Correlation Study Between Nasal Septal Deviation and Rhinosinusitis

  • Sumit Prasad
  • Saurabh Varshney
  • S. S. Bist
  • Sarita Mishra
  • Namita Kabdwal
Original Article

Abstract

Chronic rhinosinusitis (CRS) is a major cause of concern worldwide. Nasal septal deviation (NSD) may either cause osteomeatal obstruction or may interfere with proper airflow and potentially predispose to sinusitis. Due to the lack of a universally accepted classification on NSD it has not been established whether NSD influences the development of sinusitis or not. Mladina in 1987 proposed a classification in which he classified NSD into seven different categories. The aims and objectives of this study are to observe the correlation between NSD and CRS and to study the relation of different grades of NSD with sinusitis as per Mladina's classification. Patients above 18 years of age presenting to ENT OPD with complaint of nasal obstruction, nasal discharge and headache were subjected to CT scan (nose and paranasal sinuses) coronal section with contiguous 5 mm thickness slice perpendicular to the hard palate in prone position. Presence of NSD and sinusitis was observed. 120 cases were studied. The mean age was 28.7 ± 9.37 years with age range 18–58 years. There were 92 (76.6 %) males and 28 (23.3 %) females with a M:F ratio of 3:1. Out of 120 cases, 114 (95 %) cases had NSD. Sinusitis was present in 63 (52.5 %) cases on CT scan. Out of 57 (50.0 %) cases with NSD and sinusitis, 13 (11.4 %) cases had sinusitis on the same side of NSD, 14 (12.28 %) cases had sinusitis on the side opposite to NSD and 30 (26.31 %) cases had sinusitis on both sides of NSD. There was no statistically significant relationship between NSD and sinusitis. As per Mladina's classification vertical deviations accounted for majority of patient’s septal deviations with 31 (27.1 %) cases of type II NSD and 24 (21.1 %) cases of type I NSD. The maximum number of cases with sinusitis had vertical deviations with type I NSD in 17 (27.0 %) cases and type II NSD in 18 (28.5 %) cases. The present study reveals that there is no correlation between NSD and sinusitis. Vertical deviations type I and type II are more prone to sinusitis as they involve the nasal valve area.

Keywords

Deviated septum Rhinosinusitis 

References

  1. 1.
    S Brown (2008) Rhinosinusitis. In: Michael Gleeson(ed) Scott-Brown’s Otolaryngology Rhinology, 7th edn. Hodder Arnold, Great Britain, p 1443–1445Google Scholar
  2. 2.
    Mladina R, Heinzel B, Belussi L, Passali D (1995) Staging in rhinosinusitis septal deformities. Rivista Italiana Di Otolaryngologi 7:16Google Scholar
  3. 3.
    Rao JJ, Kumar VEC, Babu RK, Chowdary SK, Singh J, Rangamani VS (2005) Classification of nasal septal deviations-relation to sinonasal pathology. Indian J Otolaryngol Head Neck Surg 57:199–201PubMedGoogle Scholar
  4. 4.
    Bolger W, Butuzin C, Parsons D (1991) Paranasal sinuses bony anatomical variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 101:56–64PubMedCrossRefGoogle Scholar
  5. 5.
    Azila A, Irfan M, Rohaizan Y, Shamim AK (2011) The prevalence of anatomical variations in osteomeatal unit in patients with chronic rhinosinusitis. Med J Malays 66(3):191–194Google Scholar
  6. 6.
    Dua K, Chopra H, Khurana AS, Munjal M (2005) CT scan variations in chronic sinusitis. Indian J Radiol Imaging 15(3):315–320CrossRefGoogle Scholar
  7. 7.
    Al Anazy FH (2011) The incidence of concha bullosa and its association with chronic rhinosinusitis deviated nasal septum and osteomeatal complex obstruction. Bahrain Med Bull 33(4):1–7Google Scholar
  8. 8.
    Stallman SJ, Lobo NJ, Som MP (2004) Incidence of concha bullosa and its relationship to nasal septal deviation and paranasal sinus disease. Am J Neuroradiol 25:1613–1618PubMedGoogle Scholar
  9. 9.
    Daghistani Kamal J (2002) Nasal septal deviation in Saudi patients: a hospital based study. J King Abdulazia Univ Med Sci 10:39–46CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2013

Authors and Affiliations

  • Sumit Prasad
    • 1
  • Saurabh Varshney
    • 1
    • 2
  • S. S. Bist
    • 1
  • Sarita Mishra
    • 1
  • Namita Kabdwal
    • 1
  1. 1.Department of ENTHimalayan Institute of Medical SciencesDoiwala, DehradunIndia
  2. 2.Department of OtorhinolaryngologyAll India Institute of Medical Sciences (AIIMS)RishikeshIndia

Personalised recommendations