A Review on Deviated Nasal Septum: Classification, Clinical Features and Management

Abstract

The nasal septum separates the right and left part of the nasal cavity and columellar septum, membranous septum and septum proper are the parts of it. Deviation of nasal septum is a common case of nasal obstruction presented in a clinic. A lot of classifications have been developed to help ease the study of deviated nasal septum but none of them is used as a standard. Some of the classifications include the one given by Vidigal, Guyuron, Cerek, Mladina and Cottle’s. Apart from nasal obstruction other common clinical features involving deviated nasal septum are sinusitis especially in horizontal deviation type V. Pressure on lateral wall by spurs can also cause pressure headache. Due to increased air flow in the nasal cavity, dryness occurs causing epistaxis. Obstruction of nasal cavity causes mouth breathing in return either exaggerating or leading to obstructive sleep apnoea. Septal deviation also effects the choroidal thickness and choroidal blood supply. Histopathologically, lymphocytic infiltration and squamous metaplasia occurs in septal mucosa. These changes occur mostly due to change in the aerodynamic flow. There is decreased cilia movement and inferior turbinate hypertrophy. Thickness of inferior turbinate gains importance while septoplasty as, if thickened a lot, the inferior turbinate demands excision. The deviated nasal septum is associated with sinusitis, chronic suppurative otitis media and Eustachian tube dysfunction. Management involves sub mucus resection or septoplasty. Out of the two, septoplasty is preferred as it is a conservative surgery. Only symptomatic and cosmetically grossly disfigured cases require a surgical treatment while the asymptomatic cases are generally not indicated for surgery. This study tries to review the Classification, Clinical Features and Management of Deviated Nasal Septum.

Unveiling the Potential: A Comprehensive Review of Dynamic Slow-Motion Video Endoscopy for Eustachian Tube Dysfunction Evaluation

“…By scrutinizing the dynamic structural changes in the ET, DSVE offers valuable insights into the functional status of the ET, potentially guiding treatment decisions based on the observed correlations between visual findings and patient-reported symptoms [ 8 , 23 ]. It helps to assess not only preoperative findings but also compare the improvement and effectiveness of the treatment in the postoperative period [ 6 , 24 ].…”

“…The research underscores DSVE's significance as an adjunct to impedance audiometry in assessing ET function, highlighting its role in diagnosing ETD and predicting outcomes following middle ear surgery [ 6 , 24 ]. Strong correlations between DSVE findings and middle ear disease emphasize its effectiveness in diagnosing ETD and grading tubal movements based on the severity of tubal pathology [ 6 , 24 , 29 ]. Regarding patient comfort, DSVE offers a non-invasive and well-tolerated method for evaluating ETD.…”