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deviated nasal septum
Etiology:
- congenital anomaly
- trauma to the nose
- may occur during labor & delivery
- accidents, contact sports
Epidemiology:
- most common cause of chronic unilateral nasal obstruction [3]
Pathology:
- aging may cause nasal cartilage to deteriorate, aggravating a deviated septum over time
Physical examination:
- use of bright light & nasal speculum to view the deviated nasal septum
Clinical manifestations:
- cosmetic defect
- may be asymptomatic
- noisy breathing
- difficulty breathing through a nostril or both nostrils
Complications:
- obstruction of nasal passage, reduction in airflow
- epistaxis
- recurrent sinusitis
- facial pain
Management:
- if rhinorrhea & nasal congestion, initiate nasal glucocorticoid [3]
- surgery (septoplasty) associated with improved quality of life [1]
- septoplasty more effective than medical management [4]
Related
nasal septum
General
anomaly
nose disease; nasal disorder
References
- van Egmond MMHT, Rovers MM, Hannink G et al
septoplasty with or without concurrent turbinate surgery versus
non-surgical management for nasal obstruction in adults with a
deviated septum: a pragmatic, randomised controlled trial.
Lancet. Published:June 18, 2019
PMID: 31227374
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30354-X/fulltext
- Mayo Clinic: Deviated septum
http://www.mayoclinic.com/health/deviated-septum/DS00977
- NEJM Knowledge+ Otolaryngology
- Lee SJ, Liong K, Lee HP.
Deformation of nasal septum during nasal trauma.
Laryngoscope. 2010 Oct;120(10):1931-9.
PMID: 20824645
- Carrie S et al.
Clinical effectiveness of septoplasty versus medical management for nasal
airways obstruction: Multicentre, open label, randomised controlled trial.
BMJ 2023 Oct 18; 383:e075445.
PMID: 37852641 PMCID: PMC10583133 Free PMC article
https://www.bmj.com/content/383/bmj-2023-075445