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Surgical and Radiologic Anatomy

Published in:

15-03-2024 | Computed Tomography | Original Article

Correlation of maximal nasal septal deviation with deviation at the maxillary insertion

Authors: Keshav Kumar Gupta, Dean Davda, Zahir Mughal, Andrew Lotfallah, Shahram Anari

Published in: Surgical and Radiologic Anatomy | Issue 5/2024

Abstract

Purpose

It is unclear if septal deviation at the insertion points to the nasal cavity is associated with the overall septal deviation. This study aimed to assess septal deviation at the cribriform plate (CP) and maxillary crest (MC) using CT scans and to see if there was any correlation with overall septal deviation.

Methods

All consecutive CT sinus scans between January 2020 and December 2021 were retrospectively reviewed. Patients were excluded if they had a history of head, nasal or facial trauma, or any previous nasal surgical procedure. Angles between the septum and MC and the septum and CP as well as maximal angle of septal deviation (MSD) were measured.

Results

A total of 70 scans were included in the final analysis. The mean MSD was 8.14°. The mean septal deviation was 0.89° at the CP and 2.02° at the MC. The correlation coefficient between the deviation at the CP and MSD was 0.025 and between the deviation at the MC and MSD was 0.321.

Conclusion

Our data reveal a positive correlation between septal deviation at the floor of the nose and overall septal deviation; this was not observed at the septal deviation at the roof. This could be explained due to the inherent tilt in the cribriform plate or by earlier ossification and fixation of the septum during its development at its insertion to the roof, thereby allowing further growth and potential for deviation of the lower part of the septum and its insertion to the floor.

Aksoy DÖ, Karagöz Y, Mahmutoğlu AS (2022) Ethmoid roof morphometric measurements of a pediatric population using computed tomography. Surg Radiol Anat 44:933–940. https://doi.org/10.1007/s00276-022-02951-6CrossRefPubMed

Al Dayeh AA, Rafferty KL, Egbert M, Herring SW (2013) Real-time monitoring of the growth of the nasal septal cartilage and the nasofrontal suture. Am J Orthod Dentofac Orthop 143:773–783. https://doi.org/10.1016/j.ajodo.2013.01.012CrossRef

Baddam P, Bayona-Rodriguez F, Campbell SM, El-Hakim H, Graf D (2022) Properties of the nasal cartilage, from Development to Adulthood: a scoping review. Cartilage 13:19476035221087696. https://doi.org/10.1177/19476035221087696CrossRefPubMedPubMedCentral

Daultrey C, Hardman J, Anari S (2018) The caucasian nasal septum: an in vivo computed Tomography Study. Aesthet Surg J 38:717–722. https://doi.org/10.1093/asj/sjx249CrossRefPubMed

Denour E, Roussel LO, Woo AS, Boyajian M, Crozier J (2020) Quantification of nasal septal deviation with computed Tomography Data. J Craniofac Surg 31:1659–1663. https://doi.org/10.1097/SCS.0000000000006597CrossRefPubMed

Goergen MJ, Holton NE, Grünheid T (2017) Morphological interaction between the nasal septum and nasofacial skeleton during human ontogeny. J Anat 230:689–700. https://doi.org/10.1111/joa.12596CrossRefPubMedPubMedCentral

Goh S, Karamchandani D, Anari S (2019) Relationship of the posterior septal angle to the anterior nasal spine in the caucasian nasal septum. J Laryngol Otol 133:224–226. https://doi.org/10.1017/S0022215119000185CrossRefPubMed

Holton NE, Yokley TR, Figueroa A (2012) Nasal septal and craniofacial form in european- and african-derived populations. J Anat 221(3):263–274. https://doi.org/10.1111/j.1469-7580.2012.01533.xCrossRefPubMedPubMedCentral

Huizing BH, de Groot J (2012) Functional reconstructive nasal surgery. In: Kheirandish-Gozal L, Gozal D (eds) Sleep disordered breathing in children: a comprehensive clinical guide to evaluation and treatment. Humana, New York, pp 37–38

10.

Janovic N, Janovic A, Milicic B, Djuric M (2021) Is computed Tomography Imaging of deviated nasal septum justified for obstruction confirmation? Ear Nose Throat J 100:NP131–NP136. https://doi.org/10.1177/0145561319871533CrossRefPubMed

11.

Jones GN, Pringle DR, Yin Z, Carlton MM, Powell KA, Weinstein MB, Toribio RE, La Perle KMD, Kirschner LS (2010) Neural crest-specific loss of Prkar1a causes perinatal lethality resulting from defects in intramembranous ossification. Mol Endocrinol 24:6–11. https://doi.org/10.1210/me.2009-0439CrossRef

12.

