Clinical Presentation, Diagnostic Evaluation, and Treatment Approaches for Deviated Nasal Septum (DNS)

Definition and Anatomical Considerations

The nasal septum is the structure that divides the nasal cavity into two halves. It consists of bone and cartilage and is covered by mucosa. A Deviated Nasal Septum (DNS) occurs when the septum is displaced from its midline position, leading to nasal obstruction and other associated symptoms.

Clinical Presentation

• Nasal Obstruction: One-sided or bilateral blockage of airflow.
• Breathing Difficulty: Increased resistance to nasal airflow.
• Frequent Sinus Infections: Due to disrupted mucus clearance.
• Headaches: Especially in cases of significant septal deviation.
• Nasal Congestion: Chronic stuffiness and difficulty breathing.

Diagnostic Evaluation

Diagnosis is primarily clinical, based on physical examination and patient history. Key diagnostic tools include:

• Anterior Rhinoscopy: A simple examination using a nasal speculum.
• Endoscopic Nasal Examination: Provides detailed visualization of nasal structures.
• CT Scan: Useful for assessing anatomical variations and ruling out sinus pathology.

Treatment Approaches

Treatment depends on the severity of symptoms and impact on quality of life.

• Medical Management: Includes nasal decongestants and corticosteroids to reduce inflammation.
• Surgical Intervention: Septoplasty is the definitive treatment for significant DNS, aiming to correct the septal deviation and improve airflow.
• Adjunctive Procedures: Turbinate reduction may be performed alongside septoplasty for better outcomes.

Conclusion

DNS is a common condition that can significantly affect nasal breathing and overall quality of life. Early diagnosis and appropriate management, including surgery if necessary, can lead to effective symptom relief.