The Role of Multispiral Computed Tomography in the Study of the Density of the Cartilaginous Part of the Nasal Septum

Objective. Study of the Density Characteristics of the Cartilaginous Part of the Nasal Septum in Normal, with its Perforation and Deviation using Multispiral Computed Tomography.

Materials and Methods. Multispiral Computed Tomography (MSCT) of the Nasal Septum (NS) and Sinuses was used in the Examination of 125 patients (61 women and 64 men aged 18 to 67 years). Of these, 57 patients (23 women and 34 men) with nasal septum deformity (NSD), 48 patients (28 women and 20 men) with nasal septum perforation (NSP) were performed. The control group included 20 subjects (10 women and 10 men) without NS pathology. MSCT scans were performed on a Philips Ingenuity 64 multispiral tomography scanner. The Protocol included the study of NSD variants, localization and size of NSP, nasal septum density in HU units. In cases of NSP, the density of the cartilaginous region was studied around the perforation. All statistical analyses were performed using the SPSS 23.0 software package.

Results. The data obtained on NSD variants: 1. C-shaped deviation of 9 cases (15.8 % of all cases); 2. S-shaped curvature — 21 cases (36.8 %); 3. «Crest» — 11 cases (19.3 %); 4. Dislocation of the quadrangular cartilage — 2 cases (3.5 %); 5. Thickening — 14 cases (24.6 %). The density of the cartilaginous part of the NS in the control group was 69.7500 ± 14.35591 HU units. In C-shaped deviation, the density of the cartilaginous part of the NS was 68.8947 ± 12.39576 HU, in the case of S-shaped curvature — 66.4762 ± 11.38253 HU units, «Crest» — 78.0000 ± 9.66092 HU units, in case of dislocation of the quadrangular cartilage — 78.0000 ± 9.66092 HU units, thickening — 96.2500 ± 6.18177 HU units. In cases of NSP, the density of the cartilaginous part of the NS was: with perforation sizes up to 10 mm — 67.9545 ± 10.49933 HU units, over 10 mm — 108.4231 ± 14.90281 HU units.

Conclusion. In pathological conditions (deformation and perforation of the NS), the hyaline cartilage of the nasal septum undergoes involutional changes due to complex degradation processes. MSCT contributes to obtaining detailed information about the pathological conditions of the NS, such as deformation and perforation, the study of the biomechanical properties of its cartilaginous region. The data obtained can be used in rhinology, maxillofacial surgery and regenerative medicine.

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