\"InternalRef\"\u003e11\u003c/span\u003e and \u003cspan refid=\"Tab12\" class=\"InternalRef\"\u003e12\u003c/span\u003e. As the results show, there is no relationship between gender and any of the pathological conditions with the Enlargement of unciate process on the right and left (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab11\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 11\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions and gender with Enlargement of right uncinate process.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEN\u003c/p\u003e \u003cp\u003eWOMEN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e90(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e135(60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22(\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e33(60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e129(57.33)\u003c/p\u003e \u003cp\u003e96(42.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31(56.36)\u003c/p\u003e \u003cp\u003e24(43.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.896\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e185(82.22)\u003c/p\u003e \u003cp\u003e40(17.78)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42(76.36)\u003c/p\u003e \u003cp\u003e13(23.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.320\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e244(99.56)\u003c/p\u003e \u003cp\u003e1(0.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e55(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.620\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e196(87.11)\u003c/p\u003e \u003cp\u003e29(12.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51(92.73)\u003c/p\u003e \u003cp\u003e4(7.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.247\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab12\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 12\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship between Pathological Conditions and gender with Enlargement of left uncinate process.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eNasal septal deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP- value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMEN\u003c/p\u003e \u003cp\u003eWOMEN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99(40.91)\u003c/p\u003e \u003cp\u003e143(59.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13(34.21)\u003c/p\u003e \u003cp\u003e25(65.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.433\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThickening of Sinus Mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e138(57.02)\u003c/p\u003e \u003cp\u003e104(42.98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22(57.89)\u003c/p\u003e \u003cp\u003e16(42.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.920\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolypoid mucosa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e197(81.4)\u003c/p\u003e \u003cp\u003e45(17.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e30(78.95)\u003c/p\u003e \u003cp\u003e8(21.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.719\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFluid-Air\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e241(99.59)\u003c/p\u003e \u003cp\u003e1(0.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e38(100)\u003c/p\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.691\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSclerosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO\u003c/p\u003e \u003cp\u003eYES\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e214(88.43)\u003c/p\u003e \u003cp\u003e28(11.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33(86.84)\u003c/p\u003e \u003cp\u003e5(13.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.778\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFinally, the relationship of some other characteristics of maxillary sinus and nasal cavity with gender was also investigated, the results of which are shown in Table\u0026nbsp;\u003cspan refid=\"Tab13\" class=\"InternalRef\"\u003e13\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab13\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 13\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe Relationship Between Some Characteristics of Maxillary Sinus and Nasal Cavity and Gender\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eQuantity\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAverage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eStandard deviation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe diameter of right maxillary ostium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.591071\u003c/p\u003e \u003cp\u003e1.514286\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.6935421\u003c/p\u003e \u003cp\u003e0.6443012\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.344\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe diameter of left maxillary ostium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.685714\u003c/p\u003e \u003cp\u003e1.73631\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.6627621\u003c/p\u003e \u003cp\u003e0.6866935\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.540\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe