Evaluation of choroidal thickness measurements in patients with marked nasal septal deviation

Effect of Nasal Septum Deviation on the Choroidal Thickness

INTRODUCTION

Nasal cavity blood circulation and ocular blood circulation have common pathways for both arterial blood supply and venous drainage. Therefore, nasal pathologies can affect ocular blood circulation. This study aimed to evaluate the relationship between nasal obstruction and choroidal thickness.

METHODS

A prospective study was planned by forming a group of 144 patients diagnosed with nasal septum deviation at the otorhinolaryngology clinic and 100 healthy voluntary individuals. Of the total, 69 patients with nasal right septum deviation were evaluated as Group 1, 75 patients with nasal left septum deviation as Group 2, and 100 healthy volunteers as the control group. Detailed ophthalmological examinations of all the participants were performed, and choroidal thickness was measured using spectral domain optical coherence tomography. The relationship between choroidal thickness and ocular parameters was evaluated and compared between the patient groups with nasal septum deviation and the control group.

RESULTS

When the choroidal thickness measurements of the patients in Group 1 were examined, the choroidal thickness increased in all the regions in the eye contralateral to the deviation side (left), and intraocular pressure (IOP) was higher compared to the eye on the deviation side (right) and the control group at a statistically significant level. In Group 2, the choroidal thickness measurements increased in all the regions in the eye contralateral to the deviation side (right), and IOP was higher compared to the deviation side (left) and the control group.

CONCLUSIONS

We found that the patients with nasal septum deviation had higher choroidal thickness and IOP values in the eye contralateral to deviation.

Morphometric analysis of the nasal septum in normal Chinese individuals using a three-dimensional model of the nasal septum with facial CT scanning

OBJECTIVES

Three-dimensional (3D) models were reconstructed based on computed tomography (CT) scan data and to analyze the morphometric characteristics of the nasal septum in Chinese individuals.

METHODS

Ninety-six healthy adults aged 20-83 years old without confirmed nasal disorders were enrolled in this study from 2014 to 2015. 3D models of the nasal septum were reconstructed based on their CT scan data, and 7 indices were used for the evaluation of the spacial structure of the nasal septum.

RESULTS

Data of the nasal septum revealed larger nasal septum volumes in males than those in females (P<0.01). The ratio of the cartilage volume to the total septal volume significantly decreased with age (P=0.010), whereas the ratio of the vomer volume to the total volume significantly increased with age (P=0.018). There were no significant correlations of the nasal septum with age (P=0.666) and gender (P=0.55).

CONCLUSIONS

The reconstructed 3D model of the nasal septum demonstrates that the septal volume was larger in males than in females, and the ratio of vomer volume and cartilage volume to total septal volume changed with age, which may provide a reference for clinical treatment.

Is there a relationship between Eustachian tube dysfunction and nasal septal deviation in a sample of the Lebanese population?

Background

The Eustachian tube (ET) is considered an organ by itself due to its specific functions. An ET Dysfunction (ETD) is discussed when this tube is unable to ventilate the middle ear properly. Clinically, the patient reports usually some aural fullness, “popping”, “under water” sensation as if the ear is clogged. This condition is common affecting at least 5% of the adult population. It can impair quality of life and become disabling. On the other side, the prevalence of nasal septal deviation (NSD) is believed to be around 22.83% in the adult population. Nasal septal deviation is thought to cause a decline in the middle ear ventilation according to certain authors. The primary outcome is to define the predictive value of the side of Eustachian Tube Dysfunction (ETD) symptoms vis-à-vis the side of nasal septal deviation (NSD) in patients having the two conditions concomitantly.

Methods

A cross-sectional study was conducted between July 2018 and September 2019. Overall, 60 consecutive subjects (total of 120 ears), randomly seen at the Otorhinolaryngology Outpatient Clinics at the Eye and Ear International Hospital, Lebanon, all year-round were enrolled and tested without any geographic preferences. The Eustachian Tube Dysfunction Questionnaire (ETDQ) -7 questionnaire was used to evaluate ETD.

Results

A significantly higher ETD score was found in males compared to females, in those with left septal deviation compared to right and in those who have symptoms on the left compared to right side. Frequent exposure to higher changes in altitude (commute from home to workplace) was also significantly associated with higher ETD scores (r = 0.265), whereas higher Left Tympanometric peak pressure (TPP in daPa) on tympanometry was significantly associated with lower ETD score (r = − 0.467). Furthermore, 25 patients who had symptoms on the left side had also a septal deviation to the left side (86.2%), whereas 29 (93.5%) patients who had the symptoms on the right side had septal deviation to the right side (p < 0.001).

Conclusion

Our data highlighted the importance of altitude and geographic distribution of patients especially in a population exposed to barotrauma on a daily basis like the Lebanese population. Tympanometry, on the other hand, failed to correlate with patient reported symptoms and thus needs further evaluation. The reported ETD symptoms of the patient correlates to the side of NSD.