Nasal septal deviation

Deviated nasal septums are a common, usually incidental, finding seen on brain and paranasal sinus CT studies. They are commonly seen with external nose deformities.

Clinical presentation

Symptomatic patients can present with unilateral nasal obstruction or less commonly epistaxis, obstructive sinusitis, and/or pain/pressure symptoms .

Pathology

Etiology

Nasal septum deviation can be congenital or acquired. The most common acquired cause is trauma from motor vehicle collisions, sports-related injuries, and altercations.

Associations

Deviated nasal septa are commonly associated with concha bullosa or turbinate hypertrophy with septal deviation being towards the contralateral side.

Complications

Unrecognised nasal septal deviations can contribute to failed rhinoplasty .

Radiographic features

Nasal septal deviation can be C-shaped, reverse C-shaped, S-shaped or reverse S-shaped .

Treatment and prognosis

If medical management fails, the most common surgical procedure performed is septoplasty .

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