Hight of right Infundibulum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11,06518\u003c/p\u003e \u003cp\u003e9.960714\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.268129\u003c/p\u003e \u003cp\u003e2.65041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe Hight of left Infundibulum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003cp\u003e168\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.55536\u003c/p\u003e \u003cp\u003e10.73512\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.249971\u003c/p\u003e \u003cp\u003e2.871627\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAs the results show, there is only a significant relationship between the height of the right and left infundibulum and gender (P\u0026thinsp;=\u0026thinsp;0.002), so that their amount is higher in men than women.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAnatomical variations of the sinonasal region should be carefully identified prior to surgical procedures. These anatomical variations are important for 2 reasons. First, anatomical variations have a direct correlation with the drainage and ventilation of the paranasal sinuses. Second, anatomical variations can significantly affect the safety of surgical procedures (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAccording to the results of our study, thickening of the maxillary sinus mucosa was the most common pathological condition of the maxillary sinus, as seen in nearly 43% of CBCT images of this pathology. In the study of Lu et al., This rate was 46.2%, which is close to the prevalence obtained from our study (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). The prevalence of sinus thickening was 56% (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) in the study of Ritter et al. And 58% (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e) in the study of Aksoy et al. As in our study, Akay et al. Showed that thickening of the maxillary sinus mucosa has the highest frequency among maxillary sinus pathological conditions (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eHowever, in the study of Akay et al., The prevalence of this pathology was 25%, which is much less than the frequency obtained from our study (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). In general, most studies have reported sinus thickening as the most common maxillary sinus pathology. In general, the prevalence of maxillary sinus mucosa thickening in previous studies varied from 25% in the study of Akay et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) to 58% in the study of Aksoy et al. (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e), and different studies have reported different prevalence.\u003c/p\u003e \u003cp\u003eThe difference in the pathology prevalence of maxillary sinus thickening in different studies may be due to differences in the size of the thickness that is considered as thickening. Some studies have considered an increase in mucosal thickness of more than 1 mm, some more than 2 mm, and some more than 3 mm as thickening. As a result, differences in this size have led to a different prevalence of this pathology being reported in previous studies (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe maxillary sinus is directly connected to the roots of the maxillary teeth, which causes the sinus to be associated with inflammation of these teeth, and any inflammation in these teeth alters the contents of the sinus and its normal physiology (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e); Therefore, in our study, patients with periapical inflammation and periodontal disease in the posterior maxillary teeth were excluded.\u003c/p\u003e \u003cp\u003eThe results of our study showed that the thickening of the maxillary sinus mucosa is significantly associated with paradoxical concha. The study by Kayalioglu et al. Also showed that paradoxical concha has a higher prevalence in people with sinusitis. The incidence of this disorder was reported in 12% of people with sinusitis and only 7% in people without sinusitis (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn fact, paradoxical concha blocks the middle meatus and, as a result, increases the thickness of the sinus mucosa and causes sinusitis (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Stammberger et al. Also considered paradoxical concha as a factor in sinus pathology and increased mucosal thickness. They suggested that paradoxical concha may cause complete destruction or change in the dynamics of the nasal airflow, resulting in a change in the maxillary sinus (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn our study, the prevalence of Haller cells was 45%. This rate was 36% for Tonai and Baba (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e) and 40% for Alkire and Bhattacharyya (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). In the study of Khojastepour et al., This rate was 42% (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). Also, in the study of Akay et al., The prevalence of Haller cells was reported to be about 37% (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Also, as in our study, Akay et al. Did not find a significant association between Haller cells and maxillary sinus pathology (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). The presence of Haller cells is associated with inflammatory changes in the mouth and teeth. Therefore, in our study, people with periodontal disease and any inflammation at the site were excluded from the study. Therefore, differences in the characteristics of the study population have led to different prevalence of Haller cells in studies. Also, differences in the definition and consequent diagnosis of Haller cells in studies can be the cause of differences in the results of previous studies (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). For example, Bolger et al. Defined the Haller cell as any air cell located between the ethmoid bulla and the orbital floor (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). Kennedy et al., Like us, defined cells in the midline of the orbital floor above the maxillary sinus ostium that extend into the sinus as a haller cell (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Kainz et al., However, defined the Haller cell as air cells in the orbital floor (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). Finally, the technique used can also affect the difference in results because CBCT has a higher resolution than CT methods such as Multislice CT and therefore has a higher diagnostic power in this method (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn our study, a high prevalence of agger nasi cells was observed in patients (65.71%). In different studies, the prevalence of agger nasi cells has been reported between 10 and 100% (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). Also, in our study, no significant relationship was observed between agger nasi cells and maxillary sinus pathology. However, in the study of Kaya et al., The presence of agger nasi cells was significantly associated with maxillary sinusitis (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Differences in results may be due to differences in the characteristics of the study population, racial differences, as well as different sample sizes in previous studies.\u003c/p\u003e \u003cp\u003eThe prevalence of supraorbital cells in our study was 24%. In the study of Kaya et al., This rate was 14%. In general, the prevalence of supraorbital air cells in previous studies varied from 10 to 98% (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). These differences can be due to differences in sample size, differences in population characteristics and differences in race.\u003c/p\u003e \u003cp\u003eIn this study, concha bullosa had a high prevalence as seen in 68% of the CBCT images. This rate was 44% (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e) for the study of Stallman et al. And 42% for the study of Alkire et al. (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). However, Akay et al. Reported a relatively low prevalence of concha bullosa in their study population (36%), although they did not observe a significant association between concha bullosa and maxillary sinus pathology as in our study (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Also, in the study of Kalaiarasi et al., No significant relationship was observed between concha bullosa and maxillary sinus pathology (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Similar results were observed in the Tassoker study (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). In general, the difference in the prevalence of concha bullosa in previous studies is probably due to different entry and exit criteria (which makes the studied populations have different characteristics) as well as racial differences between populations (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). In this regard, Papadopoulos et al., In a recent systematic review study of more than 50 articles, showed that race is an important factor in anatomical variation (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAs in our study, Akay et al. Showed that there was no significant relationship between nasal septal deviation and Haller cells with maxillary pathological conditions (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). However, some studies have shown that nasal septal deviation is significantly associated with maxillary sinus because it causes swelling and edema of the middle concha and obstruction of the meatus, resulting in obstruction of mucosal flow in the sinus (\u003cspan additionalcitationids=\"CR39\" citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). In general, the incidence of septal deviation in the community in various studies has been reported between 9 and 80%. The reason for the difference in the results of our studies compared to other studies that have shown a significant relationship between septal deviation and maxillary pathology can also be due to differences in the incidence of this disorder in different communities (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn our study, sinus and polypoid mucosal thickening were significantly associated with gender, so that the frequency of these pathological conditions was higher in men than women. Consistent with our study, Akay et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) as well as Janner et al. Reported a significant relationship between gender and mucosal thickening. They also showed that