The Comprehensive Review of Deviated Septum: Anatomy, Diagnosis, and Treatment Approaches
DOI:
https://doi.org/10.12775/QS.2025.37.57018Keywords
nasal septum, nasal septal deviation, nasal septoplasty, otolaryngologyAbstract
Deviated septum, a common nasal structural abnormality, often leads to symptoms like nasal obstruction, sinusitis, and sleep disturbances, impacting respiratory function and quality of life. This clinical review emphasizes the critical role of septoplasty in the treatment of nasal septum deviation (NSD). While the nasal septum's anatomy is essential for proper airflow, deviations can cause significant issues, particularly in severe cases.
Diagnosis involves clinical evaluation and imaging to assess the extent of deviation. Septoplasty, the gold standard treatment, realigns the septum to restore normal airflow and alleviate symptoms. The review also explores advances in septoplasty techniques aimed at improving outcomes and reducing recovery time. Overall, septoplasty remains the most effective intervention for managing NSD, with ongoing research focused on refining surgical methods and enhancing patient care.
References
Teixeira, J., Certal, V., Chang, E. T., & Camacho, M. (2016). Nasal Septal Deviations: A Systematic Review of Classification Systems. Plastic surgery international, 2016, 7089123. https://doi.org/10.1155/2016/7089123
Alghamdi FS, Albogami D, Alsurayhi AS, et al. Nasal Septal Deviation: A Comprehensive Narrative Review. Cureus. 2022;14(11):e31317. Published 2022 Nov 10. doi:10.7759/cureus.31317
Strohl KP, Butler JP, Malhotra A. Mechanical properties of the upper airway. Compr Physiol. 2012;2(3):1853-1872. doi:10.1002/cphy.c110053 [7]
Sobiesk JL, Munakomi S. Anatomy, Head and Neck, Nasal Cavity. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
Pérez-Piñas, Sabaté J, Carmona A, Catalina-Herrera CJ, Jiménez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000;197 ( Pt 2)(Pt 2):221-227. doi:10.1046/j.1469-7580.2000.19720221.x
Maier W, Ruf I. Morphology of the nasal capsule of primates--with special reference to Daubentonia and Homo. Anat Rec (Hoboken). 2014;297(11):1985-2006. doi:10.1002/ar.23023
Dalgorf DM, Harvey RJ. Chapter 1: Sinonasal anatomy and function. Am J Rhinol Allergy. 2013;27 Suppl 1:S3-S6. doi:10.2500/ajra.2013.27.3888
El-Taher M, AbdelHameed WA, Alam-Eldeen MH, Haridy A. Coincidence of Concha Bullosa with Nasal Septal Deviation; Radiological Study. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 3):1918-1922. doi:10.1007/s12070-018-1311-x
Al-Rawi NH, Uthman AT, Abdulhameed E, Al Nuaimi AS, Seraj Z. Concha bullosa, nasal septal deviation, and their impacts on maxillary sinus volume among Emirati people: A cone-beam computed tomography study. Imaging Sci Dent. 2019;49(1):45-51. doi:10.5624/isd.2019.49.1.45
Kucybała I, Janik KA, Ciuk S, Storman D, Urbanik A. Nasal Septal Deviation and Concha Bullosa - Do They Have an Impact on Maxillary Sinus Volumes and Prevalence of Maxillary Sinusitis?. Pol J Radiol. 2017;82:126-133. Published 2017 Mar 4. doi:10.12659/PJR.900634
Koo SK, Kim JD, Moon JS, Jung SH, Lee SH. The incidence of concha bullosa, unusual anatomic variation and its relationship to nasal septal deviation: A retrospective radiologic study. Auris Nasus Larynx. 2017;44(5):561-570. doi:10.1016/j.anl.2017.01.003
Li L, Zang H, Han D, London NR Jr. Impact of Varying Types of Nasal Septal Deviation on Nasal Airflow Pattern and Warming Function: A Computational Fluid Dynamics Analysis. Ear Nose Throat J. 2021;100(6):NP283-NP289. doi:10.1177/0145561319872745
Kamani T, Yılmaz T, Sürücü S, Bajin MD, Günaydın RÖ, Kuşçu O. Histopathological changes in nasal mucosa with nasal septum deviation. Eur Arch Otorhinolaryngol. 2014;271(11):2969-2974. doi:10.1007/s00405-014-2990-x
Dadgarnia MH, Baradaranfar MH, Mazidi M, Azimi Meibodi SM. Assessment of Septoplasty Effectiveness using Acoustic Rhinometry and Rhinomanometry. Iran J Otorhinolaryngol. 2013;25(71):71-78.
