Prospective controlled study of nasal septum deviation impact on nasal
Objectives: To assess the relation between the type of nasal septum
deviation and the degree of subjective complaint of nasal obstruction.
Methods: One hundred healthy controls and one hundred-fourteen
septoplasty patients were investigated for nasal obstruction using
endoscopic examination and Nasal Obstruction Symptom Evaluation (NOSE)
scale. Septal deviations were classified as septal spur, C or S shape
deformity at coronal or axial plane and combined deformity. The degree
of septal deviation was assessed, whether the septal deviation was in
contact with lateral nasal wall or not. Results: Septoplasty patients
showed to have higher NOSE scores when compared to the controls.
According to multiple comparison test results, patients with septal spur
had significantly lower NOSE scores compared with patients with
different type of septal deformity (septal spur 45.00(SD=15.80) vs. C
type deformity 60.95(SD=15.25), S type deformity 63.40(SD=14.95),
combined deformity 76.25(SD=8.55), p˂0.05). There was no significant
difference in NOSE score according to septal deviation degree, whether
the septal deviation contacts with the lateral nasal wall or not. After
septoplasty the mean intervention groups’ NOSE score improved from
61.30(SD=17.20) points to 17.00(SD=15.45) points (p<0.01).
Conclusions: Septal deviation, regardless of the anatomical location or
shape of deviation results in impaired nasal breathing when measured by
NOSE scale and compared to population average. Septal spur deformity
causes significantly lower NOSE scores when compared with C or S type
deformity, or combined deformity, indicating that patients with septal
spur express milder symptoms of nasal obstruction. After septoplasty
patients’ breathing improves significantly despite the type and location
of septal deformity.