Nasal septum deviation (comprehensive descriptive review)

Nasal septum deviation (comprehensive descriptive review)

Authors

  • R.I. Rakhimov 7th City Clinical Hospital of Tashkent
  • G.K. Babakhanov 7th City Clinical Hospital of Tashkent
  • N.A. Rasulova Tashkent Pediatric Medical Institute
  • U.Kh. Umarov 7th City Clinical Hospital of Tashkent
  • S.A. Kosimov 7th City Clinical Hospital of Tashkent

DOI:

https://doi.org/10.57231/j.ejohns.2023.2.1.017

Keywords:

nasal deformity, quality of life (QoL), septoplasty, cosmetics, nasal septum deviation

Abstract

The number of publications is increasing every year. In this regard, there is an increasing need to inform the audience about the achievements of practical otorhinolaryngology in Uzbekistan. According to the plan of the administration, great importance is attached to the self-training of personnel with the involvement of cathedral workers.The nasal septum is a bone-cartilaginous wall that divides the nasal cavity into two right and left halves. Asymptomatic minor deviation of the septum is considered normal and occurs in the majority of the population of the Republic. Nasal septum Deviation (NSD) is one of the topical issues not only in otorhinolaryngology, but in many aspects of practical medicine such as pediatric dentistry, pediatrics, therapy, neurology, etc. This is evidenced by extensive literature, indicating a change in the functions of distant organs and systems of the body. Reported global prevalence rates (epidemiology) vary widely. Previous NSDI classification systems have been proposed according to the shape of the nasal septum, viewed horizontally and vertically. In some patients, the degree of deviation may affect nasal airflow, causing obstruction or impaired olfactory function. Headache, rhinosinusitis, high blood pressure, obstructive sleep apnea, and breathing noises are also clinical manifestations of a deviated septum. The clinical (rhinoscopic) picture is sufficient to make a diagnosis, while imaging techniques may be necessary for medical documentation. Radiological imaging techniques such as computed tomography (MSCT) are used to classify and assess the nature of the curvature of the septum. The method of treatment of the curvature of the nasal septum is surgical correction. Septoplasty is the most common rhinoplasty with high satisfaction and low complication rates. In this descriptive review, we present comprehensive information about the concept, clinical presentation, diagnosis, treatment options, and quality of life for patients with deviated septum. The article is intended for a wide range of otorhinolaryngologists and other specialties. Literary Internet sources with links for self-study are recommended.

References

Teixeira J, Certal V, Chang ET, Camacho M. Nasal septal deviations: a systematic review of classification systems. Plast Surg Int. 2016;2016:7089123. [PMC free article] [PubMed] [Google Scholar]

Alshehri Alshehri, Abdullah A. Prevalence and clinical features of deviated nasal septum in the pediatric age group in Najran Region, Saudi Arabia. Saudi J Otorhinolaryngol - Head Neck Surg. 2022;24:1–5. [Google Scholar]

Ким В.Н. Этиология, клиника и лечение искривлений перегородки носа: Автореф. дис. ... канд. мед. наук. 1985.

Лопатин А.С. Реконструктивная хирургия деформаций перегородки носа. -Рос. ринология, 1994, приложение 2- С.36-37.

de Aguiar Vidigal T, Martinho Haddad FL, Gregório LC, Poyares D, Tufik S, Azeredo Bittencourt LR. Subjective, anatomical, and functional nasal evaluation of patients with obstructive sleep apnea syndrome. Sleep Breath. 2013;17:427–433. [PubMed] [Google Scholar]

Lawson VG. Management of the twisted nose. https://europepmc.org/article/med/625080. J Otolaryngol. 1978;7:56–66. [PubMed] [Google Scholar]

Mladina R, Cujić E, Subarić M, Vuković K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol. 2008;29:75–82. [PubMed] [Google Scholar]

van Egmond MM, Rovers MM, Tillema AH, van Neerbeek N. Septoplasty for nasal obstruction due to a deviated nasal septum in adults: a systematic review. Rhinology. 2018;56:195–208. [PubMed] [Google Scholar]

Watters C, Brar S, Yapa S. Septoplasty. 2022 Nov 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan–.PMID: 33620795 Free Books & Documents. [PubMed] [Google Scholar]

Kucybała I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal septal deviation and concha bullosa - do they have an impact on maxillary sinus volumes and prevalence of maxillary sinusitis? Pol J Radiol. 2017;82:126–133. [PMC free article] [PubMed] [Google Scholar]

El-Taher M, AbdelHameed WA, Alam-Eldeen MH, Haridy A.Coincidence of concha bullosa with nasal septal deviation; radiological study. Indian J Otolaryngol Head Neck Surg. 2019;71:1918–1922. [PMC free article] [PubMed] [Google Scholar]

