The prevalence of nasal septal deviation in children from Kahramanmaras, Turkey

Is there a relationship of nasal septum deviation with pharyngeal airway dimension and craniocervical posture?

OBJECTIVE

This study aimed to evaluate the effects of nasal septum deviation on the pharyngeal airway and craniocervical posture measurements using cone beam computed tomography (CBCT).

METHODS

This retrospective study analyzed the CBCTs of 25 patients with and without nasal septum deviation. Various parameters defining the pharyngeal airway and craniocervical and facial skeletal morphology were measured and compared between the groups after confirming intra-examiner reliability.

RESULTS

Compared to the control group, the group with nasal septum deviation had a statistically significantly shorter nasopharyngeal length (p < 0.001), longer vertical airway length (p < 0.002), and larger cervical column curvature angle (p < 0.006).

CONCLUSION

Children with a nasal septum deviation of 4 mm or more on their CBCT scan are susceptible to unfavorable pharyngeal airway and craniocervical postural changes.

"Should Pediatric Septal Surgery and Septorhinoplasty Be Performed for Nasal Obstruction?"-A Systematic Review of the Literature

Corrective septal surgery for children with nasal obstruction has historically been avoided due to concern about the impact on the growing nose, with disruption of midfacial growth. However, there is a paucity of data evaluating complication and revision rates post-nasal septal surgery in the pediatric population. In addition, there is evidence to suggest that failure to treat nasal obstruction in children may itself result in facial deformity and/or developmental delay. The aim of this systematic review is to evaluate the efficacy and safety of septal surgery in pediatric patients with nasal obstruction. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. MEDLINE, Embase, and the Cochrane Library were searched. Original studies in pediatric patients (<18 years of age) with nasal obstruction were eligible for inclusion. Patients with cleft lip or palate as their primary diagnosis were excluded. Our primary outcomes were patient-reported outcome measures (PROMs), postsurgical complications, and revision rates. Secondary outcomes included surgical technique, anatomical considerations, and anthropometric measurements. Eighteen studies were included (1,080 patients). Patients underwent septoplasty, septorhinoplasty, rhinoplasty, or a combination of procedures for nasal obstruction. Obstruction was commonly reported secondary to trauma, nasal septal deviation, or congenital deformity. The mean age of the patients was 13.04 years with an average follow-up of 41.8 months. In all, 5.6% patients required revision surgery and there was an overall complication rate of 7.8%. Septal surgery for nasal obstruction in children has low revision and complication rates. However, a pediatric-specific outcome measure is yet to be determined. Larger prospective studies with long-term follow-up periods are needed to determine the optimal timing of nasal surgery for nasal obstruction in the pediatric population.

Evaluation of Malocclusion Types in Adult Patients with Nasal Septal Defects - An Observational Cross-Sectional Analysis

Introduction

The nasal septum is crucial in the development of the craniofacial structures. Deviated nasal septum is one of the anatomical causes of mouth breathing which in turn lead to malocclusion.

Aims and Objectives

To evaluate the dentofacial and cephalometric characteristics in individuals with nasal breathing obstruction brought on by nasal septal deviation, as well as the relationship between these defects and various malocclusions and the degree of facial asymmetry.

Materials and Methods

A two-point evaluation was adopted for the selected patients, one at the ENT department using clinical examination and CT-PNS and the severity classified according to the Mladina classification and another at the dental department, using clinical examinations, PA cephalograms, lateral cephalograms, and facial photographs.

Results and Discussion

The association between malocclusion and various grades of septal deviation was statistically significant with a P value of 0.006. Results showed that 13 patients are with Class I skeletal pattern, 20 patients with Class II, and 7 patients with Class III skeletal pattern. None of the grade 7 nasal septal deviation patients had class I malocclusion and none of the grade 2 nasal septal deviation patients had class III malocclusion. Class II division I malocclusion was the most common type noted in patients with nasal septal deviation. Grade 7 nasal septal deviation was associated with the maximum amount of ANS and mentioned deviation indicating significant facial asymmetry.

Conclusion

Class-II Division-1 malocclusion was the most common type noted and Class III malocclusion was more common in higher grades of nasal septal deviation. Maxillary and mandibular asymmetry worsens significantly with an increase in the grade of nasal septal deviation and is one of the significant factors in causing facial asymmetry.

