Is pneumatization of middle turbinates compensatory or congenital?

Objective: To determine the frequency of concha bullosa (CB) and the association between the degree of pneumatization and the severity of septum deviation in both paediatric and adult groups by CT evaluation and to investigate whether the pneumatization of middle turbinates is compensatory or congenital. Method: We retrospectively reviewed digitally stored paranasal sinus CT images of 86 paediatric and 204 adult patients. The severity of the deviation and cross-sectional area of the pneumatized area of the CB were determined using tomography images. The septums were divided into three groups according to the severity of deviation. The cross-sectional area of the contralateral side divided by the cross-sectional area of the deviation was calculated and described as the interturbinate ratio. Results: When bilateral CB was found, the pneumatization of the CB was more prominent on the contralateral side than on the deviation side in both the paediatric and the adult groups. However, we found that the interturbinate ratios were not statistically different between the paediatric and adult groups. Also, the interturbinate ratios were independent degrees of deviation in children and adults. The frequency of CB was low in the adult group compared with the paediatric group. Conclusion: Interturbinate ratios were not statistically different between paediatric and adult groups and were independent of the severity of deviation. These findings suggest that the pneumatization process is not compensatory. Dentomaxillofacial Radiology (2012) 41, 564-570. doi: 10.1259/dmfr/31644208