Septal Deviation Research Articles

Endoscopic dacrocystorhinostomy: Reasons for failure and possible solutions.

Endoscopic dacryocystorhinostomy is a well-established procedure with high success rate. There are multiple causes of failure of this procedure which affect surgical success. To analyze causes of failure in endoscopic dacryocystorhinostomy and ascertain methods to overcome causes of failure. After approval from the Institutional Review Board a retrospective review of 119 patients was undertaken over an 11-year period from 2008 to 2018. A tertiary care hospital in North India. Patients presenting to the Otorhinolaryngology out-patient department and diagnosed as failed endoscopic dacryocystorhinostomy cases. After thorough preoperative workup consisting of history, examination and diagnostic nasal endoscopy, patients underwent revision endoscopic dacryocystorhinostomy. After exclusion of 2 cases, 117 patients were included in the study. The mean age at presentation was 31.4 years. Number of previous surgeries: 92 patients had had one surgery, 20 patients had had two surgeries, 5 patients had had three surgeries and 9 patients had had multiple surgeries before presentation. All patients (100%) had epiphora, 75 (64.1%) patients had associated discharge and 4 (3.4%) had persistent medial canthal swelling. Duration of symptoms following previous surgery was 1-6 weeks. Commonest cause of failure was incomplete sac exposure in 117/117 cases (100%). Other causes were cicatricial closure of ostium in 47 (40.1%), synechiae in 20 (17%), canalicular obstruction in 4(3.4%), lacrimal sac diverticulum in 3 (2.5%), nasal polyps in 2 (1.7%), concha with adhesion in 2 (1.7%), septal deviation in 2 (1.7%) cases. Meticulous and thorough sac exposure is the most important factor affecting surgical success. Comprehensive preoperative assessment of cases, meticulous surgical technique, and postoperative follow up are needed for successful outcomes.

Temperature-controlled radiofrequency treatment of the nasal valve in nasal airway obstruction patients with septal deviation.

Nasal valve treatment with TCRF results in NAO symptom improvement in the presence of septal deviation. Severe septal deviation does not impact the beneficial effect of TCRF nasal valve treatment. Symptoms improve with TCRF nasal valve treatment even if septal deviations involve the nasal valve.

Association between nasal septal deviation and tinnitus: Insights from a 9-year nationwide cohort study.

Tinnitus is a condition where sound is perceived in the ear or head when no external sound stimulation is present. To date, no study has explored the correlation between nasal septal deviation (SD) and tinnitus using large-scale real-world data. This study hypothesized a potential relationship between tinnitus and SD, which we investigated using a 9-year large-scale cohort study. Nationwide cohort observational study. The SD group was selected from 1 million individuals randomly extracted from the National Health Insurance Service database. The non-SD group was obtained through propensity score matching considering several variables. The primary endpoint was tinnitus diagnosis. The study (SD) group included 10,790 individuals, and the non-SD group (control group) included 21,580 individuals. The overall hazard ratio (HR) for tinnitus in the SD group was 1.74 (95% CI: 1.62-1.89). In the subgroup analysis, the HR was 0.73 (95% CI: 0.68-0.79) for tinnitus in the male group, 1.12 (95% CI: 1.04-1.21) in the group with high economic status, 0.81 (95% CI: 0.75-0.89) in the group living in metropolitan areas, and 0.45 (95% CI: 0.42-0.49) in the younger age group (<50 years). In the SD group, the HR for tinnitus after septoplasty significantly decreased to 0.75 (95% CI: 0.63-0.90). From long-term follow-up, the prevalence of tinnitus was 1.74 times higher in the SD group compared with the control group. This phenomenon significantly decreased after septoplasty.

Influence of septal deviation side on preoperative eustachian tube dysfunction and the effectiveness of septoplasty in alleviating eustachian tube dysfunction.