Nasal obstruction in adults: how it affects psychological status?

OBJECTIVE

This study investigated the psychological status of patients with unilateral or bilateral complete nasal obstruction.

METHOD

The study included 49 consecutive cases of unilateral or bilateral complete nasal obstruction. In order to assess participants' personality traits, both groups completed the Personality Belief Questionnaire, State-Trait Anxiety Inventory form, Beck Depression Inventory and Beck Anxiety Inventory.

RESULTS

The groups were similar in terms of demographic characteristics. Patients with unilateral or bilateral complete nasal obstruction had higher scores on all the psychological assessments compared with the healthy controls, except for the Beck Anxiety Inventory. Although all personality assessment scores were higher in patients, the only differences that were statistically significant were in the dependent, antisocial and avoidant personality trait scores.

CONCLUSION

The psychological conditions of patients with structural deformities that cause nasal obstruction may be affected, and appropriate treatment should be provided to improve their symptoms and quality of life.

Association between nasal septum deviation and transverse maxillary development: A retrospective cross-sectional study

INTRODUCTION

The few studies investigating the relationship between nasal septum deviation (NSD) and maxillary development, using different assessment methods and the age of subjects, reported contradicting results.

METHODS

The association between NSD and transverse maxillary parameters was analyzed using 141 preorthodontic full-skull cone-beam computed tomography scans (mean age, 27.4 ± 9.01 years). Six maxillary, 2 nasal, and 3 dentoalveolar landmarks were measured. The intraclass correlation coefficient was used to assess intrarater and interrater reliability. The correlation between NSD and transverse maxillary parameters was analyzed using the Pearson correlation coefficient. Each transverse maxillary parameter was compared among 3 groups of different degrees of severity using the analysis of variance test. Transverse maxillary parameters were also compared between the more and less deviated nasal septum sides using the independent t test.

RESULTS

A correlation between deviated septal width and palatal arch depth (r = 0.2, P <0.013) and significant differences in palatal arch depth (P <0.05) among 3 NSD severity groups classified with deviated septal width was noted. There was no correlation between septal deviated angle and transverse maxillary parameters and no significant difference for transverse maxillary parameters among the 3 groups of NSD severity classified by septal deviated angle. No significant difference in transverse maxillary parameters was found when comparing the more and the less deviated sides.

CONCLUSIONS

This study suggests that NSD can affect palatal vault morphology. The magnitude of NSD may be a factor associated with transverse maxillary growth disturbance.

The influence of nasal deviation on the perception of maxillary dental centreline and smile aesthetics

OBJECTIVE

To assess the impact of nasal deviation on the perception of the maxillary dental centreline position as judged by orthodontists, dentists and laypersons.

DESIGN

Cross-sectional study.

SETTING

Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK.

PARTICIPANTS

Three groups of raters comprising 30 orthodontists, 30 dentists and 30 laypersons.

METHODS

A frontal photograph of a smiling white woman was captured and digitally manipulated with varying degrees of nasal deviation and dental centreline (DC) position in increments of 1.5 mm and 3 mm to the right and left. Three rater groups assessed the attractiveness of images using a visual analogue scale (VAS). Multiple regression analysis was undertaken, and images were compared using the Tukey HSD method.

RESULTS

Using a mixed linear model, the intraclass correlation coefficient (ICC) was estimated in the range of 69%-86%, indicating good inter-rater reliability. The interaction between image rating and nasal position (P < 0.001), DC position (P < 0.001) and the relationship between nose and DC position (P < 0.001) were found to be statistically significant with symmetrical upper midline and nasal tip position, both considered to be most aesthetically pleasing. Image rating was not influenced by rater group type (P = 0.995), age (P = 0.983) or sex (P = 0.476).

CONCLUSION

There was a preference for a central and coincident nose and maxillary DC position uniformly across the rater groups. Deviations of the nose, DC and their interactions negatively impacted on perceived smile aesthetics with increasing extent and opposing direction of deviations rated progressively more unaesthetic. No differences were observed between orthodontists, general dental practitioners and lay people with respect to perceived impact on smile aesthetics.

The Relationship Between an Accessory Maxillary Ostium and Variations in Structures Adjacent to the Maxillary Sinus without Polyps

Introduction  The maxillary sinus and its variations are very important to dentistry and rhinology.

