Morphological characterization of the nasal airway complex in a Chilean population

Abstract

Introduction: The assessment and treatment of nasal obstruction can be challenging due to its multiple etiologies. The nasal airway complex (NAC) comprises the septum, nasal floor, pyriform aperture, inferior turbinates, vestibular body, and upper and lower lateral cartilages. Surgical approaches (septoplasty, turbinoplasty, nasal valve techniques) to address the structural basis of nasal obstruction focus on managing the soft tissue structures of the NAC (septum, inferior turbinates, lateral cartilages). Thus, the nasal floor is the only structure of the NAC that has not received attention as a site contributing to reversible nasal obstruction. Previous studies have demonstrated an association between nasal obstruction and a narrow and high arched nasal floor. Aim: To characterize skeletal parameters of the maxillary bone and nasal airway. Materials and Methods: Descriptive study where measurements of distances and angles along the bony framework of the nasal airway and hard palate were performed in 200 computed tomographies of paranasal cavities. These included anterior, middle, and posterior nasal floor width, anterior maxillary angle, maxillary width, and palatal vault height. Results: Mean and standard deviation are presented for each measurement grouped in anterior, middle, and posterior nasal cavity. Discussion and Conclusion: Treatment of the NAC remains challenging as our understanding improves of its contributing factors. Persistent nasal obstruction may be observed in patients with narrow and high arched hard palate, despite previous nasal interventions. These patients could be candidates for additional procedures, such as maxillary expansion. Characterizing skeletal parameters of the maxillary bone and nasal airway in the population allows for a better understanding of the role and treatment of the nasal floor in nasal obstruction.

Keywords: nasal obstruction, nasal floor, narrow nasal floor, high arched palate, maxillary expansion.