The Eustachian Tube Dysfunction Questionnaire 7 (ETDQ-7) serves as a valuable tool for assessing eustachian tube dysfunction (ETD). We investigated the impact of septal deviation side on ETD using preoperative ETDQ-7 scores and evaluated the effectiveness of septoplasty based on postoperative ETDQ-7 scores. We conducted a retrospective analysis of patients with septal deviation who were scheduled for septoplasty. ETDQ-7 surveys were conducted preoperative and 1 and 3 months postoperative. 120 patients were included, with 72 completing the ETDQ-7 at all three time points. The average prevalence of ETD was 29.2%. Preoperative ETDQ-7 scores showed no significant difference between convex and concave nasal sides. However, the prevalence of ETD was significantly higher on the convex side (28.3% vs. 15.8%), especially in unilateral ETD cases. Preoperatively, the positive ETD group had significantly higher ETDQ-7 scores on the convex side while no significant difference was found between concave and convex sides in the negative ETD group. Postoperatively, the positive ETD group showed significant improvement in ETDQ-7 scores with significantly higher on the convex side (66.7% vs. 33.3%). ETDQ-7 scores improved after septoplasty, with more improvement in the positive ETD group. Septoplasty significantly improves ETD, particularly in the preoperative positive ETD group, by reducing ETDQ-7 scores. The prevalence of ETD was higher on the convex side preoperatively, and the positive ETD group exhibited significant postoperative improvements, especially on the convex side. This suggests that the direction of septal deviation influences ETD prevalence and surgery outcomes, although septoplasty alleviates ETD on both sides.

Nasal Tip Reshaping in Orthognathic Surgery: A Novel Intraoral Minimally Invasive Approach.

Current concepts in orthognathic surgery focus on not just rectifying dentoskeletal irregularities but also improving facial aesthetic and function. In this respect, nasal reshaping holds extraordinary significance in determining surgery effectiveness and patient satisfaction. Facial preoperative evaluations emphasize the paramount functional and aesthetic impacts of caudal septum in tip reshaping. Deviations in this anatomical subunit could lead to significant nasal obstructions and aesthetic changes as twisted nasal tip, affecting projection, rotation, and columellar-alar relationship. These considerations are essential in orthofacial surgery, as maxillary movements might exacerbate or worsen preexisting nasal tip deformity. In this paper, we aim to describe a novel and innovative minimally invasive approach presenting a detailed account of a rhinoseptoplasty in which the entire nasal tip reshaping procedure was performed intraorally during orthognathic surgery. The technique focused on achieving optimal nasal tip projection and rotation, centering, and stabilization through strategic maneuvers such as incremental dissection of maxillary spine chondroperiosteal junction, superoposterior strut preservation, vertical and caudal septum resection, and anterior nasal spine tip support. Techniques including subnasal drilling and septal stabilization suture are detailed. Specific attention is given to addressing deficiencies in posterior septal angle and labiocolumellar relationship. Postoperative care is described and subjective evaluations were performed to assess patient and surgeon satisfaction with facial symmetry and overall aesthetic improvements. In our experience, the described approach offers valuable surgical finesse to orthognathic surgery, effectively targeting caudal septum deviations and nasal tip droopy. Its unique perspective enhances both functional and aesthetic results, particularly in the context of profiloplasty. No external nasal incision was performed and the totality of nasal tip reshaping was scarless and performed through an intraoral approach. Surgical precision in execution of this novel and tailored surgical approach has been shown to have a profound impact for enhancing outcomes of orthofacial surgery procedure.

