Criteria for Defining ‘Severe Septal Deviation’

Abstract

Objective: Criteria for defi ning 'severe septal deviation' and to describe the clinical profi le of the same.Study: Retrospective study. Materials and methods: Hundred patients who were diagnosed with severe DNS and treated with extracorporeal septoplasty (ECSP) from September 2010 to December 2012, were retrospectively evaluated for this study. A review of their clinical charts formed the basis of this study. Results• In this study, majority of patients (96%) had nasal obstruction as their prime symptom followed by postnasal discharge in 60% cases, headache in 40% cases and anterior nasal discharge in 30% cases. External nasal deformity was reported by 22 patients. Snoring was seen in 24% of patients with same percentage complaining of altered sense of smell and throat discomfort. Epistaxis, sneezing and facial pain were seen in 14% patients. Epiphora was complained by only 8% of patients. • In this study, nasal endoscopy/anterior rhinoscopy was used to type the septal deformity. The commonest septal deviation was C-shaped cephalocaudal (48%), followed by S-shaped cephalocaudal (18%), C-shaped AP (16%), S-shaped AP (12%) and sharp septal deviation/angulation in 6% cases. • All but three patients (6%) had deviated nasal septum involving multiple Cottle's areas. These three patients had sharp septal angulation involving Cottle's area 2 only. • In this study, most common region involving DNS was area 1 + 2 + 3 (48%) followed by area 2 + 4 + 5 (28%) and 1 + 2 + 3 + 4 (18%). • Area 2 was invariably involved in 100% of cases. • NOSE (nasal obstruction symptom evaluation) scores. • Preoperatively, mean NOSE score was 67.60 ± 5.26 (65.34-72.86). • NSS (nasal symptoms score):-Preoperatively, mean NSS was -5.08 ± 0.38 (-5.46--4.70). Conclusion• A septal deviation is regarded as 'severe' if patient satisfi es all of the below-mentioned criteria: -Preoperatively, mean NOSE score should be 65.34 or more. IJHNS RESEARCH ARTICLE

Computed Tomographic Study of Variants of Deviated Nasal Septum in Adult Population: A Descriptive, Cross-sectional, Hospital-based Study

“…[1][2][3] Deviation near the Cottle's/nasal valve region is often linked with snoring/obstructive sleep apnoea (OSA). 4,5 Deviation also plays a credible role in the development of sagittal occlusal disharmonies and in facial retrusion with cleft lip and palate. 3,6,7 Deviation in the deepest part of the nose in the form of a spur often results in the impaction of its tip in the region of the sphenopalatine foramen and may cause unilateral hemi cranial headaches of Sluder's type, an important differential diagnosis of trigeminal neuralgia (TN).…”