Lawson VG. Management of the twisted nose. J Otolaryngol. 1978;7(1):56-66.
Mladina R, Cujić E, Subarić M, Vuković K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol. 2008;29(2):75-82. doi:10.1016/j.amjoto.2007.02.002
Li L, Zang H, Han D, London NR. Impact of Varying Types of Nasal Septal Deviation on Nasal Airflow Pattern and Warming Function: A Computational Fluid Dynamics Analysis. Ear, Nose & Throat Journal. 2021;100(6):NP283-NP289. doi:10.1177/0145561319872745
Bugten V, Nilsen AH, Thorstensen WM, Moxness MH, Amundsen MF, Nordgård S. Quality of life and symptoms before and after nasal septoplasty compared with healthy individuals. BMC Ear Nose Throat Disord. 2016;16:13. Published 2016 Oct 28. doi:10.1186/s12901-016-0031-7
Kumar L, Belaldavar BP, Bannur H. Influence of Deviated Nasal Septum on Nasal Epithelium: An Analysis. Head Neck Pathol. 2017;11(4):501-505. doi:10.1007/s12105-017-0819-9
Abdesallam HA, Mahrous AK, Hashim AH. Epistaxis Management. EJHM. 2007;26:55–62
Gilyoma JM, Chalya PL. Etiological profile and treatment outcome of epistaxis at a tertiary care hospital in Northwestern Tanzania: a prospective review of 104 cases. BMC Ear Nose Throat Disord. 2011;11:8. Published 2011 Sep 5. doi:10.1186/1472-6815-11-8
Özturan O. Epistaksis. In: Çelik O, editor. Kulak Burun Boğaz hastalıkları ve Bas Boyun cerrahisi. İstanbul: Turgut Yayıncılık; 2002. pp. 357–67
Yeom SW, Kim MG, Lee EJ, et al. Association between septal deviation and OSA diagnoses: a nationwide 9-year follow-up cohort study. J Clin Sleep Med. 2021;17(10):2099-2106. doi:10.5664/jcsm.9352
Gupta N, Singh PP, Bagla RK. Will Septal Correction Surgery for Deviated Nasal Septum Improve the Sense of Smell? A Prospective Study. Surg Res Pract. 2015;2015:496542. doi:10.1155/2015/496542
Leopold DA. The relationship between nasal anatomy and human olfaction. Laryngoscope. 1988;98(11):1232-1238. doi:10.1288/00005537-198811000-00015
Behnke J, Dundervill C, Bulbul M, Armeni M, Ramadan HH, Makary CA. Using the sino-nasal outcome test (SNOT-22) to study outcome of treatment of nasal obstruction. Am J Otolaryngol. 2023;44(4):103879. doi:10.1016/j.amjoto.2023.103879
van Egmond MMHT, Rovers MM, Tillema AHJ, van Neerbeek N. Septoplasty for nasal obstruction due to a deviated nasal septum in adults: a systematic review. Rhinology. 2018;56(3):195-208. doi:10.4193/Rhin18.016
Most SP, Rudy SF. Septoplasty: Basic and Advanced Techniques. Facial Plast Surg Clin North Am. 2017;25(2):161-169. doi:10.1016/j.fsc.2016.12.002
Shah J, Roxbury CR, Sindwani R. Techniques in Septoplasty: Traditional Versus Endoscopic Approaches. Otolaryngol Clin North Am. 2018;51(5):909-917. doi:10.1016/j.otc.2018.05.007
Kim DY, Nam SH, Alharethy SE, Jang YJ. Surgical Outcomes of Bony Batten Grafting to Correct Caudal Septal Deviation in Septoplasty. JAMA Facial Plast Surg. 2017;19(6):470-475. doi:10.1001/jamafacial.2017.0092
Tasca I, Compadretti GC, Losano TI, Lijdens Y, Boccio C. Extracorporeal septoplasty with internal nasal valve stabilisation. Acta Otorhinolaryngol Ital. 2018;38(4):331-337. doi:10.14639/0392-100X-1525
Tian Q, Chu T, Sun H, Pang M. Outcomes of Endonasal Septoplasty and Extracorporeal Septal Reconstruction in Anterocaudal Septal Deviation. Ear Nose Throat J. 2021;100(5_suppl):645S-651S. doi:10.1177/0145561320903147