Effect of septoplasty on physical performance

The nasal septum is a key component of the nasal structure, affecting proper airflow and providing support for the nasal structures. A deviated septum (DSN) can lead to breathing disorders, impaired nasal patency, recurrent nosebleeds, olfactory disorders and frequent upper respiratory tract infections. In competitive sports, where ventilation performance is critical, septal deviation can adversely affect athletic performance. The purpose of this study is to evaluate the effect of septoplasty on patients' physical performance. Methodes This article is based on the available literature found in the Google Scholar, PubMed database with the use of key words such as ,,septoplasty'', ,,nasal septal deviation'', ,,septoplasty quality of life'', ,,nasal septal deviation athletes'', ,,septoplasty sport'', ,,nasal obstruction sport''. Results Conducted studies show that surgical correction of a deviated nasal septum improves physical performance as well as respiratory and cardiovascular functions. Restoring proper airflow through the nose after surgery leads to a noticeable improvement in physical performance, highlighting the significance of septoplasty in enhancing patient comfort and improving athletic outcomes.

A customized nasal dilator and breather for patient with deviated nasal septum

Nasal obstruction due to deviated nasal septum (DNS) is commonly defined as patient discomfort manifested as a sensation of insufficient airflow through the nose. The definitive treatment for a DNS is septoplasty, this customized nasal device can be used as an adjunct to treatment. And can be used as a breather until The patient receives or underwent definitive treatment. This device contains a nasopharyngeal airway tube and a customized nasal dilator, the nasopharyngeal airway tube is made of soft and elastic medical plastics, with good biocompatibility, without skin damage and allergy, which will be inserted inside. which will be inserted inside the affected nostril and it fits accurately between the septum and the lateral endonasal tissue, the nasal dilator which is composed of heat-cure acrylic resin helps to keep the nasopharyngeal airway in position withoutdislodging. The device also has an elastic band on both sides which can be worn like a mask by the patient. The nasopharyngeal tube of this device has a stopper that prevents the nasopharyngeal tube to go inside the nostril accidentally and the said tube is sterilizable and easily replaceable (even by the patient).

Nasal injuries in amateur male boxers before and after the 2013 rule change by the International Boxing Association removing the protective headgear

Boxing is a popular combat sport in which participants frequently experience head trauma. The neurological impact of boxing has been widely discussed, but the impact on the bone and soft tissue of the head has been less investigated. For this study, a national emergency department database was used to investigate the impact of a 2013 rule change — removing the requirement for amateurs to wear head protection — on the frequency and type of facial injuries sustained by amateur boxers. Over the study period (2006–2021) there were 11 760 injuries, with 6261 occurring before the change and 5499 occurring after (p < 0.001). The number of contusions, fractures, hematomas, and hemorrhages all significantly decreased after the rule change, while the number of lacerations did not. Additionally, the number of septal deviations increased from 16 to 97 (p < 0.001). According to age-group-specific analysis, injuries decreased in both the 0–17 and 24–29 cohorts, but increased in the 18–23 group. The results suggest that the rule change may have had a protective effect on the risk of craniofacial trauma in amateur boxers, potentially due to increased risk-averse behavior by the boxers, who may feel less protected during sparring because of the lack of head protection.

Nasal Septal Deviation Classifications Associated with Revision Septoplasty

Nasal Septal Deviation Classifications Associated with Revision Septoplasty

The Surgical Significance of Phenotypic Variability in the Setting of Tetralogy of Fallot.

The phenotypic feature of tetralogy of Fallot is anterocephalad deviation of the muscular outlet septum, or its fibrous remnant, relative to the septoparietal trabeculation, coupled with hypertrophy of septoparietal trabeculations. Although this feature permits recognition of the entity, no two cases are identical. Once diagnosed, treatment is surgical. The results of surgical treatment have improved remarkably over recent decades. The results are now sufficiently excellent, including those in the developing world, that attention is now directed toward avoidance of morbidity, while still seeking, of course to minimize any fatalities due to surgical intervention. It is perhaps surprising that attention thus far has not been directed on the potential significance of phenotypic variation relative to either mortality or morbidity subsequent to surgical correction. The only study we have found specifically addressing this variability focused on the extent of aortic override, and associated malformations, but made no mention of variability in the right ventricular margins of the interventricular communication, nor the substrates for subpulmonary obstruction. In this review, therefore, we assessed the potential significance of known morphological variability to the outcomes of surgical intervention in over 1,000 individuals undergoing correction by the same surgeon in a center of excellence in a developing country. We sought to assess whether the variations were associated with an increased risk of postoperative death, or problems of rhythm. In our hands, double outlet ventriculoarterial connection was associated with increased risk of death, while the presence of a juxta-arterial defect with perimembranous extension was associated with rhythm problems.

