Relationship between nasal septal deformity, symptoms and disease severity in chronic rhinosinusitis

Abstract

The objective of this study was to evaluate the interaction of nasal septal deformity (NSD), including the contribution of septal spurs, with the severity of subjective symptoms, impairment of health-related quality of life (HRQoL) and sinus mucosal hyperplasia in patients with chronic rhinosinusitis (CRS). One hundred seventeen patients with CRS were assigned to three groups with mild, moderate or severe NSD, according to the measured nasal septal angle, including the presence of contact septal spurs. All CRS patients completed the visual analog scale (VAS) symptom severity score and the Sino-Nasal Outcome Test (SNOT-22) questionnaire. Symptoms scores, SNOT-22 and Lund-Mackay (LM) scores among the three NSD groups were compared. Related anatomy from the study group was compared with 100 control patients. VAS score for postnasal discharge in CRS patients was significantly higher in patients with mild NSD. There was a significantly higher LM score in CRS patients with severe NSD, compared to those with mild (P = 0.001) or moderate NSD (P = 0.005). CRS patients with a contact spur demonstrated a significantly higher LM score (P = 0.006) compared to those without a contact spur, and no differences in VAS symptom scores or HRQoL scores. There was a similar prevalence of septal deformities in CRS patients and in the non-ENT population. Our results support the conclusion that in patients with CRS, associated NSD or contact septal spur do not contribute significantly to CRS symptom severity or HRQoL impairment, but may have an impact on sinus mucosal hyperplasia.

Effect of Septum Deviation on Osteomeatal Complex Distances

“…Orlandi showed that there is a significant relationship between septal deviation and rhinosinusitis in patients with a septal deviation of at least 10° 17 . In contrast, Gregurics et al in their study with 117 patients, they found that there was no correlation between sinusitis and the degree of septal deviation 18 .…”

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

“…In a 2009 study, Polat and Dostbil evaluated patients with NSD using rhinoscintigraphy and reported that the administration of septoplasty improved the reduced nasal mucociliary transport rate (NMTR). 35 Although there have been several studies supporting this finding, Greguric et al 36 and Collet et al 37 reported that they found no definitive role of NSD in the pathogenesis of chronic rhinosinusitis. 32 Similarly, Yasan et al…”

Comparison of the Type and Severity of Nasal Septal Deviation between Chronic Rhinosinusitis Patients Undergoing Functional Endoscopic Sinus Surgery and Controls

“…These changes can make the patients susceptible to CRS [ 27 ]. Gregurić et al [ 17 ] stated that only severe nasal septal deviation had a significant correlation with the severity of sinusitis. Poorey and Gupta [ 29 ] demonstrated that increased angle of septal deviation further increased the changes in the maxillary sinus mucosa.…”

“…Nasal septal deviation has been implicated in CRS by mechanical outflow obstruction, impairment of the mucociliary function, decreasing access for surgical management, and complicating postoperative care [ 12 – 14 ]. Some studies have suggested that CRS is correlated with nasal septal deviation [ 15 , 16 ], but some others claim that there is no correlation [ 17 , 18 ]. This controversy is in need of further investigation.…”