Criteria for Defining Severe Septal Deviation

Objective: Criteria for defi ning ‘severe septal deviation’ and to describe the clinical profi le of the same. Study: Retrospective study. Materials and methods: Hundred patients who were diagnosed with severe DNS and treated with extracorporeal septoplasty (ECSP) from September 2010 to December 2012, were retrospectively evaluated for this study. A review of their clinical charts formed the basis of this study. Results • In this study, majority of patients (96%) had nasal obstruction as their prime symptom followed by postnasal discharge in 60% cases, headache in 40% cases and anterior nasal discharge in 30% cases. External nasal deformity was reported by 22 patients. Snoring was seen in 24% of patients with same percentage complaining of altered sense of smell and throat discomfort. Epistaxis, sneezing and facial pain were seen in 14% patients. Epiphora was complained by only 8% of patients. • In this study, nasal endoscopy/anterior rhinoscopy was used to type the septal deformity. The commonest septal deviation was C-shaped cephalocaudal (48%), followed by S-shaped cephalocaudal (18%), C-shaped AP (16%), S-shaped AP (12%) and sharp septal deviation/angulation in 6% cases. • All but three patients (6%) had deviated nasal septum involving multiple Cottle’s areas. These three patients had sharp septal angulation involving Cottle’s area 2 only. • In this study, most common region involving DNS was area 1 + 2 + 3 (48%) followed by area 2 + 4 + 5 (28%) and 1 + 2 + 3 + 4 (18%). • Area 2 was invariably involved in 100% of cases. • NOSE (nasal obstruction symptom evaluation) scores. • Preoperatively, mean NOSE score was 67.60 ± 5.26 (65.34