Computed Tomography Analysis of the Nasal Septal Deviation and Related Paranasal Sinus Pathologies

Purpose: Nasal Septum Deviation (NSD), which is defined as a dislocated septum, is a prevalent condition that is mostly asymptomatic; however, it can cause difficulties such as nasal obstruction and rhinosinusitis symptoms. Other Paranasal Sinuses (PNS) disorders, e.g., Osteo Meatal Complex (OMC) obstruction, have been assumed to be correlated with NSD. This study investigates the possible correlation of specific radiological findings of PNS pathologies in patients with or without the existence and direction of NSD. We also discussed the different types of NSD and their incidence among different groups stored by age, gender, etc. Materials and Methods: This is a cross-sectional study conducted at multiple imaging centers in Iran between July 2019 and February 2020 to estimate the prevalence of deviated nasal septum and correlate between NSD and other findings using paranasal sinus scans. All the individuals who met the inclusion and exclusion criteria were included in the study. NSD types have been classified based on Mladina's method. Results: We prospectively reviewed PNS Computed Tomography (CT) scans obtained from 254 cases (82 men and 172 women), aged 18 to 81 years (mean: 35.53), evaluated over seven months. Out of 254 cases, 135 (53 %) patients had NSD, without any direction predominance (right-sided vs. left-sided), and equally distributed between genders. The most common NSD types were type V with a frequency of 42.22% and type III with a frequency of 24.44%. Other PNS CT findings were also investigated in our patients, like OMC obstruction, pansinusitis, mucocele, air-fluid level, mucosal thickening, and concha bullosa. There was no statistically significant correlation between any of these pathologies and NSD (P-value &gt; 0.05). Conclusion: Although NSD was observed in more than half of our cases' PNS CTs, there was no significant correlation between NSD and other findings in most subjects. This reveals that the effectiveness of septal repair surgeries in relieving patients' symptoms might not be as high as expected.

Evaluation of Predictive Value of CT Pulmonary Angiography for Right Ventricular Failure in Patients with Pulmonary Embolism

Purpose: Right ventricle failure is a well-known complication following pulmonary thromboembolism. Although Computed Tomography Pulmonary Angiography (CTPA) findings are supposed to be a surrogate for patients’ outcome, investigations based on this issue is not still elucidated. Thus, in the current study, we assessed patients’ CTPA findings and compared the result with echocardiographic findings. Materials and Methods: A total of 36 patients with proven pulmonary thromboembolism were enrolled and a comparison was made between indices in CTPA (interventricular septal deviation to the right side, inferior vena cava contrast reflux, and right ventricle diameter to left ventricle diameter ratio) and echocardiographic findings for detecting right ventricular failure. Also, the reliability of the aforementioned indices was sought for predicting mortality. Results: No significant correlation was found between CTPA indices and echocardiographic findings. The highest sensitivity and positive predictive value in CT pulmonary angiography for detecting right ventricle dysfunction were revealed to be for Right Ventricle Diameter (RVD) / Left Ventricle Diameter (LVD) &gt; 1 (63.64%), abnormal septal deviation (75.00%), respectively. Conclusion: Our results revealed that CTPA indices can reliably predict the upcoming mortality risk. On the other hand, these indices were not well-correlated with echocardiographic findings.

