Association of Deviated Nasal Septum and Sinusitis: A Radiological Study

Abstract

Introduction:Deviation of nasal septum (DNS) is the most common anatomical variant in sinonasal region. It is usually asymptomatic, but it sometimes can cause different sinonasal symptoms. The severity of the symptoms is related to associate abnormalities like agger nasi cells, onodi cells, haller cells, concha bullosa and inferior turbinate hypertrophy. Methods:Patients were retrospectively selected by a computer-assisted search of all the reports of CT scans performed with a clinical symptom referable to the sinonasal region, headache, nasal obstruction, recurrent sinusitis, chronic sinusitis, acute sinusitis, allergic sinusitis in S, Nijalinagppa Medical College and Hanagal Shri Kumareshwar Hospital & Research Centre between December 1, 2016 and November 30, 2017 to detect the presence of deviated nasal septum. A total of 524 CT studies were identified. Of these cases, studies with malignancy, motion artifacts, Traumatic fractures, polyps, post-op status were excluded. The study design did not involve any patient contact hence no approval by the local ethics committee was required. Results:The sinusitis was identified in 54 patients (10.4%). The age range was 8 to 75 years with a mean age of 33.5 years. Majority of the patients in our study belonged to 21 to 30 year age group (n=21). 36 were males, 18 were females. Midline nasal septum was seen in 31 patients, among them 14 had sinusitis and 17 showed clear sinuses. Right sided septal deviation was seen in 12 patients. Among them 11 had sinusitis and one patient showed clear sinuses. Left sided septal deviation was noted in 9 cases. Among them 6 had sinusitis and 3 showed no signs of sinusitis. S shaped septum was seen in 2 patients. Septal deviation with spur was seen in 3 patients. Sinusitis was seen in 14 patients with midline septum (45.1%). In 17 patients with midline septum there was no sinusitis (54.9%). Right sided septal deviation with associated sinusitis was seen in 11 of the total 12 cases. There was statistically significant association of septal deviation and sinusitis in our study. Conclusion:The association of midline nasal septum with sinusitis is seen in 44.1% of the cases in our study. The association of deviated nasal septum with sinusitis is seen in 81% of the cases in our study. There was statistically significant association of septal deviation with sinusitis (p value <0.05) in our study.