sinus mucosal thickening was more common in men (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e). This finding is also consistent with the findings of a study by Sheikhi et al. (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn addition, the results of our study showed that the height of the infundibulum had a significant relationship with gender and its rate was higher in men. Akay et al. Showed that the height of the infundibulum and the diameter of the maxilla ostomy are higher in men than women (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). However, de Carvalho et al. did not observe a significant relationship between infundibulum height and maxillary ostium diameter and gender (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). The reason for the difference in the results of previous studies can be the difference in exclusion criteria, measurement technique and also the difference in the race population (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn our study, no significant relationship was observed between maxillary pathological conditions and anatomical variations of the nasal cavity with age, and only the size of the uncinate process was directly related to age. The results of Akay et al.'s study also showed that there is no significant relationship between age and pathological conditions of maxillary sinus and its anatomical variations. Although they showed that the incidence of maxillary sinus pathology increases with age, but this increase was not significant (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results of this study showed that maxillary sinus thickening has the highest frequency of pathological conditions in patients. Also, among the anatomical variations of the nasal cavity, the size of the uncinate process on the right and left was the most frequent. In addition, in this study, a significant relationship was observed between the thickening of the maxillary sinus mucosa and paradoxical concha. However, no association was found between nasal septal deviation, concha bullosa, uncinate process size, diameter of maxillary sinus ostium and infundibulum height with maxillary sinus pathological conditions. Finally, the CBCT method seems to be a reliable method in the study of anatomical variations and its relationship with the pathological conditions of the maxillary sinus. Basic knowledge of anatomical variations and their relationship to the maxillary sinus mucosa is essential for sinus surgery as well as dental implants\u0026rsquo;.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCBCT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eCone-beam computed tomography\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003eAcknowledgements\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Vice-Chancellor of Research and Technology of Hamadan University of Medical Sciences provided funding for this study (14000131766).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthors\u0026rsquo; contributions\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFA were principal investigators; MJ were secondary investigators tooth collection and data measurements during imaging; ASH imaging and writing the original draft and following submission, NHS was involved in the statistical analysis. All authors read and approved the final manuscript\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFunding\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Vice-Chancellor of Research and Technology of Hamadan University of Medical Sciences provided funding for this study (14000131766).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe complete documentation of all patients enrolled in this study belongs to the authors, and are available only upon reasonable request.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEthics approval and consent to participate\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study was approved by the ethics committee of Hamadan University of Medical Sciences (IR.UMSHA.REC. 1399.749). All patients consented to the use of their extracted teeth for research purposes prior to extraction at the department of oral and maxillofacial surgery, and signed an informed consent form for this purpose.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent for Publication\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eNot applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eCompeting interests\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests in relation to the present study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAuthor details\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e1Dental School, Hamadan University of Medical Sciences, Hamadan, Iran. 2Department of oral and maxillofacial surgery Hamadan, Iran. 3Dental Implants Research Center, Department of Oral and Maxillofacial Radiology, Hamadan, Iran.4Department of epidemiology, Hamadan University of Medical Sciences, Shahid Fahmideh Blvd, 65166474\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eParks ET. Cone beam computed tomography for the nasal cavity and paranasal sinuses. Dental Clinics. 2014;58(3):627-51.\u003c/li\u003e\n \u003cli\u003eKoo SK, Kim JD, Moon JS, Jung SH, Lee SH. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: a retrospective radiologic study. Auris Nasus Larynx. 