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Journals / Turkish Journal of Clinics and Laboratory / 2025 / Cilt: 16 Sayı: 4

Frequency and Classification of Septal Deviation Types in Patients Undergoing Septorhinoplasty

Septorinoplasti Uygulanan Hastalarda Septal Deviasyon Tiplerinin Sıklığı ve Sınıflandırılması

Yakup Avsar(Avşar Kliniği)0000-0002-1005-2870
Ali Yılmaz(TRAKYA ÜNİVERSİTESİ)0000-0003-2277-8772
Pages
654–661
Publication Date
2026-01-01
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Type IIIC was the most frequent pattern in the overall cohort, followed by Type IVD.

📌 3 Key Takeaways

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Objective & Hypothesis:Aims: Nasal septal deviation (NSD) patterns are typically described by shape, but the anatomical distribution in septorhinoplasty patients—and its relation to symptoms—is not well established.
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Key Findings & Data:This study aimed to (i) determine the frequency and anatomical levels (high, central, base, caudal) of SD and its morphological subtypes, and (ii) compare findings between symptomatic and asymptomatic patients Methods: We retrospectively analyzed 378 consecutive septorhinoplasty cases using standardized rhinoscopic/endoscopic data.
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Conclusion & Impact:Type IIIC was the most frequent pattern in the overall cohort, followed by Type IVD.
🔬Design:Araştırma Makalesi
📍Scope:Comprehensive Sample
⚙️Variables:septal deviasyon · kaudal septum · septorinoplasti

Abstract

Aims: Nasal septal deviation (NSD) patterns are typically described by shape, but the anatomical distribution in septorhinoplasty patients—and its relation to symptoms—is not well established. This study aimed to (i) determine the frequency and anatomical levels (high, central, base, caudal) of SD and its morphological subtypes, and (ii) compare findings between symptomatic and asymptomatic patients Methods: We retrospectively analyzed 378 consecutive septorhinoplasty cases using standardized rhinoscopic/endoscopic data. NSD was classified by localization (high, central, base, caudal), presence of crest/spur, and new hierarchical morphology: Type I (localized), Type II (septal tilt), Type III [C-shape; Anteroposterior (AP) / Cephalocaudal (CC); ±crest/spur], Type IV (S-shape; AP/CC; ±crest/spur). Result: Central SD was most common (81.2%), followed by caudal (61.1%), high (48.9%), and base (40.7%). Caudal deviation (74.3% vs 53.0%, P<0.001), external nasal deformity (64.2% vs 50.4%, P=0.009), and septal crest (77.7% vs 62.6%, P=0.002) were more frequent in symptomatic patients. AP C-shape (38.4%) was the most prevalent morphology; CC S-shape (26.2%) exceeded CC C-shape (8.7%). Type IIIC was the most frequent pattern in the overall cohort, followed by Type IVD. In the subgroup comparison, Type IIIA was significantly more common in asymptomatic than in symptomatic patients (8.3% vs. 1.4%, p=0.019). Conclusion: NSD in septorhinoplasty patients shows a central-dominant pattern, with caudal deviations and crests linked to symptoms. Our novel classification system—integrating location, shape, and lesions—may enhance clinical evaluation and surgical planning.

Özet

Amaç: Nazal septal deviasyon (NSD) paternleri genellikle şekle göre tanımlanır; ancak septorinoplasti hastalarında anatomik dağılımı ve semptomlarla ilişkisi yeterince ortaya konmamıştır. Bu çalışma (i) septal deviasyonun (SD) sıklığını, anatomik düzeylerini (yüksek, santral, taban, kaudal) ve morfolojik alt tiplerini belirlemeyi; (ii) semptomatik ve asemptomatik hastalar arasında bulguları karşılaştırmayı amaçladı. Yöntemler: Standartlaştırılmış rinoskopi/endoskopi verileri kullanılarak ardışık 378 septorinoplasti olgusu retrospektif olarak analiz edildi. NSD; lokalizasyona (yüksek, santral, taban, kaudal), kret/spur varlığına ve yeni hiyerarşik morfoloji sınıflamasına göre sınıflandırıldı: Tip I (lokalize; izole kret/spur veya kaudal dislokasyon), Tip II (septal tilt), Tip III [C-şekilli: IIIA izole anteroposterior (AP) -C, IIIB izole sefalokaudal (CC)-C, IIIC AP-C + kret/spur, IIID CC-C + kret/spur], Tip IV (S-şekilli: IVA izole AP-S, IVB izole CC-S, IVC AP-S + kret/spur, IVD CC-S + kret/spur). Bulgular: En sık santral SD görüldü (%81,2); bunu kaudal (%61,1), yüksek (%48,9) ve taban (%40,7) deviasyon izledi. Kaudal deviasyon (%74,3’e karşı %53,0; P<0,001), dış burun deformitesi (%64,2’ye karşı %50,4; P=0,009) ve septal kret (%77,7’ye karşı %62,6; P=0,002) semptomatik hastalarda daha sıktı. AP C-şekli (%38,4) en yaygın morfolojiydi; CC S-şekli (%26,2), CC C-şeklinden (%8,7) daha fazlaydı. Tüm hastalarda Tip IIIC daha sıktı ve bunu Tip IVD izledi. Asemptomatik hastalarda semptomatik hastalara kıyasla Tip IIIA anlamlı olarak daha yüksekti (%8,3 karşı %1,4; P=0,019). Sonuç: Septorinoplasti hastalarında NSD santral-dominant bir patern göstermekte olup kaudal deviasyonlar ve kretler semptomlarla ilişkilidir. Lokalizasyonu, şekli ve lezyonları entegre eden yeni sınıflama sistemimiz klinik değerlendirmeyi ve cerrahi planlamayı geliştirebilir.

