Clinical Implications of Nasal Septal Deformities

Abstract

tween the types of SD since all of them play some specific role in the nasal and general physiology in man. Keywords: Classification, nasal septum, nose deformities Clinical Implications of Nasal Septal Deformities : 29.10.2014 Accepted: 22.01.2015 • DOI: 10.5152/balkanmedj.2015 Available at www.balkanmedicaljournal.orgCite this article as: Mladina R, Skitarelić N, Poje G, Šubarić M. Clinical implications of nasal septal deformities. Balkan Med J 2015;32:137-46. Copyright 2015 © Trakya University Faculty of MedicineBalkan Med J 2015;32:137-46 Invited Review | 137 has been growing since then, and this has been the standard method at least 40 clinical researches in various countries all over the world . Twelve years after Mladina published his classification and after it had been used for many clinical researches, in 1999, Guyuron published his suggestions, promoting six types which, at first sight, seemed to be more user friendly than Mladina's (43). Guyuron suggested the following types: tilt, antero-posterior C, antero-posterior S, cephalo-caudal S, cephalo-caudal C, and wide spurs. This classification, as for that described by Mladina, includes six types of SD. Moreover, his antero-posterior C corresponds to Mladina type 3, the antero-posterior S looks exactly like Mladina's type 4, the cephalo-caudal C is extremely rare and exists only as an exception after the really serious trauma to the nose (superiorinferior direction of force), and, finally, the cephalo-caudal S is extremely similar to Mladina's well-known type 6. Finally, so-called "wide spurs" are the same as Mladina's type 5. Therefore, overall, both classifications describe almost the same deformities but in "different languages".Four years later, in 2003, Buyukertan classified SD by separating the nasal septum into 10 segments with an intention to better localize the deformity (44).After that, in 2007, the Baumanns published a new classification of septal "deviations" (45). According to their schematic drawings, not real endo-photographs, types 1 and 2 appear to be the same as Mladina's type 5, their type 3 corresponds to Mladina's type 6, types 4 and 5 are very similar to type 7, i.e. a combination of type 5 and type 2 in their type 4, and type 5 and type 3 in their type 5, whereas their type 6 very closely resembles Mladina's type 3. However, the Baumanns' classification does not include "S-shaped" or "reverse S-shaped" septums, i.e. Mladina's type 4 or Guyuron's "anterior-posterior S".Some studies on the incidence of SD in man, based on the Mladina classification and simple anterior rhinoscopy without the decongestion and endoscopy of the nose, showed the incidence of septal deformities to increase slowly from childhood to adulthood, finally becoming very high, reaching close to 90% of the population in the world (29-31).Once it became obvious that SD in man are well defined and differ between themselves, it became very interesting to see how a particular type of septal deformity can influence the owner's nose. We have been using the Mladina ...

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