2017;44(5):561-70.\u003c/li\u003e\n \u003cli\u003eG\u0026uuml;ldner C, Ningo A, Voigt J, Diogo I, Heinrichs J, Weber R, et al. Potential of dosage reduction in cone-beam-computed tomography (CBCT) for radiological diagnostics of the paranasal sinuses. Eur Arch Otorhinolaryngology 2013; 270:1307\u0026ndash;1315.\u003c/li\u003e\n \u003cli\u003eRoman RA, Hedeşiu M, Gersak M, Fidan F, Băciuţ G, Băciuţ M. Assessing the prevalence of paranasal sinuses anatomical variants in patients with sinusitis using cone beam computer tomography. Clujul Medical. 2016;89(3):423.\u003c/li\u003e\n \u003cli\u003ede Carvalho ABG, Costa ALF, Fuziy A, de Assis ACS, Veloso JRC, Junior LRCM, et al. Investigation on the relationship of dimensions of the maxillary sinus drainage system with the presence of sinusopathies: a cone beam computed tomography study. Archives of oral biology. 2018;94:78-83.\u003c/li\u003e\n \u003cli\u003eBell G, Joshi B, Macleod R. Maxillary sinus disease: diagnosis and treatment. British dental journal. 2011;210(3):113-8.\u003c/li\u003e\n \u003cli\u003eAramani A, Karadi RN, Kumar S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients-CT findings. J Clin Diagn Res. 2014 Oct;8(10):KC01\u0026ndash;04.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eLee JW, Yoo JY, Paek SJ, Park W-J, Choi EJ, Choi M-G. et al. Correlations between anatomic variations of maxillary sinus ostium and postoperative complication after sinus lifting. J Korean Assoc Oral Maxillofac Surg. 2016;42(5):278\u0026ndash;83. doi: 10.5125/jkaoms.2016.42.5.278\u003c/li\u003e\n \u003cli\u003eTadinada A, Fung K, Thacker S, Mahdian M, Jadhav A, Schincaglia GP. Radiographic evaluation of the maxillary sinus prior to dental implant therapy: a comparison between two-dimensional and three-dimensional radiographic imaging. Imaging science in dentistry. 2015;45(3):169.\u003c/li\u003e\n \u003cli\u003evan den Bergh JP, ten Bruggenkate CM, Disch FJ, Tuinzing DB. Anatomical aspects of sinus floor elevations. Clin Oral Implants Res. 2000 Jun;11(3):256\u0026ndash;65.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eKaya M, \u0026Ccedil;ankal F, Gumusok M, Apaydin N, Tekdemir I. Role of anatomic variations of paranasal sinuses on the prevalence of sinusitis: Computed tomography findings of 350 patients. Nigerian journal of clinical practice. 2017;20(11):1481-8.\u003c/li\u003e\n \u003cli\u003eTassoker M. What are the risk factors for maxillary sinus pathologies? A CBCT study. Oral radiology. 2020;36(1):80-4.\u003c/li\u003e\n \u003cli\u003eAkay G, Yaman D, Karadağ \u0026Ouml;, G\u0026uuml;ng\u0026ouml;r K. Evaluation of the Relationship of Dimensions of Maxillary Sinus Drainage System with Anatomical Variations and Sinusopathy: Cone-Beam Computed Tomography Findings. Medical Principles and Practice. 2020;29(4):354-63.\u003c/li\u003e\n \u003cli\u003eHansen JG, Schmidt H, Rosborg J, Lund E. Predicting acute maxillary sinusitis in a general practice population. Bmj. 1995;311(6999):233-6.\u003c/li\u003e\n \u003cli\u003eLindbaek M, Johnsen U-H, Kaastad E, D\u0026oslash;lvik S, M\u0026oslash;ll P, Laerum E, et al. CT findings in general practice patients with suspected acute sinusitis. Acta radiologica. 1996;37(3P2):708-13.\u003c/li\u003e\n \u003cli\u003eRao JJ, Kumar EV, Babu KR, Chowdary VS, Singh J, Rangamani SV. Classification of nasal septal deviations\u0026mdash;relation to sinonasal pathology. Indian journal of otolaryngology and head and neck surgery. 2005;57(3):199-201.\u003c/li\u003e\n \u003cli\u003eStackpole SA, Edelstein DR. The anatomic relevance of the Haller cell in sinusitis. American journal of rhinology. 1997;11(3):219-24.\u003c/li\u003e\n \u003cli\u003eBhandary SK. Study of relationship of concha bullosa to nasal septal deviation and sinusitis. Indian Journal of Otolaryngology and Head \u0026amp; Neck Surgery. 2009;61(3):227-9.\u003c/li\u003e\n \u003cli\u003eKhojastepour L, Haghnegahdar A, Khosravifard N. Suppl-1, M5: Role of Sinonasal Anatomic Variations in the Development of Maxillary Sinusitis: A Cone Beam CT Analysis. The open dentistry journal. 2017;11:367.\u003c/li\u003e\n \u003cli\u003eSom PM, Curtin HD. Head and Neck Imaging E-Book: Elsevier Health Sciences; 2011.\u003c/li\u003e\n \u003cli\u003eKalaiarasi R, Ramakrishnan V, Poyyamoli S. Anatomical variations of the middle turbinate concha bullosa and its relationship with chronic sinusitis: a prospective radiologic study. International archives of otorhinolaryngology. 2018;22(3):297-302\u003c/li\u003e\n \u003cli\u003eAramani A, Karadi R, Kumar S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients-CT findings. Journal of clinical and diagnostic research: JCDR. 2014;8(10):KC01.\u003c/li\u003e\n \u003cli\u003eLu Y, Liu Z, Zhang L, Zhou X, Zheng Q, Duan X, et al. Associations between maxillary sinus mucosal thickening and apical periodontitis using cone-beam computed tomography scanning: a retrospective study. Journal of endodontics. 2012;38(8):1069-74.\u003c/li\u003e\n \u003cli\u003eRitter L, Lutz J, Neugebauer J, Scheer M, Dreiseidler T, Zinser MJ, et al. Prevalence of pathologic findings in the maxillary sinus in cone-beam computerized tomography. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2011;111(5):634-40.