title: An often neglected area in crooked nose: middle turbinate pneumatization.
abstract: BACKGROUND
  Crooked or deviated nose is a deviation of the nose from the straight vertical position of the face. Extensive pneumatization of the middle turbinate, also called concha bullosa or bullous middle turbinate (BMT) is known to be one of the possible etiologic factors in nasal obstruction, recurrent sinusitis, and headache. There is no study concerning a link between BMT and crooked nose.
  
  
  OBJECTIVE
  To investigate the association between crooked nose and the presence of a BMT.
  
  
  METHODS
  A total of 199 patients who underwent open septorhinoplasty were retrospectively analyzed. Preoperative paranasal Computerized Tomography (CT) findings, preoperative photodocumentation, and anterior rhinoscopic examination findings were documented. Of the 199 patients, 169 were found to meet the criteria and were included in the study. CT scans were examined to note the presence of BMT, inferior turbinate hypertrophy, and septum deviation (SD). SDs and crooked noses were classified.
  
  
  RESULTS
  Ninety-four of 169 patients (56%) presented a crooked nose deformity and seventy-five of 169 patients (44%) presented a straight nose. While 49 (52%) crooked nose patients had a bulbous and extensive BMT, 20 patients with straight nose (26.6%) had a BMT. A statistically significant relationship was found between the presence of crooked nose and BMT, regardless of the side of the disease (p=0.011).
  
  
  CONCLUSIONS
  This study revealed a link between crooked nose and BMT.
authors.affiliation: Derince Research and Training Hospital, Department of Otolaryngology, Kocaeli, Turkey. Electronic address: ozdogan.fatih@gmail.com.
authors.forename: Fatih
authors.initials: F
authors.lastname: Özdoğan
authors.affiliation: Derince Research and Training Hospital, Department of Otolaryngology, Kocaeli, Turkey.
authors.forename: Halil Erdem
authors.initials: HE
authors.lastname: Özel
authors.affiliation: Derince Research and Training Hospital, Department of Otolaryngology, Kocaeli, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Esen
authors.affiliation: Derince Research and Training Hospital, Department of Otolaryngology, Kocaeli, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Altıparmak
authors.affiliation: Derince Research and Training Hospital, Department of Otolaryngology, Kocaeli, Turkey.
authors.forename: Selahattin
authors.initials: S
authors.lastname: Genç
authors.affiliation: Derince Research and Training Hospital, Department of Otolaryngology, Kocaeli, Turkey.
authors.forename: Adin
authors.initials: A
authors.lastname: Selçuk
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology*; D009300:Nasal Septum / Q000473:pathology* / Q000601:surgery; D009667:Nose Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D012225:Rhinoplasty / Q000379:methods; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D055815:Young Adult
keywords: Corneto; Crooked nose; Nariz torto; Nasal airway; Rhinoplasty; Rinoplastia; Turbinate; Via respiratória nasal