Maniglia CP, Maniglia JV. Rhinoseptoplasty in children. Braz J Otorhinolaryngol. 2017;83(4):416-419. doi:10.1016/j.bjorl.2016.04.019
Nofal AAB. Fashioned Mucoperichondrium Flap Technique in Caudal Septal Deviation. OTO Open. 2021;5(2):2473974X211013744. Published 2021 May 10. doi:10.1177/2473974X211013744
Dizdar D, Bozan A, Dizdar SK, Göde S, Alpay HC. Evaluation of nasal symptoms in septoplasty patients using SNOT-22. Acta Otorhinolaryngol Ital. 2019;39(2):98-102. doi:10.14639/0392-100X-2061
Gupta N. Endoscopic septoplasty. Indian J Otolaryngol Head Neck Surg. 2005;57(3):240-243. doi:10.1007/BF03008021
Avcı D, Hartoka Sevinç A, Güler S. The systolic pulmonary artery pressure and the E/e' ratio decrease after septoplasty in patients with grade 2 and 3 pure nasal septal deviation. Braz J Otorhinolaryngol. 2021;87(5):497-504. doi:10.1016/j.bjorl.2020.10.006
Smitha SG, Jagannath B, Mathew AS. Impact of Septal Correction on the Blood Pressure of Hypertensive Patients with Deviated Nasal Septum. Indian J Otolaryngol Head Neck Surg. 2016;68(1):46-51. doi:10.1007/s12070-015-0840-9
Ketcham AS, Han JK. Complications and management of septoplasty. Otolaryngol Clin North Am. 2010;43(4):897-904. doi:10.1016/j.otc.2010.04.013
Dąbrowska-Bień J, Skarżyński PH, Gwizdalska I, Łazęcka K, Skarżyński H. Complications in septoplasty based on a large group of 5639 patients. Eur Arch Otorhinolaryngol. 2018;275(7):1789-1794. doi:10.1007/s00405-018-4990-8
Rettinger G, Kirsche H. Complications in septoplasty. Facial Plast Surg. 2006;22(4):289-297. doi:10.1055/s-2006-954847
Koc S, Uysal IO, Uysal EB, Yenişehirli G, Duygu F. The comparison of bacteremia and amount of bleeding during septoplasty. Eur Arch Otorhinolaryngol. 2012;269(4):1139-1142. doi:10.1007/s00405-011-1789-2
Joshi RR, Riley CA, Kacker A. Complication Rates Following Septoplasty With Inferior Turbinate Reduction. Ochsner J. 2019;19(4):353-356. doi:10.31486/toj.19.0002
Valsamidis K, Printza A, Constantinidis J, Triaridis S. The Impact of Olfactory Dysfunction on the Psychological Status and Quality of Life of Patients with Nasal Obstruction and Septal Deviation. Int Arch Otorhinolaryngol. 2020;24(2):e237-e246. doi:10.1055/s-0040-1701269
Ma Q, Su K, Fu Z, Wang P, Shi H. Anxiety and depression in patients with nasal septal deviation. Am J Otolaryngol. 2020;41(3):102450. doi:10.1016/j.amjoto.2020.102450
Carmel Neiderman NN, Eisenberg N, Caspi I, et al. The effect of septal deviation on postoperative quality of life in patients undergoing radiofrequency-assisted turbinate reduction. Laryngoscope Investig Otolaryngol. 2022;7(2):325-334. Published 2022 Feb 18. doi:10.1002/lio2.759
Fidan T, Fidan V, Ak M, Sütbeyaz Y. Neuropsychiatric symptoms, quality of sleep and quality of life in patients diagnosed with nasal septal deviation. Kulak Burun Bogaz Ihtis Derg. 2011;21(6):312-317. doi:10.5606/kbbihtisas.2011.048
Saniasiaya J, Abdullah B. Quality of life in children following nasal septal surgery: A review of its outcome. Pediatr Investig. 2019;3(3):180-184. Published 2019 Sep 26. doi:10.1002/ped4.12145
Bilal N, Selcuk A, Karakus MF, Ikinciogullari A, Ensari S, Dere H. Impact of corrective rhinologic surgery on rhinogenic headache. J Craniofac Surg. 2013;24(5):1688-1691. doi:10.1097/SCS.0b013e31827c7d8f
An R, Tian L, Liu M, et al. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2016;30(1):35-38.
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