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Cite This Article

Avsar, Y., Yılmaz, A. (2026). Frequency and Classification of Septal Deviation Types in Patients Undergoing Septorhinoplasty. Turkish Journal of Clinics and Laboratory, Cilt: 16 Sayı: 4, 654–661. https://doi.org/10.18663/tjcl.1844214

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References (23)

  1. Alghamdi FS, Albogami D, Alsurayhi AS, Almoallem S, Alghamdi A, Al-Sultan AS et al. Nasal Septal Deviation: A Comprehensive Narrative Review. Cureus 2022; 14: e31317.
  2. Teixeira J, Certal V, Chang ET, Camacho M. Nasal Septal Deviations: A Systematic Review of Classification Systems. Plast Surg Int 2016; 2016: 7089123.
  3. Mladina R, Cujic E, Subaric M, Vukovic K. Nasal septal deformities in ear, nose, and throat patients: an international study. Am J Otolaryngol 2008; 29: 75-82.
  4. Mladina R. The role of maxillar morphology in the development of pathological septal deformities. Rhinology 1987; 25: 199-205.
  5. Baumann I, Baumann H. A new classification of septal deviations. Rhinology 2007; 45: 220-3.
  6. Jin HR, Lee JY, Jung WJ. New description method and classification system for septal deviation. J Rhinol 2007; 14: 27-31.
  7. Guyuron B, Uzzo CD, Scull H. A practical classification of septonasal deviation and an effective guide to septal surgery. Plast Reconstr Surg 1999; 104: 2202-29.
  8. Lee JW, Baker SR. Correction of caudal septal deviation and deformity using nasal septal bone grafts. JAMA Facial Plast Surg 2013; 15: 96-100.
  9. Rohrich RJ, Gunter JP, Deuber MA, Adams WP Jr. The deviated nose: optimizing results using a simplified classification and algorithmic approach. Plast Reconstr Surg 2002; 110: 1509-23.
  10. Nikkerdar N, Karimi A, Bazmayoon F, Golshah A. Comparison of the Type and Severity of Nasal Septal Deviation between Chronic Rhinosinusitis Patients Undergoing Functional Endoscopic Sinus Surgery and Controls. Int J Dent 2022; 2022: 2925279.
  11. Cerkes N. The crooked nose: principles of treatment. Aesthet Surg J 2011; 31: 241-57.
  12. Gurung U, Bathwal R, Dongol K. Nasal Mucociliary Clearance Time in Symptomatic versus Asymptomatic Deviated Nasal Septum: A Comparative Analysis. Turk Arch Otorhinolaryngol 2025; 63: 121-226.
  13. Ashwinirani S, Suragimath G, Telrandhe S, Suragimath DG. Deviated Nasal Septum: A Comprehensive Review. J Datta Meghe Inst Med Sci Univ 2024; 19: 406-11.
  14. Kim J, Han SH, Kim SW, Cho JH, Park YJ, Kim SW. Clinical significance of the sphenoidal process of the cartilaginous nasal septum: A preliminary morphological evaluation. Clin Anat 2010; 23: 265-9.
  15. Buyukertan M, Keklikoglu N, Kokten G. A morphometric consideration of nasal septal deviations by people with paranasal complaints; a computed tomography study. Rhinology 2003; 41: 21-4.
  16. Lee DJ, Jo H, Kwon HN, Park JH, Kim SD, Cho KS. Causes and management of persistent septal deviation after septoplasty. Sci Rep 2022; 12: 19574.
  17. Javed A, Alburaiki A, Kamber Zaidi A, Farooq MU, Limbrick J, Anari S. Caudal septoplasty, a literature review. Rhinology 2025; 63: 306-15.
  18. Subbiah NK, Bakshi SS, Arumugam S, Ghoshal JA. Clinical and Radiological Significance of Anatomical Variations in Paranasal Sinuses: A Retrospective CT-Based Study. Cureus 2025; 17: e82506.
  19. Janovic N, Janovic A, Milicic B, Djuric M. Relationship between nasal septum morphology and nasal obstruction symptom severity: computed tomography study. Braz J Otorhinolaryngol 2022; 88: 663-8.
  20. Malpani SN, Deshmukh P. Deviated Nasal Septum a Risk Factor for the Occurrence of Chronic Rhinosinusitis. Cureus 2022; 14: e30261.
  21. Salihoglu M, Cekin E, Altundag A, Cesmeci E. Examination versus subjective nasal obstruction in the evaluation of the nasal septal deviation. Rhinology 2014; 52: 122-6.
  22. Kim TK, Jeong JY. Deviated nose: Physiological and pathological changes of the nasal cavity. Arch Plast Surg 2020; 47: 505-15.
  23. Garaycochea O, Alobid I. On the Cottle areas and the proposal for a new classification of septal areas. Rhinology 2023; 61: 190-2.