Nasal Septal Deviation and External Nasal Deformity: A Correlative Study of 100 Cases

Abstract

A prospective study of 100 consecutive patients of deviated nasal septum to analyze association of septal deviation with external nasal deformity was undertaken at Acharya Vinoba Bhave rural Hospital of Jawaharlal Nehru Medical College, Sawangi (Meghe) Wardha from January 2009 to September 2010. Nasal septal deviations were evaluated by clinical examination and diagnostic nasal endoscopy while external nasal deformities, after evaluating, were documented using high resolution photography Nasal septal deviations were classified in seven types from I to VII by using Mladina's classification modified by Janardhan et al. Jang classification was employed to classify external nasal deformities. 66% of the patients with deviated nasal septum were symptomatic while 34 lacked symptoms. Nasal obstruction was the most frequent symptom in 64% followed by nasal discharge in 33% Type VII was the most common type of deviation in 29%. Study revealed that 67% of the patients with deviated nasal septum had external nasal deformity and of the 67 patients with external deformity, Type I deformity was most frequent (26%). Remarkable feature of our study was Type I, III, V septal deviations were not associated with external deviation Type II septal deviations were commonly associated with Type III external deformity (7%) and Type IV septal deviation were closely associated with Type I external deformity (12%).

Association of external nose deformity in individuals with nasal septal deviation

“…In various other studies, mean age of 34.7 years, 33.5 years has been reported. 2,10 These findings by different investigators are in keeping with our findings.…”

“…In contrast to our findings, Sam et al found type VII (29%) as the most common septal deviation. 2 In another study conducted by Janardhan et al found Type V (45%), as the most common septal deviation. 11 In our study the least common type of deviation was type VI.…”

“…Male to female ratio is 1.56:1 in the present study, other studies have 1.7:1, 2.2:1. 2,11 Preponderance in males can be reasoned out by the fact that most common etiology of deviated nasal septum is nasal trauma which occurs more frequently in males. 2 Symptomatic patients (60%) presented most commonly with nasal obstruction as a common symptom followed by nasal discharge.…”

“…1 Monumental statement made by Beckhius 'As goes the septum so goes the nose' speaks profusely on the indispensable role of nasal septum in supporting the framework. 2 Correction of this deformity presents a challenge because frequently, both a functional problem (airway conduction) and an aesthetic problem must be addressed. 3 The cause may be congenital or acquired secondary to previous trauma or surgery.…”

“…4 Whenever there is an external deformity of nose, its anatomical basis may be rooted in bony pyramid defect, cartilaginous framework defect, septal deformity or combination of this vectors. 2 The intrinsic and extrinsic forces influencing septal deviation must be diagnosed accurately and eliminated during the operation. 6,7 Traditional correction of the deviated nose involves septal correction, separation of both upper lateral cartilage from the septum and bony pyramid manipulation after osteotomies.…”