Clinical Implications of Nasal Septal Deformities
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.
___
- 1. Cottle MH, Loring RM, Fischer GG, Gaynon IE. The maxillapremaxilla
approach to extensive nasal septum surgery. AMA
Arch Otolaryngol 1958;68:301-13. [CrossRef]
- 2. Mladina R. The role of maxillar morphology in the development
of pathological septal deformities. Rhinology
1987;25:199-205.
- 3. Song SY, Kim IT, Chang KH, Lee KS, Kim HJ, Lim HJ. The
Prevalence of Nasal Septal Deformities among Children in Kindergarten
and First Grade in Anyang and Kunpo Cities. J Rhinol
1999;6:58-60.
- 4. Van Loosen J. Post natal development of the human nasal septum
and its related structures. Thesis. Erasmus Univeristy Rotterdam.
The Netherlands, 2000.
- 5. Yildirim I, Okur E. The prevalence of nasal septal deviation in
children from Kahramanmaras, Turkey. Int J Pediatr Otorhinolaryngol
2003;67:1203-6. [CrossRef]
- 6. Rao JJ, Vinay Kumar EC, Ram Babu K, Sathavahana Chowdary
V, Singh J, Rangamani SV. Classification of nasal septal deviations
- Relation to sinonasal pathology. Indian J Otolaryngol
Head Neck Surg 2005;57:199-201.
- 7. Min YG, Jung HW, Kim CS. Prevalence study of nasal septal
deformities in Korea: results of a nation-wide survey. Rhinology
2005;33:61-5.
- 8. Carinci F, Rullo R, Farina A, Morano D, Festa VM, Mazzarella
N, et al. Non-syndromic orofacial clefts in Southern Italy: pattern
analysis according to gender, history of maternal smoking,
folic acid intake and familial diabetes. J Craniomaxillofac Surg
2005;33:91-4. [CrossRef]
- 9. Oliveira AKP, Júnior EE, Santos LV, Bettega G, Mocellin M.
Prevalence of Deviated Nasal Septum in Curitiba, Brazil. Int
Arch Otorhinolaryngol 2005;9:288-92.
- 10. Skitarelic NB, Vukovic K, Skitarelic NP. Comparative evaluation
of conventional versus endoscopic septoplasty for limited septal deviation and spur. J Laryngol Otol 2009;123:939-
40. [CrossRef]
- 11. Zielnik-Jurkiewicz B, Olszewska-Sosińska O.The nasal septum
deformities in children and adolescents from Warsaw, Poland.
Int J Pediatr Otorhinolaryngol 2006;4:731-6. [CrossRef]
- 12. Chmielik M, Brożek-Mądry E, Chmielik LP. Influence of the
type of septum deviation on some parameters in the upper airways.
New Medicine 2006;3:71-3.
- 13. Neskey D, Eloy JA, Casiano R. Nasal, Septal, and Turbinate Anatomy
and Embryology. Otolaryngol Clin N Am 2009:42;193-205. [CrossRef]
- 14. Teul I, W Zbislawski W, S Baran S, Czerwinski F. Deformation
of the nasal septum in children, adolescents, and adults in Western
Pomerania Province of Poland. Eur J Med Res 2009;14(Suppl
4):244-7. [CrossRef]
- 15. Aljibori AS, Hassan AD, Alwan AM. Assessment of nasal septal
deformities by anterior rhinoscopy and nasal endoscopy. Tikrit
Med J 2010;16:14-20.
- 16. Huizing EH, de Groot JAM, editors. Functional reconstructive
nasal surgery. Stuttgart-New York: Thieme; 2003. [CrossRef]
- 17. Bianco M, Sanna N, Bucari S, Carmela F, Palmieri V, Zepilli
P. Female boxing in Italy: 2002-2007 report. Br J Sports Med
2011;45:563-70. [CrossRef]
- 18. Sam A, Deshmukh Prsad T, Patil C, Shraddha J, Rashmi P. Nasal
Septal Deviation and External Nasal Deformity: A Correlative
Study of 100 Cases. Indian J Otolaryngol Head Neck Surg
2012;64:312-8. [CrossRef]
- 19. Wee JH, Kim DW, Lee JE, Rhee CS, LeeCH, Min YG et al.
Classification and prevalence of nasal septal deformity in Koreans
according to two classification systems. Acta Otolaryngol
2012;132(Suppl 1):952-7. [CrossRef]
- 20. Mladina R, Skitarelić NB, Skitarelić NP. The human external nose
and its evolutionary role in the prevention of obstructive sleep
apnea. Otolaryngol Head Neck Surg 2010;143:712. [CrossRef]
- 21. Rehman A, Sajad Hamid, Mushtaq Ahmad, Arsalan F. Rashidl.
A Prospective Study of Nasal Septal Deformities in Kashmiri
Population Attending a Tertiary Care Hospital. Inter J Otolaryngol
Head Neck Surgery 2012;1:77-84. [CrossRef]
- 22. Swenson KE. Nasal septal deviation in a longitudinal growth
sample. Master of Science thesis, University of Iowa, Iowa,
2012.
