Serrated Inferior Turbinate Variation and Sinonasal Findings on CBCT

The nasal cavity contains several anatomical structures that contribute to normal respiratory function, including regulation of airflow, filtration, humidification, and temperature control of inspired air. The inferior turbinate is a key component of the lateral nasal wall and consists of a bony framework covered by vascular mucosa. Variations in the morphology and dimensions of the inferior turbinate may influence nasal airflow and the anatomical relationship between the nasal cavity and adjacent sinonasal structures.

Serrated inferior turbinate is a rare anatomical variation characterized by irregular serrated bony contours along the medial surface of the inferior turbinate. Previous studies have mainly focused on the prevalence and morphological description of inferior turbinate variations; however, the potential association between serrated inferior turbinate variation and maxillary sinus mucosal changes has not been sufficiently investigated.

Cone-beam computed tomography (CBCT) provides three-dimensional, high-resolution imaging of the maxillofacial region and allows detailed assessment of bony structures, paranasal sinuses, and sinonasal anatomical variations. In this study, CBCT images will be retrospectively analyzed to determine whether the presence of serrated inferior turbinate variation is associated with changes in the ipsilateral maxillary sinus mucosa and other sinonasal anatomical parameters.

The study population will consist of individuals who underwent CBCT imaging for routine diagnostic purposes. Images will be evaluated for the presence or absence of serrated inferior turbinate variation. Additional radiological assessments will include maxillary sinus mucosal thickness, presence of polypoid mucosal thickening or retention cysts, inferior turbinate dimensions, nasal septal deviation angle, and other sinonasal anatomical findings.

All evaluations will be performed on existing CBCT datasets without additional imaging procedures or interventions. Patient confidentiality will be maintained throughout the study, and all analyses will be performed using anonymized imaging data.

The findings of this study may contribute to a better understanding of the clinical and radiological significance of serrated inferior turbinate variation and may improve the assessment and reporting of sinonasal anatomical variations in CBCT examinations.

Inclusion criteria

• Individuals aged 18-75 years.
• Patients who underwent cone-beam computed tomography (CBCT) imaging for routine diagnostic purposes between January 2025 and June 2026.
• CBCT images including both maxillary sinuses, nasal cavity, ostiomeatal complex, and inferior turbinates.
• CBCT images with sufficient diagnostic quality and clearly visible anatomical boundaries for evaluation and measurements.
• CBCT images in which the anatomical landmarks required for nasal septal deviation angle measurement (crista galli, maxillary spine, and the most deviated point of the nasal septum) can be clearly identified.

Exclusion criteria

• Patients with maxillofacial trauma, fractures, or conditions affecting the midface anatomy.
• Patients with congenital craniofacial anomalies (e.g., cleft lip and palate) or syndromes affecting facial anatomy.
• Patients with a history of sinonasal, inferior turbinate, or maxillary sinus surgery.
• CBCT images with insufficient diagnostic quality, motion artifacts, or metal artifacts preventing accurate evaluation.
• Patients with pathological lesions affecting the maxillary sinus or nasal cavity anatomy, including cysts, tumors, or aggressive inflammatory lesions.
• CBCT findings suggestive of fungal sinusitis, including heterogeneous hyperdense contents, calcifications, bone expansion, or invasive changes.