Al-Rawi NH, Uthman AT, Abdulhameed E, Al Nuaimi AS, Seraj Z. Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: a cone-beam computed tomography study. Imaging Sci Dent. 2019;49:45–51. [PMC free article] [PubMed] [Google Scholar]

Kwon SH, Lee EJ, Yeo CD, et al. Is septal deviation associated with headache?: a nationwide 10-year follow-up cohort study. Medicine (Baltimore) 2020;99:0. [PMC free article] [PubMed] [Google Scholar]

Ekinci A, Karataş D, Yetiş A, Demir E, Özcan M. Serum oxidative stress levels in patients with nasal septal deviation. Turk Arch Otorhinolaryngol. 2017;55:125–128. [PMC free article] [PubMed] [Google Scholar]

Laçin N, Yalçın M, Demirkol M. Evaluation of the angulation of the nasal septum deviation as an anatomical variation for increased frequency of antral pseudocyst: a cone beam computed tomography study [PREPRINT] Folia Morphol (Warsz) 2021 [PubMed] [Google Scholar]

Wang Y, Bonaparte JP. Diagnosis and management of septal deviation and nasal valve collapse - a survey of Canadian otolaryngologists. J Otolaryngol Head Neck Surg. 2019;48:71. [PMC free article] [PubMed] [Google Scholar]

Papadopoulou AM, Chrysikos D, Samolis A, Tsakotos G, Troupis T. Anatomical variations of the nasal cavities and paranasal sinuses: a systematic review. Cureus. 2021;13:0. [PMC free article] [PubMed] [Google Scholar]

Cellina M, Gibelli D, Cappella A, Martinenghi C, Belloni E, Oliva G. Nasal cavities and the nasal septum: Anatomical variants and assessment of features with computed tomography. Neuroradiol J. 2020;33:340–347. [PMC free article] [PubMed] [Google Scholar]

Martina R, Cioffi I, Farella M, Leone P, Manzo P, Matarese G, Portelli M, Nucera R, Cordasco G. Transverse changes determined by rapid and slow maxillary expansion--a low-dose CT-based randomized controlled trial. Orthod Craniofac Res. 2012;15:3:159-68. doi: 10.1111/j.1601-6343.2012.01543.x. Epub 2012 Mar 27.

Lo Giudice A, Fastuca R, Portelli M, Militi A, Bellocchio M, Spinuzza P, Briguglio F, Caprioglio A, Nucera R. Effects of rapid vs slow maxillary expansion on nasal cavity dimensions in growing subjects: a methodological and reproducibility study. Eur J Paediatr Dent. 2017;18:4:299-304. doi: 10.23804/ejpd.2017.18.04.07.

Хасанов С.А., Бабаханов Г.К., Хасанов У.С., Махсудов С.Н. Интеграционная тактика ринолога и ортодонта при симптомокомплексе Хасанова у детей. Новости дерматовенерологии и репродуктивного здоровья. 2014;2:36-38. http://www.moscowuniversityclub.ru/article/files/14440_79490625.pdf#page=36

Хасанов С.А., Махсудов С.Н., Бабаханов Г.К. Эндоназальная остеопластика срединного небного шва у детей с искривлением перегородки носа при аномалиях развития верхней челюсти. Вестник Кыргызской медицинской академии им. И.К. Ахунбаева 2019;2:66-71. https://www.elibrary.ru/download/elibrary_41300126_99535500.pdf

Gulimbay Babakhanov, Saidakram Khasanov, Sunnat Makhsudov, Tevfik Metin Önerci. Cephalometric measurements of the nasal cavity in children with a narrowing of the upper jaw. Евразийский вестник педиатрии. 2019;3:102-110 стр. https://tashpmi.uz/14-czefalometricheskie-pokazateli-polosti-nosa-u-detej-s-suzheniem-verhnej-chelyusti/

Хасанов С.А., Махсудов С.Н., Бабаханов Г.К. Оториноларингологические и ортодонтические вопросы патологии риномаксиллярного комплекса у детей / [Под редакцией С.А. Хасанова]: Ташкентский педиатрический медицинский институт Минздрава РУз. –Т.: «Университет», 2022. 284 с.