Association Between Deviated Nasal Septum and Function of Eustachian Tube among Patients Attending a Tertiary Care Center

Deviated nasal septum is the most common cause of severe and chronic nose blockage. The eustachian tube (ET) is a tube that connects the middle ear cavity and the nasopharynx and provides middle ear ventilation. The relationship between DNS and ETF is controversial in medical literature. This study tried to find the association between deviated nasal septum and function of eustachian tube. This prospective study was conducted in Nepal Medical College Teaching Hospital, Otorhinolarynology Department from November 2022 to October2023 after acquiring ethical clearance from Institutional Review Committee. All the patients presenting to the outpatient clinic over the age of 19 with deviated nasal septum (DNS) were included. Statistical analysis was done using SPSS. A p value of &lt; 0.05 was considered statistically significant. Our study had 71 males (54.6%) and 59 females (45.4%) with mean age 37.2±15.9 years. Of 130 patients, 56 (43.1%) had DNS to right side while 74 (56.9%) to left. All patients had moderate DNS. Age group, gender, and laterality of DNS of the patient did not show any significant association with ETDQ7 score, tympanograms and middle ear pressures on either side. Moderate DNS did not affect ETF in a significant way.

Quantifying the Domino Effect of Septoplasty on Eustachian Tube Function and Nasal Resistance in Patients With Chronic Otitis Media: A Cross-Sectional Study.

Background Eustachian tube dysfunction is characterized by insufficient dilation, leading to secondary pathologies in the middle ear. By comparing pre- and post-operative grades of Eustachian tube functionand nasal resistance measurements, this study seeks to determine if septoplasty can improve Eustachian tube function in cases where nasal septal deviation is likely to cause mechanical dysfunction. We also aim to validate the JainBhalerao endoscopic classification of nasal septal deviation by assessing its utility in identifying septal deviations at a higher risk of causing Eustachian tube dysfunction. The ultimate goal is to establish guidelines for aural indications of septoplasty in treating Eustachian tube dysfunction-related middle ear disorders. Material and methods This prospective observational study was carried out from 1stJune 2022 to 31st March 2024 in the Department of Otorhinolaryngology at Acharya Vinoba Bhave Rural Hospital, involving 66 patients diagnosed with chronic otitis media and a deviated nasal septum with Eustachian tube dysfunction. Pre-operative and post-operative improvement in Eustachian tube function and Nasal resistance and their correlation werestudied using dynamic slow-motion video endoscopy and active anterior rhinomanometry, respectively. Statistical analysis included the chi-square test. Results Sixty-six patients diagnosed with chronic otitis media and deviated nasal septum with Eustachian tube dysfunction included in this study had a mean age of 35.6 years with 43 (65.2%) male predominance. Gross luminal narrowing and discrepancy of the volume of both nasal cavities led to higher degrees of Eustachian tube dysfunction due to pressure drop on the affected side, as observed in types 6, 7, and 8 as per Jain Bhalerao classification of deviated nasal septum. Nasal resistance measured using active anterior Rhinomanometry (Rhinodebitometry) showed a positive association of severity of nasal resistance in the types 6, 7, and 8 DNS of the Jain Bhalerao classification of deviated nasal septum. It demonstrated an improvement in the grade of Eustachian tube function and nasal resistance post-septoplasty. Conclusion The deviated nasal septum is one of the causes of Eustachian tube dysfunction and increased nasal resistance. Certain types of DNS are adversely associated with the causation of greater degrees of Eustachian tube dysfunction of mechanical type. Nasal septal deviation correction improved Eustachian dysfunction and nasal resistance after septoplasty.

