Role of CT Nose Paranasal Sinuses and Nasal Endoscopy for Decision Making in a Case of Deviated Nasal Septum
Main Article Content
Abstract
Introduction
Deviated nasal septum (DNS) can be asymptomatic in an individual or may cause nasal obstruction. The condition is generally diagnosed clinically and based on clinical diagnosis it is managed Surgically by large without much heed to diagnostic procedure. Thus, often underlying other causes of Obstruction is missed. Thus, it becomes essential to evaluate every patient presenting with history of Nasal obstruction and clinically Deviated septum, with aid of Nasal Endoscopy and CT scan Nose Paranasal Sinuses (PNS) to rule out/diagnose other coexisting conditions.
Methods and Methodology
100 patients who presented with nasal obstruction and clinically diagnosed to have Deviated Nasal Septum were then subjected to Nasal Endoscopy and CT scan Nose and PNS and findings were noted for analysis.
Results and Analysis
Of these 100 patients, 48 patients were found to have coexisting pathological conditions/anatomical variants. Various anatomical and pathological Conditions were found to coexist together. Inferior turbinate hypertrophy in 34% is the most common pathological condition found to be associated with DNS followed by of sinusitis in 25% patients apart from polyp, concha bullosa and paradoxical middle turbinate.
Discussion
Studies done so far shows there is a definite link of deviated nasal septum to various anatomical and pathological conditions of the nose. CT Scan Nose PNS and Nasal Endoscopy plays a vital role in diagnosing such anomalies.
Conclusion
Most of the patients, presenting with nasal obstruction and having Deviated Nasal Septum, undergo management without proper analysis and returns with recurrence of symptoms which could be analyzed properly if Nasal endoscopy and CT scan is employed during diagnosis of the condition, reducing risk of treatment failure.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
M. M. Elahi MM, Frenkiel S. Septal Deviation and Chronic Sinus Disease. Am J Rhinol. 2000; 14(3):175-9. doi:10.2500/105065800782102735
Smith KD, Edwards PC, Saini TS. The prevalence of concha bullosa and nasal septal deviation and their relationship to maxillary sinusitis by volumetric tomography. Int J Dent. 2010. pii: 404982. Epub 2010 Aug 24
C. S. Cotter, S. Stringer, K. R. Rust and A. Mancuso. The Role of Computed Tomography Scans in Evaluating Sinus Disease in Pediatric Patients. Int J Pediatric Otorhinolaryngol. 1999; 50(1):63-8. doi:10.1016/S0165-5876(99)00204-9
Matschke R, Fliebach A. Septum Deviation and Concomitant Sinusitis. HNO 1985; 33(12):541-4
Danese M, Duvoisin B, Agrifolio A, Cherpillod J, Krayenbulh M. Influence of naso-sinusal anatomic variants on recurrent, persistent or chronic sinusitis, X-ray computed tomographic evaluation in 112 patients. J Radiologie, 1997; 78(9):651-7
Rehman, A., Hamid, S., Ahmad, M. and Rashid, A. (2012) A Prospective Study of Nasal Septal Deformities in Kashmiri Population Attending a Tertiary Care Hospital. Int J Otolaryngol Head Neck Surg. 2012; 1:77-84. doi: 10.4236/ijohns.2012.13016
Orhan I, Aydın S, Ormeci T, Yılmaz FA. Radiological analysis of inferior turbinate in patients with deviated nasal septum by using computed tomography. Am J Rhinol Allergy 2014; 28(1):e68-72. doi: 10.2500/ajra.2014.28.4007
Aktas D, Kalcioglu MT, Kutlu R, Ozturan O, Oncel S. The relationship between the concha bullosa, nasal septal deviation and sinusitis. Rhinology 2003; 41(2):103-6
Moorthy PNS, Kolloju S, Madhira S, Jowkar AB. Clinical Study on Deviated Nasal Septum and its Associated Pathology. International Journal of Otolaryngology and Head & Neck Surgery 2014; 3:75-81. http://dx.doi.org/10.4236/ijohns.2014.32016
Calhoun KH, Waggenspack GA, Simpson CB, Hokanson JA, Bailey BJ. CT evaluation of the paranasal sinuses in symptomatic and asymptomatic populations. Otolaryngol Head Neck Surg. 1991;104(4):480-3.