Kamani T, Yılmaz T, Sürücü S, Bajin MD, Günaydın RÖ, Kuşçu O. Histopathological changes in nasal mucosa with nasal septum deviation. Eur Arch Otorhinolaryngol. 2014;271:2969–2974. [PubMed] [Google Scholar]

Salihoglu M, Cekin E, Altundag A, Cesmeci E. Examination versus subjective nasal obstruction in the evaluation of the nasal septal deviation. Rhinology. 2014;52:122–126. [PubMed] [Google Scholar]

O'Reilly BJ, Simpson DC, Dharmeratnam R.Recurrent epistaxis and nasal septal deviation in young adults. Clin Otolaryngol Allied Sci. 1996;21:12–14. [PubMed] [Google Scholar]

Mamikoglu B, Houser S, Akbar I, Ng B, Corey JP. Acoustic rhinometry and computed tomography scans for the diagnosis of nasal septal deviation, with clinical correlation. Otolaryngol Head Neck Surg. 2000;123:61–68. [PubMed] [Google Scholar]

Lebowitz RA, Galli SKD, Holliday RA, Jacobs JB. Nasal septal deviation: a comparison of clinical and radiological evaluation. Operat Techniq Otolaryngol - Head Neck Surg. 2001;12:104–106. [Google Scholar]

Obstructive sleep apnea (OSA): practice essentials, background, pathophysiology. [ Sep; 2022 ];Wickramasinghe Wickramasinghe, H H, Zab Mosenifar. https://emedicine.medscape.com/article/295807-overview Medscape [Accessed 19 July 2022] 2022 5 [Google Scholar]

Yeom SW, Kim MG, Lee EJ, et al. Association between septal deviation and OSA diagnoses: a nationwide 9-year follow-up cohort study. J Clin Sleep Med. 2021;17:2099–2106. [PMC free article] [PubMed] [Google Scholar]

Sam A, Deshmukh PT, Patil C, Jain S, Patil R. Nasal septal deviation and external nasal deformity: a correlative study of 100 cases. Indian J Otolaryngol Head Neck Surg. 2012;64:312–318. [PMC free article] [PubMed] [Google Scholar]

Aziz T, Biron VL, Ansari K, Flores-Mir C. Measurement tools for the diagnosis of nasal septal deviation: a systematic review. J Otolaryngol Head Neck Surg. 2014;43:11. [PMC free article] [PubMed] [Google Scholar]

Codari M, Zago M, Guidugli GA, et al. The nasal septum deviation index (NSDI) based on CBCT data. Dentomaxillofac Radiol. 2016;45:20150327. [PMC free article] [PubMed] [Google Scholar]

Andrades P, Cuevas P, Danilla S, et al. The accuracy of different methods for diagnosing septal deviation in patients undergoing septorhinoplasty: a prospective study. J Plast Reconstr Aesthet Surg. 2016;69:848–855. [PubMed] [Google Scholar]

Carmel-Neiderman NN, Safadi A, Wengier A, et al. The role of imaging in the preoperative assessment of patients with nasal obstruction and septal deviation – A retrospective cohort study. Int Arch Otorhinolaryngol. 2021;25:0–8. [PMC free article] [PubMed] [Google Scholar]

Most SP, Rudy SF.Septoplasty: basic and advanced techniques. Facial Plast Surg Clin North Am. 2017;25:161–169. [PubMed] [Google Scholar]

Shah J, Roxbury CR, Sindwani R.Techniques in septoplasty: traditional versus endoscopic approaches. Otolaryngol Clin North Am. 2018;51:909–917. [PubMed] [Google Scholar]

Kim DY, Nam SH, Alharethy SE, Jang YJ.Surgical outcomes of bony batten grafting to correct caudal septal deviation in septoplasty. JAMA Facial Plast Surg. 2017;19:470–475. [PMC free article] [PubMed] [Google Scholar]

Tasca I, Compadretti GC, Losano TI, Lijdens Y, Boccio C.Extracorporeal septoplasty with internal nasal valve stabilisation. Acta Otorhinolaryngol Ital. 2018;38:331–337. [PMC free article] [PubMed] [Google Scholar]

Tian Q, Chu T, Sun H, Pang M. Outcomes of endonasal septoplasty and extracorporeal septal reconstruction in anterocaudal septal deviation. Ear Nose Throat J. 2021;100:645–651. [PubMed] [Google Scholar]

Maniglia CP, Maniglia JV. Rhinoseptoplasty in children. Braz J Otorhinolaryngol. 2017;83:416–419. [PMC free article] [PubMed] [Google Scholar]

Nofal AA. Fashioned mucoperichondrium flap technique in caudal septal deviation. OTO Open. 2021;5:2473974. [PMC free article] [PubMed] [Google Scholar]

Bogović V, Milanković SG, Zubčić Ž, et al. Open approach in rhinoplasty. Southeast Eur Med J. 2019;3:56–62. [Google Scholar]