Characterising Sinonasal Pneumatization in Patients with Nasal Septal Deviation: A CBCT-Based Study

Characterising Sinonasal Pneumatization in Patients with Nasal Septal Deviation: A CBCT-Based Study

Prevalence of concha bullosa in a pediatric population

ObjectiveExisting literature on the prevalence of middle turbinate pneumatization, or concha bullosa (CB), in the pediatric population is limited. CB is an anatomic variant important to identify prior to sinonasal surgery and is often associated with congenital nasal septal deviation (SD). This paper aims to describe the prevalence of CB in the pediatric population on head imaging. MethodsA retrospective chart review was performed for 695 children undergoing CT head for trauma from 2021 to 2022. Nearly equal numbers of males and females were evaluated, with at least 19–20 per year from 0.5 to 18 years. Patients with significant facial fractures, sinusitis, craniofacial syndromes, prior sinus surgery, and sinonasal masses were excluded. Two pediatric neuroradiologists evaluated the CTs. CB was defined as aeration >50 % of the vertical height of the middle turbinate. ResultsIn this study, 384 patients were included. The prevalence of CB was 153 (39.8 %), which was significantly higher in children >4 years (p < 0.0001). Lamellar type CB was the most common, present in 160 out of 768 middle turbinates assessed (20.8 %). SD occurred in 60 (39.2 %) patients with CB and was more commonly contralateral to the CB. ConclusionsThe prevalence of CB in the pediatric population is at the lower range of what is reported in the adult literature. The most common type of CB in patients is lamellar. Similar to previous studies, there is an association between CB and contralateral SD. Finally, there is a positive correlation between the severity of CB and the severity of SD.

Exploring the Relationships Between Clinical Examination Findings, Subjective Reported Symptoms and Objective Nasal Patency Measures in Nasal Obstruction: A Baseline NAIROS Sub-Study Analysis.

The role of objective nasal airflow measures using peak nasal inspiratory flow (PNIF) and rhinospirometry in supporting clinical examination findings when offering patients septoplasty remain undefined. To explore the baseline relationships between clinical examination findings, subjective reported symptoms and objective nasal patency measures in nasal obstruction. This is a sub-study of the NAIROS trial. Participants with nasal obstruction secondary to septal deviation were included in this NAIROS sub-study. The side of septal deviation, enlargement of inferior turbinate (IT), the need for IT reduction if septoplasty was being performed, the area of septum deflecting into the airway and observer rated airway block (ORAB-arbitrarily divided by <50% and >50% blockage) were assessed by clinicians. The subjective score of nasal obstruction was assessed using the Double Ordinal Assessed Subjective Scale (DOASS). Objective nasal patency measures (e.g., nasal partitioning ratio, [NPR] and PNIF) were measured using PNIF and rhinospirometry. The mean NPR for left-sided, both-sided and right-sided septal deviation was -0.35, -0.02 and 0.51, respectively (p < 0.001). There was very weak correlation between the requirement for IT reduction and PNIF change (0.13, p < 0.01). There was no difference in mean PNIF (94 L/min vs. 93 L/min) and mean DOASS (0.33 vs. 0.38) for participants with ORAB rated <50% and >50%. The mean NPR for participants with ORAB >50% was higher than for those with ORAB <50% (0.51 vs. 0.41, p = 0.002). There was strong correlation between the DOASS and NPR (+0.737, p < 0.001). The mean DOASS score for right-sided, both-sided and left-sided septal deviation was 0.32, 0.05 and -0.29, respectively (p < 0.001). This study identified strong relationships between the clinician rated side of septal deflection, the patient reported DOASS and the objective NPR measurements. NPR and the clinician rated degree of airway blockage were concordant.