- 23. Salaheldin AH. Effect of deviated nasal septum and hypertrophy
of inferior turbinate on middle ear pressure. Pan Arab J Rhinology
2012;2:59-65.
- 24. Kanu S, Baldev S, Sanjeev S, BS Verma. Endoscopic septoplasty:
prospective study in 50 cases of septal nasal deformity. Clin
Rhinol An Int J 2013;6:92-5. [CrossRef]
- 25. Moore MI. Objective evidence for the efficacy of surgical management
of the deviated nasal septum as a treatment for chronic
nasal obstruction. Doctoral Thesis. Cardiff School of Biosciences,
University of Wales, Cardiff University, Cardiff, 2013.
- 26. Oswal V, Remacle M, Jovanovic S, Zeitels SM, Krespi JP, Hopper
C. Principles and Practice of Lasers in Otorhinolaryngology
and Head and Neck. Suregrey. 2nd ed. Amsterdam: Kugler Publication,
2014.
- 27. Lin JK, Wheatley FC, Handwerker J, Harris NJ, Wong BJF. Analyzing
Nasal Septal Deviations to Develop a New Classification
System: A Computed Tomography Study Using MATLAB and
OsiriX. JAMA Facial Plast Surg 2014;16:183-7. [CrossRef]
- 28. Zhang Z, Fang S, Zhang Q, Chen L, Liu Y, Li K, et al. Analysis
of Complications in Primary Cleft Lips and Palates Surgery. J
Craniofac Surg 2014;25:968-71. [CrossRef]
- 29. Šubarić M, Mladina R. Nasal septum deformities in children and
adolescents: A cross sectional study of children from Zagreb,
Croatia. Int J Ped Otorhinolaryngol 2002;63:41-8. [CrossRef]
- 30. Mladina R, Čujić E, Šubarić M, Vuković K. Nasal septal deformities
in ear, nose and throat patients: An International Study.
Am J Otolaryngol 2008;29:75-82. [CrossRef]
- 31. Mladina R, Krajina Z. The influence of the caudal process on the
formation of septal deformities. Rhinology 1989;27:113-9.
- 32. Mladina R. The influence of palato-cranial base (basomaxillary)
angle on the length of the caudal process of the nasal septum in
man. Rhinology 1990;28:185-9.
- 33. Verwoerd CD, Mladina R, Nolst Trenite GJ, Pigott RW. The
nose in children with unilateral cleft lip and palate. Int J Ped
Otorhinolaryngol 1995;32:45-52. [CrossRef]
- 34. Mladina R, Đanić D, Miličić D. Histological changes of the
middle turbinate mucosa in various septal deformities. Riv Otolaryngol
Aud Fon 1996;3:151-5.
- 35. Mladina R, Ostojić D, Koželj V, Heinzel B, Bastaić Lj.
Pathological septal deformities in cleft palate children.
L’Otorinolaryngologia Pediatrica 1997;2-3:75-80.
- 36. Mladina R, Miličić D, Đanić D. Septal deformities can influence
the mucociliary transport impairment of the middle turbinate
mucosa. In: Baum G, Priel Z, Roth Y, Liron N, Ostfeld EJ, eds.
Cilia, Mucus and Mucociliary Interactions. Marcel Dekker, Inc.,
New York, 1998:219-28.
- 37. Jurlina M, Mladina R, Dawidowsky K, Ivanković D, Bumber
Ž, Šubarić M. Correlation between the minimal cross-sectional
area of the nasal cavity and body surface area: preliminary results
in normal patients. Am J Rhinol 2002;16:209-21.
- 38. Mladina R, Šubarić M. Are some septal deformities inherited? Type 6
revisited. Int J Pediatr Otorhinolaryngol 2003;67:1291-4. [CrossRef]
- 39. Mladina R, Skitarelić N, Vuković K, Subarić M, Carić T, Orihovac
Z. Unilateral cleft lip/palate children: The incidence of type
6 septal deformities in their parents. J Craniomaxillofac Surg
2008;36:335-40. [CrossRef]
- 40. Mladina R, Skitarelić NB, Skitarelić NP. Could we prevent
unilateral cleft lip/palate in the future? Med Hypotheses
2009;73:601-3. [CrossRef]
- 41. Poje G, Zinreich JS, Skitarelíć N, Đuríc Vukovíć K, Passàli GC,
Passàli D, et al. Nasal septal deformities in chronic rhinosinusitis
patients: clinical and radiological aspects. Acta Otorhinolaryngol
Ital 2014;34:117-22.
- 42. Cingi C, Bayar Muluk N, Acar M, Skitarelić N, Markešić J,
Vugrinec O, et al. International study of the incidence of particular
types of septal deformities in chronic rhinosinusitis patients:
The outcomes from five countries. Am J Rhinol Allergy
2014;28:404-13. [CrossRef]