Tuesday, April 25, 2017

The Basics : Deviated Nasal Septum

Hello

Deviated Nasal Septum - "Abnormal and asymmetrical alignment of the nasal septum that results in acute nasal obstruction and other symptoms of upper respiratory tract."

AETIOLOGY -

1. Trauma : Abnormal pressure ( lateral or frontal ) applied to nasal septum results in its deviation to one side or another.
- The lateral blow may cause displacement of septal cartilage from the vomerine groove and maxillary crest.

Groove on which septal cartilage sits ( encircled ) - lateral view
Diagram by IkaN.

- Frontal blow causes crushing injuries to the nose, usually occurs in sportspersons especially the boxers.

2. Developmental anomalies : Palate forms the base of nasal septum. Highly arched palate, cleft palate or lip, and dental abnormalities can all lead to deviation of the septum.

3. Racial factors : Caucasians have more incidence of DNS.

4. Hereditary : Familial predisposition.


TYPES of DNS -

1. Anterior dislocation : dislocation of nasal septum into one of the chambers. ( unilateral nasal obstruction )
2. C - shaped dislocation : simple curve to one side with compensatory hypertrophy of turbinates in other side. It causes unilateral nasal obstruction.
3. S - shaped deformity : causes bilateral nasal obstruction
4. Spurs : shelf - like projections may lead to headache and epistaxis. ( unilateral obstruction )
5. Thickening : due to septal hematoma

CLINICAL FEATURES of DNS mnemonic

TREATMENT - Only required if the symptoms are severe. The procedures are to be done once the patient is more than 17 years old.

- Septoplasty : The most deviated parts of nasal septum are removed and rest of the parts are surgically corrected and repositioned.

- Submucous resection ( SMR ) : Mucoperiosteal and mucoperichondral flaps that overlie one side of the septum are lifted. Most of the septum is removed and flaps repositioned.


Thats all
Hope this helped :)

- Jaskunwar Singh

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