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<p>Septal deviations often do not correlate with the perception of nasal obstruction, reflecting a mismatch between subjective symptoms and objective findings. This study aimed to evaluate the site and degree of septal deviation associated with symptomatic nasal obstruction and to identify potential predictive factors influencing its severity.&#xa0;This prospective study over one year included patients with clinically evident deviated nasal septum. Subjective assessment of nasal obstruction was done with visual analogue scores (VAS) while objective assessment included nasal endoscopy, computerized tomography (CT) of the paranasal sinus and four phase rhinomanometry.&#xa0;Among the 71 patients with septal deviation, 36 exhibited symptoms. Mean VAS scores for the entire cohort and symptomatic subgroup were 3.72 and 7.2, respectively. Although segment 3 was most frequently deviated, symptomatic patients demonstrated significantly higher incidence of segment 5 deviation. Involvement of other segments, total number of segments affected, and CT parameters were comparable between symptomatic and asymptomatic patients. Rhinomanometry revealed a significantly greater difference in nasal resistance between the deviated and non-deviated sides among symptomatic patients compared to their asymptomatic counterparts.&#xa0;Perception of nasal obstruction may not solely result from structural narrowing in the nasal valve region. Posterior septal deviations and asymmetry in nasal resistance appear to contribute significantly. This study highlights the importance of a significant difference in resistance between sides for symptoms to become pronounced, rather than a mere structural change due to a deviated nasal septum.</p>

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Septal Deviation and Nasal Obstruction: A Clinico-Radiological Study with Rhinomanometric Analysis

  • 期刊论文

  • 发表日期：

    2026年3月3日

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  • Kiran Babu,
  • Lalee Varghese,
  • Bijesh Kumar Yadav,
  • Regi Kurien

摘要

Septal deviations often do not correlate with the perception of nasal obstruction, reflecting a mismatch between subjective symptoms and objective findings. This study aimed to evaluate the site and degree of septal deviation associated with symptomatic nasal obstruction and to identify potential predictive factors influencing its severity. This prospective study over one year included patients with clinically evident deviated nasal septum. Subjective assessment of nasal obstruction was done with visual analogue scores (VAS) while objective assessment included nasal endoscopy, computerized tomography (CT) of the paranasal sinus and four phase rhinomanometry. Among the 71 patients with septal deviation, 36 exhibited symptoms. Mean VAS scores for the entire cohort and symptomatic subgroup were 3.72 and 7.2, respectively. Although segment 3 was most frequently deviated, symptomatic patients demonstrated significantly higher incidence of segment 5 deviation. Involvement of other segments, total number of segments affected, and CT parameters were comparable between symptomatic and asymptomatic patients. Rhinomanometry revealed a significantly greater difference in nasal resistance between the deviated and non-deviated sides among symptomatic patients compared to their asymptomatic counterparts. Perception of nasal obstruction may not solely result from structural narrowing in the nasal valve region. Posterior septal deviations and asymmetry in nasal resistance appear to contribute significantly. This study highlights the importance of a significant difference in resistance between sides for symptoms to become pronounced, rather than a mere structural change due to a deviated nasal septum.