Objective  To investigate the effect of the accessory maxillary ostium (AMO) on the variations of adjacent structures of the maxillary sinus.

Methods  The computed tomography (CT) images of 400 patients were retrospectively evaluated. The prevalence of AMO was calculated. The relationship between morphological variations of adjacent structures of maxillary sinus such as agger nasi cell (ANC), Haller cell (HC), nasal septum deviation (NSD), hypertrophy of inferior concha (HIC), pneumatization of middle concha (PMC), mucus retention cyst (MRC), mucosal thickening (MT), and maxillary sinusitis (MS), as well as the presence of AMO, were investigated.

Results  Presence of AMO was diagnosed in 42 patients (10.5%), having been found in 4.5% of the patients only on the right side, in 1.25% of the patients only on the left side, and in 4.75% of the patients on both sides. There is an increasing incidence of ANC, HC, NSD, HIC, and PMC in the presence of AMO and MS. There is a decreasing incidence of MRC in the presence of AMO. Furthermore, AMO does not affect the incidence of MT.

Conclusion  This study showed that most parameters, except for MRC and MT, had increasing incidence in the presence of AMO. It is important for radiologists and rhinologists to have knowledge about the location of AMO and the presence of variations of MS adjacent structures to avoid surgical complications.

Rapid Maxillary Expansion Has a Beneficial Effect on the Ventilation in Children With Nasal Septal Deviation: A Computational Fluid Dynamics Study

Nasal septal deviation (NSD) is one of the most common nasal diseases. Different from common clinical examination methods, computational fluid dynamics (CFD) can provide visual flow information of the nasal cavity. The dimension and volume of the nasal cavity are easily affected by rapid maxillary expansion (RME). The purpose of this study was to use CFD to evaluate the effect of RME on the aerodynamics of the nasal cavity in children with maxillary transverse deficiency and NSD. Computational fluid dynamics was implemented after 3D reconstruction based on the CBCT of 15 children who have completed RME treatment. After treatment, the volume increases in the nasal cavity, nasopharynx, oropharynx, and pharynx were not statistically significant. The wall shear stress of the nasal cavity after RME, 1.749 ± 0.673 Pa, was significantly lower than that before RME, 2.684 ± 0.919 Pa. Meanwhile, the maximal negative pressure in the pharyngeal airway during inspiration was smaller after RME (-31.058 Pa) than before (-48.204 Pa). This study suggests that RME has a beneficial effect on nasal ventilation. The nasal airflow became more symmetrical in the bilateral nasal cavity after RME. Pharyngeal resistance decreased with the reduction in nasal resistance and the increase in the volume of oropharynx after RME.

Morphological, anatomical, radiological and clinical features of Mladina type 6 nasal septum deformations in humans

PURPOSE

The objective of this study was to prove the higher frequency of the type 6 deformations overall compared to the results obtained by conventional diagnostic methods, such as computed tomography images and clinical examination.

METHODS

The study was performed at the Institute of Anatomy, where a total of 114 randomly selected skulls were examined. The skulls were then scanned in a fixed position using the cone-beam technique (CBCT). The literature epidemiological data of the clinical incidence of type 6 in studies that also used Mladina classification were obtained.

RESULTS

There was a statistically significant difference (p < 0.0001) in the frequency of type 6 deformation as diagnosed by visual inspection (22.8%) and computed tomography (7.9%). The frequency obtained by CT imaging amounted 7.9% and was almost the same as the results obtained by a clinical examination which varied between 9 and 11%.

CONCLUSIONS

The frequency of type 6 nasal septal deformation is higher by visual inspection of the skulls than by computed tomography imaging at a level of significance of 0.05. The incidence of type 6 findings on coronal CT images of paranasal sinuses is approximately the same as that found with anterior rhinoscopy. Type 6, visible or concealed; probably have one-fourth to one-fifth people in population, so the number of clinically overlooked and/or unrecognized types 6 is much greater than we thought it to be.

Prevalence of nasal septum deviation using cone-beam computed tomography: A cross-sectional study

Background and Aim:

Nasal septum deviation (NSD) increases the chance of nasal obstruction, sinusitis, and upper airway and middle ear infections and can affect vocal cord activity, beauty, and breathing. The present study investigated the prevalence of NSD and its relation to gender, age, and history of trauma using cone-beam computed tomography (CBCT).