\u003c/li\u003e\n \u003cli\u003eAksoy U, Orhan K. Association between odontogenic conditions and maxillary sinus mucosal thickening: a retrospective CBCT study. Clinical oral investigations. 2019;23(1):123-31.\u003c/li\u003e\n \u003cli\u003eKayalioglu G, Oyar O, Govsa F. Nasal cavity and paranasal sinus bony variations: a computed tomographic study. Rhinology. 2000;38(3):108-13.\u003c/li\u003e\n \u003cli\u003eStammberger H, Wolf G. Headaches and sinus disease: the endoscopic approach. Annals of Otology, Rhinology \u0026amp; Laryngology. 1988;97(5_suppl):3-23.\u003c/li\u003e\n \u003cli\u003eTonai A, Baba S. Anatomic variations of the bone in sinonasal CT. Acta oto-laryngologica Supplementum. 1996;525:9-13.\u003c/li\u003e\n \u003cli\u003eAlkire BC, Bhattacharyya N. An assessment of sinonasal anatomic variants potentially associated with recurrent acute rhinosinusitis. The Laryngoscope. 2010;120(3):631-4.\u003c/li\u003e\n \u003cli\u003eBolger WE, Parsons DS, Butzin CA. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. The Laryngoscope. 1991;101(1):56-64.\u003c/li\u003e\n \u003cli\u003eKennedy DW, Zinreich SJ. The functional endoscopic approach to inflammatory sinus disease: current perspectives and technique modifications. American Journal of Rhinology. 1988;2(3):89-96.\u003c/li\u003e\n \u003cli\u003eKainz J, Braun H, Genser P. Haller\u0026apos;s cells: morphologic evaluation and clinico-surgical relevance. Laryngo-rhino-otologie. 1993;72(12):599-604.\u003c/li\u003e\n \u003cli\u003ePerez‐Pinas I, Sabate J, Carmona A, Catalina‐Herrera C, Jimenez‐Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. Journal of anatomy. 2000;197(2):221-7.\u003c/li\u003e\n \u003cli\u003eMesserklinger W. On the drainage of the normal frontal sinus of man. Acta oto-laryngologica. 1967;63(2-3):176-81.\u003c/li\u003e\n \u003cli\u003eMeyers RM, Valvassori G. Interpretation of anatomic variations of computed tomography scans of the sinuses: a surgeon\u0026apos;s perspective. The Laryngoscope. 1998;108(3):422-5.\u003c/li\u003e\n \u003cli\u003eStallman JS, Lobo JN, Som PM. The incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. American Journal of Neuroradiology. 2004;25(9):1613-8.\u003c/li\u003e\n \u003cli\u003ePapadopoulou A-M, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical Variations of the Nasal Cavities and Paranasal Sinuses: A Systematic Review. Cureus. 2021;13(1).\u003c/li\u003e\n \u003cli\u003eHolton NE, Yokley TR, Figueroa A. Nasal septal and craniofacial form in European‐and African‐derived populations. Journal of anatomy. 2012;221(3):263-74.\u003c/li\u003e\n \u003cli\u003eAramani A, Karadi R, Kumar S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients-CT findings. Journal of clinical and diagnostic research: JCDR. 2014;8(10):KC01.\u003c/li\u003e\n \u003cli\u003eBayrak S, Ustaoglu G, Demiralp K\u0026Ouml;, \u0026Ccedil;akmak ESK. Evaluation of the characteristics and association between schneiderian membrane thickness and nasal septum deviation. Journal of Craniofacial Surgery. 2018;29(3):683-7.\u003c/li\u003e\n \u003cli\u003eKucybała I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal septal deviation and concha bullosa\u0026ndash;do they have an impact on maxillary sinus volumes and prevalence of maxillary sinusitis? Polish journal of radiology. 2017;82:126.\u003c/li\u003e\n \u003cli\u003eJanner SF, Caversaccio MD, Dubach P, Sendi P, Buser D, Bornstein MM. Characteristics and dimensions of the Schneiderian membrane: a radiographic analysis using cone beam computed tomography in patients referred for dental implant surgery in the posterior maxilla. Clinical oral implants research. 2011;22(12):1446-53.\u003c/li\u003e\n \u003cli\u003eSheikhi M, Pozve NJ, Khorrami L. Using cone beam computed tomography to detect the relationship between the periodontal bone loss and mucosal thickening of the maxillary sinus. Dental research journal. 2014;11(4):495.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cone Beam Computed Tomography, Nasal cavity, Anatomical variations, Maxillary sinus","lastPublishedDoi":"10.21203/rs.3.rs-4732532/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4732532/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective\u003c/strong\u003e: 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.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: 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.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: 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).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: 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.\u003c/p\u003e","manuscriptTitle":"Investigation of the relationship between nasal cavity variations and pathological conditions of maxillary sinuses in Cone Beam Computed Tomography","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-11 12:41:07","doi":"10.21203/rs.3.rs-4732532/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"35b61874-5b4c-4377-8ee2-a0fb8cfa1e20","owner":[],"postedDate":"August 11th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-08-20T11:22:00+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-11 12:41:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4732532","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4732532","identity":"rs-4732532","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}