gms | German Medical Science

Background: Septal deviation is a common finding on routine rhinologic examination in patients without complaints of nasal obstruction.

Following anatomic studies in 1882, Zuckerkandl was the first to describe what he called “physiological nasal septal deviation”. Objective of this analysis was to assess the frequencies of the nasal septum as a straight divider of the nasal cavity.

Methods: 60 computed tomographies (CT) were evaluated by measuring the following: deviation of the nasal septum from a constructed median line and distances between the inferior turbinate, the middle turbinate to the lateral nasal wall. CT scans were not performed for rhinological reasons.

Findings: 54 CT scans revealed nasal septal deviation. The range of distance between the extent of septal deviation and the median line was 2mm to 12mm (mean value 4.6mm). The distance from the nasal septum to the inferior turbinate, to the middle turbinate and to the nasal wall was found to be smaller on the side of the deviation than contralaterally. This was not significant.

Conclusions: In anatomically normal skulls, the nasal septum divides the nasal cavity into two separate cavities of approximately equal volumes. Rarely, the nasal septum is a straight divider and revealed “physiological deviation”. Equilibrium in volume of both nasal cavities is essential for a turbulence free nasal cycle. Therefore, aim of septal surgery shouldn’t be a straight septum but two nasal cavities of equal volumes.