Subjects and Methods:

This cross-sectional study was performed on the data from CBCT examinations of 386 patients referred to two oral and maxillofacial radiology centers in Tehran, Iran, from January 2016 to January 2017. The presence of NSD and its type according to the Mladina's classification were evaluated. The effect of age, gender, and history of trauma on the prevalence of NSD was considered using a logistic regression.

Results:

86.6% (confidence interval = 0.81, 0.91) of the patients showed NSD. The prevalence was 19.4% type 1, 6.2% type 2, 20.7% type 3, 5.4% type 4, 4.4% type 5, 0.3% type 6, and 30.3% with type 7. The logistic regression indicated that the chance of deviation of nasal septum increased with age and every 10-year increase in age increased the odds of septal deviation by 0.32 (P < 0.001 and odds ratio = 1.032). Gender (P = 0.094) and history of trauma (P = 0.79) had no effects on the chance of deviation of nasal septum.

Conclusion:

This study showed that the frequency of NSD was 86.6%, with type 7 being the most common type, followed by type 3 and 1. NSD showed no association with trauma and gender, and the increase in age increases the chance of NSD.

Quality of life in children following nasal septal surgery: A review of its outcome

Nasal septal surgery among children remains controversial because of its adverse effect on craniofacial development. Recent studies, however, have demonstrated that early nasal septal correction prevents the midfacial and nasal growth deformity that is the inevitable consequence of nasal septal abnormality. Nasal septal surgery in children has been reported to lead to significant improvement in quality of life. We reviewed the existing literature to evaluate the outcomes of pediatric nasal septal surgery.

Morphological interaction between the nasal septum and nasofacial skeleton during human ontogeny

The nasal septal cartilage is thought to be a key growth center that contributes to nasofacial skeletal development. Despite the developmental influence of the nasal septum however, humans often exhibit a high frequency of septal deviation suggesting discordance in the growth between the septum and surrounding nasofacial skeleton. While there are numerous etiological factors that contribute to septal deviation, the surrounding nasofacial skeleton may also act to constrain the septum, resulting in altered patterns of growth. That is, while the nasal septum has a direct morphogenetic influence on aspects of the nasofacial skeleton, other nasofacial skeletal components may restrict septal growth resulting in deviation. Detailing the developmental relationship between these structures is important not only for understanding the causal determinants of nasal septal deviation, but also for developing a broader understanding of the complex interaction between the facial skeleton and chondrocranium. We selected 66 non-syndromic subjects from the University of Minnesota Orthodontic Clinic who ranged from 7 to 18 years in age and had an existing pretreatment cone-beam computed tomography (CBCT) scan. Using CBCT data, we examined the developmental relationship between nasal septal deviation and the surrounding nasofacial skeleton. We measured septal deviation as a percentage of septal volume relative to a modeled non-deviated septum. We then collected a series of coordinate landmark data in the region immediately surrounding the nasal septum in the midsagittal plane representing the nasofacial skeleton. First, we examined ontogenetic changes in the magnitude of nasal septal deviation relative to chronological age and nasofacial size. Next, using Procrustes-based geometric morphometric techniques, we assessed the morphological relationship between nasal septal deviation and nasofacial skeletal shape. Our results indicate that variation in the magnitude of nasal septal deviation was established in our earliest age group and maintained throughout ontogeny. Moreover, nasal septal deviation was correlated with non-allometric variation in nasofacial shape restricted to the region of the anterior sphenoid body. Ultimately, our results suggest that early developmental variation in midline basicranial components may act to alter or constrain patterns of nasal septal growth.

Nasal septal deviation with obstructive symptoms: Association found with asthma but not with other general health problems

BACKGROUND

Nasal septal deviation (NSD) is a very common deformity. Because it may induce chronic upper airway obstruction in the nose, clinicians encounter some patients who have concerns about whether this can be a risk factor for general health. However, the influence of NSD on general health has rarely been studied.

OBJECTIVE

To determine associations between NSD, especially NSD with nasal obstructive symptom, and general health problems in an adult Korean population.

