Significance of Nasal Septum Angulation and Its Association with Rhinosinusitis Symptom Scores

Introduction: Nasal septum deviations have been strongly associated with severity of the rhinosinusitis. However, majority of study cannot conclude the direct association between the severity of deviation and rhinosinusitis symptoms. The angulation of the deviated septum however may have a stronger association with the severity of the rhinosinusitis. This angulation is critical to be assessed during clinical examination and have important implications in the subsequent functional endoscopic sinus surgery.
Objectives: The aim of the study was to determine the association of angulation of nasal septum with the severity of rhinosinusitis as measured by symptoms score and Visual Analog Score (VAS).
Methodology: The study was a cross sectional study conducted at two different centres in Malaysia. The study protocol was approved by Ethics Committee (USM/JEPeM/140254). Ninety-eight patients who were diagnosed with rhinosinusitis and fulfilled the selection criteria were assessed for the symptoms score and VAS and the measurement of angulation of nasal septum was performed thru a coronal view of CT paranasal sinuses in bone window setting at osteomeatal complex level.
Results: The result from one-way ANOVA test revealed a significant association between category of severity of septal angulation and the symptom score of rhinosinusitis with the p-value of 0.025. In addition, the result from one-way ANOVA test also revealed a significant association between category of severity of septal angulation and the VAS of rhinosinusitis (p-value < 0.05).
Conclusion: We conclude that severity of nasal septum angulation is significantly associated with severity of rhinosinusitis based on symptoms score and VAS, and these findings could be used in tailored management of rhinosinusitis patient especially during functional endoscopic sinus surgery.