Kim JH, Jung DJ, Kim HS, Kim CH, Kim TY (2014) Analysis of the development of the nasal septum and measurement of the harvestable septal cartilage in koreans using three-dimensional facial bone computed tomography scanning. Arch Plast Surg 41:163–170. https://doi.org/10.5999/aps.2014.41.2.163CrossRefPubMedPubMedCentral

13.

Lee JA, Wu V, Ozgen B, Joe SA, Lee VS (2022) Radiological Assessment of High Anterior Septal deviation and its impact on Sinus Access. Laryngoscope 132:1166–1171. https://doi.org/10.1002/lary.29806CrossRefPubMed

14.

Lindahl JW (1954) The deviated nasal septum. Practitioner 173:315–317PubMed

15.

Mays S (2012) Nasal septal deviation in a mediaeval population. Am J Phys Anthropol 148:319–326. https://doi.org/10.1002/ajpa.22046CrossRefPubMed

16.

Moreddu E, Puymerail L, Michel J, Achache M, Dessi P, Adalian P (2013) Morphometric measurements and sexual dimorphism of the piriform aperture in adults. Surg Radiol Anat 35:917–924. https://doi.org/10.1007/s00276-013-1116-2CrossRefPubMed

17.

Periyasamy V, Bhat S, Sree Ram MN (2019) Classification of Naso Septal Deviation Angle and its clinical implications: a CT scan imaging study of Palakkad Population, India. Indian J Otolaryngol Head Neck Surg 71:2004–2010. https://doi.org/10.1007/s12070-018-1425-1CrossRefPubMed

18.

Radulesco T, Hazbri D, Dessi P, Adalian P, Michel J (2019) Geometric morphometric contribution to septal deviation analysis. Surg Radiol Anat 41:823–831. https://doi.org/10.1007/s00276-019-02235-6CrossRefPubMed

19.

Ryu JY, Park KS, Kim MJ, Yun JS, Lee U, Lee SS, Roh BY, Seo JU, Choi CU, Lee WJ (2020) Craniofacial anthropometric investigation of relationships between the nose and nasal aperture using 3D computed tomography of Korean subjects. Sci Rep 30:1–9. https://doi.org/10.1038/s41598-020-73127-8CrossRef

20.

Saladin KS (2012) Anatomy and Physiology (6th ed.). New York, NY: McGraw Hill. ISBN 9780073378251

21.

Seltzer AP (1963) The problem of the nasal septum. J Albert Einstein Med Cent 11:283–299

22.

Siegel MI, Mooney MP, Eichberg JW, Gest T, Lee DR (1990) Septopremaxillary ligament resection and midfacial growth in a chimpanzee animal model. J Craniofac Surg 1:182–186. https://doi.org/10.1097/00001665-199001040-00006CrossRefPubMed

23.

Steiner A (1959) A certain aspect of nasal trauma in the prenatal period. Md State Med J 8:557PubMed

24.

Teul I, Slawinski G, Lewandowski J, Dzieciolowska-Baran E, Gawlikowska-Sroka A, Czerwinski F (2010) Nasal septum morphology in human fetuses in computed tomography images. Eur J Med Res 15:202–205. https://doi.org/10.1186/2047-783x-15-s2-202CrossRefPubMedPubMedCentral

25.

Van Loosen J, Van Zanten GA, Howard CV, Verwoerd-Verhoef HL, Van Velzen D, Verwoerd CD (1996) Growth characteristics of the human nasal septum. Rhinology 34:78–82PubMed

26.

Vetter U, Heit W, Helbing G, Heinze E, Pirsig W (1984) Growth of the human septal cartilage: cell density and colony formation of septal chondrocytes. Laryngoscope 94:1226–1229CrossRefPubMed

27.

Vetter U, Pirsig W, Heinze E Postnatal-growth of the human septal cartilage—preliminary report (1984). Acta Otolaryngol 97:13–16

Title: Correlation of maximal nasal septal deviation with deviation at the maxillary insertion
Authors: Keshav Kumar Gupta
Dean Davda
Zahir Mughal
Andrew Lotfallah
Shahram Anari
Publication date: 15-03-2024
Publisher: Springer Paris
Keywords: Computed Tomography
Computed Tomography
Published in: Surgical and Radiologic Anatomy / Issue 5/2024
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-024-03334-9

At a glance: The STEP trials

Springer Medicine

Correlation of maximal nasal septal deviation with deviation at the maxillary insertion

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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