METHODS

This nationwide study analyzed data from the Korea National Health and Nutritional Examination Survey, 2008-2009. NSD was evaluated by using a nasal endoscope, and a nasal obstructive symptom was assessed via individual interviews. The survey also investigated general health problems, such as medical comorbidity, mental health status, and quality of life. Medical conditions included neurocardiovascular, respiratory, metabolic, musculoskeletal, gastrointestinal, and malignant diseases. To eliminate the effect of combined nasal problems in otorhinolaryngology, subjects with rhinosinusitis and allergic rhinitis were excluded. This study focused on obstructive NSD, which is defined as an anatomic NSD with a chronic nasal obstructive symptom.

RESULTS

We enrolled 8865 participants, and the prevalence of NSD was 44.8%. No general health problems showed a significant association with NSD. However, the prevalence of NSD with an obstructive symptom was 2.1%. Obstructive NSD had no association with all the general health problems, except asthma. A significant association was found between obstructive NSD and asthma (odds ratio 2.648 [95% confidence interval, 1.211-5.791]).

CONCLUSION

Among various general health problems, our study found that NSD was associated with asthma only when NSD was accompanied by a chronic nasal obstructive symptom.

International study of the incidence of particular types of septal deformities in chronic rhinosinusitis patients: the outcomes from five countries

BACKGROUND

Chronic rhinosinusitis (CRS) may be more frequent in patients with particular types of septal deformities. The aim of this article was to investigate the incidence of particular types of septal deformities in adult CRS patients and healthy volunteers in various countries to determine whether some of them are more frequent in those groups.

METHODS

This international multicentric study involved 505 subjects from five countries: Croatia, Romania, Italy, Russia, and Turkey. The types of septal deformities were observed and grouped according to the Mladina classification. Subjects were examined by means of native anterior rhinoscopy, anterior rhinoscopy after decongestion, and fiber endoscopy with topical anesthesia. CRS patients have been diagnostically proved by computed tomography scanning of the paranasal sinuses.

RESULTS

Considering the CRS patients, the prevalence of so-called vertical deformities (types 2, 3, and 4) was seen. Among them, type 3 deformity was found most frequently in Turkey, Croatia, Italy, and Romania.

CONCLUSION

Type 3 deformity has been found frequently in CRS patients in all five of the countries. Russian subjects exhibited a high frequency of type 4 deformity. Because this type consists of types 2 and 3, the later, again, has been proven to be prevalent in CRS patients also in this group of patients.

Clinical Implications of Nasal Septal Deformities

The first attempts to systematize septal distortions have been given by Cottle who defined four groups of septal deformities: subluxation, large spurs, caudal deflection and tension septum. Fortunately, the variations of the septal deformities show a certain order, thus enabling more precise classification. Mladina was the first to make user-friendly classification of septal deformities in six basic types. He also described the seventh type, named "Passali deformity", which presents individually, but is always a well-defined combination between some of the previous six types. Mladina types of septal deformities (SD) are divided in two main groups: so called "vertical" deformities (types 1, 2, 3 and 4), and "horizontal" ones (types 5 and 6). This classification was immediately well accepted by rhinologists worldwide and started to be cited from the very beginning. Since then it has been continuously cited increasingly more often, thus making Mladina classification a gold standard whenever clinical researches on nasal septum are concerned. More than forty clinical studies based on this classification have been performed to date. It is extremely important to make a strict distinction between the types of SD since all of them play some specific role in the nasal and general physiology in man.

Nasal sequelae of Treacher Collins syndrome

OBJECTIVE

This study aimed to determine external and endonasal deformity, and satisfaction with nasal functioning and appearance, in Treacher Collins syndrome.

STUDY DESIGN

A cross-sectional cohort study was conducted.

METHODS

Eleven adult patients with Treacher Collins syndrome were compared with 151 controls in terms of satisfaction with nasal functioning and appearance by means of the Nasal Appearance and Function Evaluation Questionnaire. In all patients with Treacher Collins syndrome, external nasal deformities were scored on standardized digital photographs of the nose as rated independently by three experienced physicians. Endonasal deformity was determined by standardized nasal endoscopy.

RESULTS

The patients were relatively satisfied with the various esthetic nasal subunits. The most significant functional problems were snoring (P = 0.001) and quality of phonation (P = 0.003). The main external nasal deformities were the dorsal hump (73%), external deviation (≤55%), the bifid or bulbous nasal tip (55%), and columellar septal luxation (55%). In 82% of the patients, a septal deviation was found, often associated with spurs.

