CT Assessment of Nasal Septal Deviations

Background The nasal cavities are complex anatomical structures with high variability that relate to different functions. Different anatomic variants may manifest at this site, mainly involving the nasal septum and turbinate. Nasal septal deviation (NSD) is a common finding in both clinical and radiological examinations. It has variable shapes, directions, and significance, which made a difference either in the complaint of the patient or in his management planes in addition to other associated pathologies of the paranasal sinuses. ENT clinical examination is the first step of evaluation, but CT scan is considered the main diagnostic tool for assessment of NSD. Methods A retrospective study of 50 cases (33 males and 17 females) underwent a non-enhanced CT scan of PNS and was diagnosed as one of the variable types and degrees of NSD with no history of nasal trauma to be studied and evaluated as regarding type, direction, maximal distance of deviation from Medline and associated pathologies. Conclusion CT scan is the main tool as an imaging modality for the diagnosis of deviated nasal septum. Our study has concluded that NSD is more common in males than in females. Deviation is generally more to the left slightly than to the right. Our study considered 3 main types of NSD Curve, Spur, and Z shape. Spur type is the commonest, then curve types, and the least common type is the Z shape. Hypertrophied lower concha at the contralateral side of deviation was noticed but not confirmed as an etiology. The maximal distance of deviation is generally less than 1.5 cm. CT is the best was for detailed assessment of deviated nasal septum either for diagnosis or for good planning of treatment.