Septoplasty versus non-surgical management for deviated nasal septum: a systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the efficacy and safety of septoplasty versus non-surgical management for patients experiencing nasal obstruction due to deviated nasal septum (DNS). We conducted a comprehensive search of PubMed, Scopus, Embase, Web of Science, Cochrane Library, Clinicaltrials.gov, ICTRP, and ISRCTN for relevant RCTs. The primary outcomes included the Nasal Obstruction Symptom Evaluation (NOSE) scale, Sino-Nasal Outcome Test (SNOT-22), Peak Nasal Inspiratory Flow (PNIF), surgical complications, and quality of life. Data were synthesized using RevMan 5.4 and STATA 18, with effect estimates presented as mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI). The study protocol was registered with PROSPERO (ID: CRD42024538373). Our search identified 537 studies, of which 3 RCTs involving 721 participants met the inclusion criteria. The meta-analysis revealed that septoplasty significantly improved NOSE and SNOT-22 scores compared to non-surgical interventions at 6 and 12 months of follow-up, despite no notable differences at 3 months post-treatment. No significant difference was observed regarding nasal flow assessed by PNIF. The rate of complications was low, ranging from 0.31% (revision rate) to 4.12% (bleeding and infection rates). Additionally, our qualitative synthesis showed an improvement in the quality of life at 6 and 12 months in the septoplasty group compared with the non-surgical group. This systematic review and meta-analysis of 721 patients revealed the efficacy of septoplasty, with or without turbinate surgery, in improving nasal obstruction symptoms at 6 and 12 months. Additionally, septoplasty consists of a relatively low rate of complications such as bleeding, infection, and septal perforation. Furthermore, a low revision rate was found. Septoplasty improved the quality of life, especially after 6 and 12 months. However, our findings should be interpreted with caution, and further research is needed to consolidate our results.

Evaluation of the presence of nasal septum deviations in individuals with different skeletal malocclusions

OBJECTIVE: The aim of this study was to evaluate the presence of deviated septum in individuals with different skeletal malocclusions. MATERIALS AND METHOD: The study was performed on cone beam computed tomography images of a total of 159 individuals, 53 in each Class I, Class II, and Class III skeletal malocclusion. Nasal septum deviation was analysed in three groups as mild (type 1; &amp;lt;9°), moderate (type 2; 9-15°), and severe (type3; &amp;gt;15°). In addition, the presence of concha bullosa in different skeletal malocclusions was evaluated. The data were analyzed statistically using the Chi-square test and One-way Analysis of Variance (ANOVA). The relationship betweenskeletal malocclusions and types of deviation was determined using Cramèr’s V analysis. RESULTS: There are statistically significant differences between type 2 and type 3 in individuals with Class I skeletal malocclusion and between type 1 and type 3 in individuals with Class II skeletal malocclusion (p=0.046; p&amp;lt;0.01 respectively). In individuals with Class III skeletal malocclusion, no difference was observed between deviation types. In addition, a weak correlation was found between skeletal malocclusion and deviation types (Cramèr’s V = 0.213). No significant difference was observed between the groups in terms of concha bullosa and deviation side (p=0.215). CONCLUSION: Although a significant difference was observed in terms of deviation type in individuals with Class I and II skeletal malocclusion, a weak correlation was observed between the increase in deviation severity and skeletal malocclusions.

The Application of Mask Region-Based Convolutional Neural Networks in the Detection of Nasal Septal Deviation Using Cone Beam Computed Tomography Images: Proof-of-Concept Study.

Artificial intelligence (AI) models are being increasingly studied for the detection of variations and pathologies in different imaging modalities. Nasal septal deviation (NSD) is an important anatomical structure with clinical implications. However, AI-based radiographic detection of NSD has not yet been studied. This research aimed to develop and evaluate a real-time model that can detect probable NSD using cone beam computed tomography (CBCT) images. Coronal section images were obtained from 204 full-volume CBCT scans. The scans were classified as normal and deviated by 2 maxillofacial radiologists. The images were then used to train and test the AI model. Mask region-based convolutional neural networks (Mask R-CNNs) comprising 3 different backbones-ResNet50, ResNet101, and MobileNet-were used to detect deviated nasal septum in 204 CBCT images. To further improve the detection, an image preprocessing technique (contrast enhancement [CEH]) was added. The best-performing model-CEH-ResNet101-achieved a mean average precision of 0.911, with an area under the curve of 0.921. The performance of the model shows that the model is capable of detecting nasal septal deviation. Future research in this field should focus on additional preprocessing of images and detection of NSD based on multiple planes using 3D images.