CONCLUSION

Satisfaction with esthetics of the nose was fair, but these patients suffer from the functional problems of snoring and impaired quality of phonation. A structured nasal ENT physical examination with nasal endoscopy might determine aspects requiring more attention during treatment. Septorhinoplasty can be performed at an adult age if there is a considerable esthetic wish of the patient and/or nasal obstruction combined with septal deviation. Attention should be paid to dorsal hump reduction, correction of the deviated external osseous framework, septoplasty, and correction of the nasal tip shape.

LEVEL OF EVIDENCE

2b.

Efficiency of external nasal dilators in pediatric nasal septal deviation

INRODUCTION

Nasal septal deviation results from irregular development of the nasomaxillary complex and trauma. Treatment of nasal septal deviation in pediatric patients is one of the biggest challenges in rhinology. Surgery may alter craniofacial growth patterns, and so it may be indicated only in the selected cases. The use of external nasal dilators is a relatively new treatment modality in nasal obstruction.

OBJECTIVE

This study was performed to assess the efficacy of external nasal dilator in pediatric nasal septal deviation patients.

METHODS

Seventy-six children who were diagnosed with nasal septal deviation at our outpatient clinic were included in the study. The patients were divided into 2 groups: the external nasal dilator group was composed of 48 children that had used an external nasal dilator for at least 1 month and still been using, while the control group was comprised of 28 children that had not received any treatment and had not used an external nasal dilator. The parents of the children were asked to complete the obstructive sleep apnea 18 questionnaire. In addition, the external nasal dilator group was asked to complete the questionnaire after stopping external nasal dilator use for 2 weeks and the control group also repeated the obstructive sleep apnea 18 questionnaire.

RESULTS

The obstructive sleep apnea 18 questionnaire results were significantly different between the external nasal dilator group and the control group at the beginning of the study (i.e., when patients in the external nasal dilator group were still using their dilators, P = 0.000). On the other hand, there was no difference between the 2 groups after the patients in the external nasal dilator group had stopped using their external nasal dilator (P = 0.670).

CONCLUSION

External nasal dilator use relieved nasal septal deviation, which narrows the nasal valve. The results of this study suggest that external nasal dilator could be used in patients that are not candidates for septoplasty.

Nasal septal deviation in a mediaeval population

In modern populations, there is evidence that nasal septal deviation (NSD) may be associated with maxillary sinusitis, and that those with NSD may differ in craniofacial morphology from those without or with less severe NSD. Whether these associations hold true for earlier populations has yet to be investigated. The current work is a step toward remedying this. The study group comes from a mediaeval English archaeological site. NSD was quantified using image analysis. Maxillary sinusitis was identified from new bone formation in the antrum. Cranial morphology was assessed using standard craniometric measurements. The results provided no evidence for a relationship between NSD and maxillary sinus disease. NSD was associated with reduced measures of upper facial height, suggesting decoupling of growth in vertical height of the nasal septum and the bony structures surrounding it.

Nasal growth after pediatric septoplasty at long-term follow-up

BACKGROUND

Septoplasty in children is still a matter of open discussion, because it is thought that a surgical procedure on a developing structure might produce some adverse effects on normal nasal growth. The goal of this retrospective study is to evaluate the effects of pediatric nasal septum surgery in a long-term follow-up by anthropometry.

METHODS

Forty-four Italian patients, 25 male patients and 19 female patients, who had undergone septoplasty during childhood using the endonasal approach, were reassessed after a mean follow-up of 12.2 years. Anthropometric recordings were used to identify any growth retardation due to the operation by a comparison with previously published age-specific normative data of North American white subjects. Nasal measurements consisted of five linear parameters, three angular parameters, and three proportional index.

RESULTS

There were no significant differences in any of the measures between the sample and controls (p > 0.1) with regard to gender, with the exception of the nasolabial angle measurement. Indeed, the nasolabial angle of the female patients was significantly reduced compared with controls (p = 0.04), whereas that of the male patients was reduced compared with controls (p = 0.08). This measurement seems to be influenced by the type of operation, because it has been noted that the nasolabial angle of patients treated surgically by extracorporeal septoplasty were significantly lower than those of patients treated surgically by conservative septoplasty.

CONCLUSION

Pediatric septoplasty may be indicated in selected cases of obstructing nasal septum deformities. The operation, performed via endonasal approach, does not interfere with the normal growing nasal process.