Evaluation of the Types of Deviated Nasal Septum and Concha Bullosa and Their Association with Chronic Rhinosinusitis Severity Using the Lund–Mackay Score on Computed Tomography.

Original Article

Abstract

Objective: To determine the association between the types of deviated nasal septum and concha bullosa and the radiological severity of chronic rhinosinusitis using the Lund–Mackay score on computed tomography.

Methods: A cross-sectional analytical study was conducted on 113 patients undergoing CT examination at the CT Scan Center, DHQ Hospital, Kasur. The type and laterality of deviated nasal septum and the morphology and laterality of concha bullosa were assessed on CT. Chronic rhinosinusitis severity was evaluated using the Lund–Mackay scoring system. Associations were assessed using the chi-square test, with p < 0.05 considered statistically significant.

Results: Deviated nasal septum was present in 84 patients (74.3%), with Mladina Types II and III being the most frequently observed types. Concha bullosa was identified in 23 patients (20.4%), with bulbous morphology being the most common type. A significant association was found between Mladina classification and CRS severity (p = 0.036), with severe CRS occurring particularly frequently in Types III and VII. The different types of concha bullosa were not significantly associated with CRS severity (p = 0.579). DNS laterality and concha bullosa laterality were also not significantly associated with disease severity.

Conclusion: Specific types of deviated nasal septum, particularly Mladina Types III and VII, showed a significant relationship with radiological severity of chronic rhinosinusitis, whereas the morphological types of concha bullosa did not. These findings support evaluation of specific anatomical patterns on CT when assessing patients with chronic rhinosinusitis.