Nasal Septum Deviation Characteristics in an Orthodontic Population

Objectives: The objective of this study was to evaluate nasal septum deviation (NSD) in an orthodontic population utilizing both linear deviation and tortuosity measurements.
Methods: Pre-treatment cone beam computed tomography (CBCT) scans of 200 orthodontic patients (n=125 female) were included in this study. Subject’s nasal septums (0.4mm thick clice each) were measured for deviation via a linear deviation and tortuosity measurement every 10mm in an anterior/ posterior direction from the most posterior aspect of the piriform aperture to the most anterior aspect of the choanae. Depending on the length of the nasal septum, 4-6 coronal slices were cut for measurements. The primary analysis compared age, gender, and nasal septum deviation via tortuosity, linear deviation measurement, and linear deviation value using chi-square, fisher exact tests and linear regression analysis.
Results: The mean age of the sample was 18.4 yr with a range of 7.3 yr - 62.0 yr. NSD was prevalent in 93% of the subjects. NSD, both linear and tortuosity, was greatest at the most anterior data collection point and least at the most posterior data collection point. Older subjects (>50yrs) had a higher percentage of deviated nasal septums than did younger subjects. Interestingly, only 10% of the subjects (mean age 27.5 yr) had septums long enough (>60mm) to allow for the 6th coronal section. No significant correlation was found between gender and degree of deviation.
Conclusions: The prevalence of NSD in the current orthodontic sample population was much higher than reported in the dental literature, and is similar to the NSD prevalence levels found in the otolaryngology literature. The method of deviation measurement appears to impact the impression of NSD severity. Further studies are needed to investigate the relationship between malocclusion and the degree and type of NSD as well as explore novel approaches of NSD measurement.