Artikel
Rhinometric examination on physiological nasal septal deviation
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Veröffentlicht: | 22. September 2005 |
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Gliederung
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Background: As in literature described, there is a high incidence of up to 75% of septal deviation suggesting that not every deviation is pathological. In 1882, Zuckerkandl termed this finding “physiological nasal septal deviation”.
Objective of this analysis was to assess as well as the frequency of nasal septal deviation without any subjective or objective nasal obstruction and if rhinofunctional analysis can help differentiating between “physiological” and “pathological” septal deviation.
Methods: 83 asymptomatic patients without any trauma or nasal surgery in their past medical history were examined with acoustic rhinometry and rhinoresistometry. 78 Patients had septal deviation. This group was compared to a group of 106 healthy persons with a straight nasal septum (control) and to a group of 106 persons with septal deviation undergoing septo-(rhino-)plasty.
Findings: Comparing hydraulic diameter, there was neither a significant difference between the side of the deviation and the contralateral side in case of the physiological deviation nor a difference between the control- and the physiological-deviation-group. Compared to the control group and the physiological group, the hydraulic diameter of the deviation side in the pathological deviation group was found to be significantly smaller.
These findings could be confirmed by comparing the resistance during inspiration: There was no significant difference between the ipsi- and contralateral side in the physiological deviation group and none comparing with the control group. In the pathological group instead, the resistance was significantly higher on the side of deviation compared to the contralateral side and to the control group.
Conclusions: Septal deviation is a very common phenomenon. Therefore, it is important to make the difference between pathological deviation that has to be treated and deviation without nasal obstruction. Our data shows, that the results of functional rhinometry in patients with physiological deviation i.e. without subjective obstruction is comparable to persons with straight nasal septum. In contrast, it is significantly altered in patients with pathological deviation. Therefore, functional rhinometry is evident to discriminate physiological from pathological septal deviation and for the indication of septal surgery.