Deviated Nasal Septum Incidence and Etiology

Abstract

Septal deformity is of two kinds, which may occur independently, or together: 1) anterior cartilage deformity of the quadrilateral septal cartilage, caused by direct trauma or pressure at any age; and 2) combined septal deformity, involving all the septal components, caused by compression across the maxilla from pressures occurring during pregnancy or parturition. This is part of a facial deformity. The incidence of septal deformity was investigated in 2,380 Caucasian infants at birth, 2,112 adult skulls of five ethnic groups (European, Indian [Asian], Chinese, African and Australian Aboriginal), 918 mammals (266 higher and lower apes, 457 other placental mammals and 185 marsupials). The method of nasal testing of infants by passage of special testing struts (6 by 2 mm) is described. Forty-two percent of septa of infants were straight, 27% deviated and 31% kinked. A similar pattern was found in adult skulls, namely 21% straight, 37% deviated and 42% kinked. Anterior cartilage deformity occurred in about 4% of births. The maxillary molding theory of transmitted pressures during pregnancy or parturition, causing septal deformity, is described. The findings show that varying degrees of septal deformity occur at a constant rate at birth and in the adult. These may vary slightly for each ethnic type. Birth molding pressures are a major cause of dental malocclusion. The shape and strength of the skull and the erect posture appear to be major factors, for septal deformity did not occur in the lower animals, but occurred in 37% of the higher apes and also in a skull of a hominid 1,750,000 years old. This concept enables easy recognition at birth, and the carrying out of a rational method of treatment by manipulation and rapid maxillary expansion.

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

“…A classification with etiological correlation has been suggested [5]. This classification simply divides nasal septum into anterior cartilaginous deviation and combined (cartilaginous and bony) septal deformity.…”

“…They are typically associated with the deformity of cheek, external nares, palate and malocclusion of teeth. Therefore combined nasal deformity is part of greater generalized facial deformity [5].…”

Nasal Septal and Premaxillary Developmental Integration: Implications for Facial Reduction in Homo

“…This is evidenced, in part, by the increased frequency of septal deviation in humans relative to other mammals in which the premaxillary sutures remains patent through life (Gray, 1978;Takahashi, 1987; see also Rön-ning and Kantomaa, 1985). Nevertheless, the postnatal influence of the nasal septum potentially extends beyond the facial skeleton proper affecting the spatial relationship between the facial skeleton and neurocranium.…”

“…Furthermore, in cases of cleft lip and palate both the nasal septal cartilage and vomer exhibit an increase in growth when compared with normal individuals (Kimes et al, 1992). Similarly, in cases of nasal septal deviation in both human and nonhuman mammals, both the nasal septal cartilage and the vomer can be affected (Gray, 1978;Takahashi, 1987). Combined, the results of these studies suggest integrated growth between the nasal septal cartilage and vomer.…”

Comparative Study of Response Through Reduction in the Size of Hypertrophied Inferior Turbinate Causing Nasal Obstruction by Different Surgical Modalities: A Prospective Study

“…The etiology of nasal obstruction is diverse and not always intuitive. Although up to 42 % of population may have some form of a septal deviation and compensatory turbinate hypertrophy, only a quarter of these patients may report symptoms of nasal obstruction [2]. This point highlight one of the well described deficiencies in treating nasal obstruction.…”