Dizdar D, Bozan A, Dizdar SK, Göde S, Alpay HC. Evaluation of nasal symptoms in septoplasty patients using SNOT-22. Acta Otorhinolaryngol Ital. 2019;39:98–102. [PMC free article] [PubMed] [Google Scholar]

Chen S, Wang J, Xi X, Zhao Y, Liu H, Liu D. Rapid maxillary expansion has a beneficial effect on the ventilation in children with nasal septal deviation: a computational fluid dynamics study. Front Pediatr. 2021;9:718735. [PMC free article] [PubMed] [Google Scholar]

Zhao KQ, Pu SL, Yu HM. Endoscopic septoplasty with limited two-line resection: minimally invasive surgery for septal deviation. https://www.jove.com/video/57678/endoscopic-septoplasty-with-limited-two-line-resection-minimally J Vis Exp. 2018;5:57678. [PMC free article] [PubMed] [Google Scholar]

Gupta N, Singh PP, Bagla RK. Will septal correction surgery for deviated nasal septum improve the sense of smell? A prospective study. Surg Res Pract. 2015;2015:496542. [PMC free article] [PubMed] [Google Scholar]

Avcı D, Hartoka Sevinç A, Güler S. The systolic pulmonary artery pressure and the E/e' ratio decrease after septoplasty in patients with grade 2 and 3 pure nasal septal deviation. Braz J Otorhinolaryngol. 2021;87:497–504. [PMC free article] [PubMed] [Google Scholar]

Smitha SG, Jagannath B, Mathew AS. Impact of septal correction on the blood pressure of hypertensive patients with deviated nasal septum. Indian J Otolaryngol Head Neck Surg. 2016;68:46–51. [PMC free article] [PubMed] [Google Scholar]

Ketcham AS, Han JK. Complications and management of septoplasty. Otolaryngol Clin North Am. 2010;43:897–904. [PubMed] [Google Scholar]

Complications in septoplasty based on a large group of 5639 patients. Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H. Eur Arch Otorhinolaryngol. 2018;275:1789–1794. [PMC free article] [PubMed] [Google Scholar]

Complications in septoplasty. Rettinger G, Kirsche H. Facial Plast Surg. 2006;22:289–297. [PubMed] [Google Scholar]

The comparison of bacteremia and amount of bleeding during septoplasty. Koc S, Uysal IO, Uysal EB, Yenişehirli G, Duygu F. Eur Arch Otorhinolaryngol. 2012;269:1139–1142. [PubMed] [Google Scholar]

Complication rates following septoplasty with inferior turbinate reduction. Joshi RR, Riley CA, Kacker A. Ochsner J. 2019;19:353–356. [PMC free article] [PubMed] [Google Scholar]

Valsamidis K, Printza A, Constantinidis J, Triaridis S. The impact of olfactory dysfunction on the psychological status and quality of life of patients with nasal obstruction and septal deviation. Int Arch Otorhinolaryngol. 2020;24:0–46. [PMC free article] [PubMed] [Google Scholar]

Ma Q, Su K, Fu Z, Wang P, Shi H. Anxiety and depression in patients with nasal septal deviation. Am J Otolaryngol. 2020;41:102450. [PubMed] [Google Scholar]

Carmel Neiderman NN, Eisenberg N, Caspi I, et al. The effect of septal deviation on postoperative quality of life in patients undergoing radiofrequency-assisted turbinate reduction. Laryngoscope Investig Otolaryngol. 2022;7:325–334. [PMC free article] [PubMed] [Google Scholar]

Fidan T, Fidan V, Ak M, Sütbeyaz Y. Neuropsychiatric symptoms, quality of sleep and quality of life in patients diagnosed with nasal septal deviation. https://dergipark.org.tr/en/pub/trent/issue/66920/1046213 Turkish J Ear Nose Throat. 2011;21:312–317. [PubMed] [Google Scholar]

Saniasiaya J, Abdullah B. Quality of life in children following nasal septal surgery: a review of its outcome. Pediatr Investig. 2019;3:180–184. [PMC free article] [PubMed] [Google Scholar]

Bilal N, Selcuk A, Karakus MF, Ikinciogullari A, Ensari S, Dere H. Impact of corrective rhinologic surgery on rhinogenic headache. J Craniofac Surg. 2013;24:1688–1691. [PubMed] [Google Scholar]

An R, Tian L, Liu M, Sun Y, Zheng Y, Zhao R, Guo Y. Application of the anxiety and depression scale of patients with nasal septum deviation. https://europepmc.org/article/med/27197452 J Clin Otorhinolaryngol - Head Neck Surg. 2016;30:35–38. [PubMed] [Google Scholar]

Published

2023-03-25

Issue

Section

Articles
Loading...