Bilateral measurements of pyriform aperture width in the population according to cone beam computed tomography

A narrowed pyriform aperture (PA) can negate the success of functional rhinosurgery, and its expansion is justified in certain cases or in patients with previous unsuccessful septoplasty and/or turbinate reduction. Currently, there are no data in the scientific literature on the bilateral measurement of PA width. Objective. To assess the data of bilateral measurement of the pyriform aperture width in a population of different age groups. Patients and methods. In the study, bilateral measurements of the PA width were performed using cone beam computed tomography in 577 patients of the Central European type of the Caucasian race aged 18 and over (1154 bilateral measurements), divided by sex (304 women and 273 men) and into homogeneous groups by age according to the WHO classification (young age — up to 44 years, middle age — 45—59 years, elderly age — 60—74 age, senile age and longevity ≥75 years). Results. The mean values of the PA unilateral width were a stable parameter ranging from 9 to 10 mm on both sides in all study groups with a low 95% confidence interval (from 0.13 mm to 0.4 mm in all measurements). When measuring the aperture width on both sides, comparable results in men and women, which did not have statistically significant differences both when comparing all subjects and separately in each age group, were obtained (p>0.05). It was found that there is no significant change in the PA unilateral width with age (p>0.05). Despite the stability of the PA unilateral width, a significant sample range (8.1 mm in men and 7.04 mm in women) was noted, while in 19% of all bilateral measurements the difference between the left and right halves was 2 mm and more, and in 6.8% — 3 mm and more. Conclusion. The unilateral PA width is an important rhinosurgical parameter both for determining a significant asymmetry in the width of the nasal cavity at the PA level and for planning the necessary amount of surgery to relieve chronic nasal obstruction, and its measurement can contribute to reduction of diagnostic and surgical errors.