Nasal Septum Deviation May Affect Facial Morphologic Parameters.

Brief Summary: The aim of the study is to evaluate the relationship between the direction and degree of nasal septal deviation with nasal bone morphology , along with factors such as age and gender.

Detailed Description: The nasal septum is located in the middle of the nasal cavity and it forms the major part of the nose structure. It is divided into a posterior part by the vomer and perpendicular plate of the ethmoid bone and an anterior part by the quadrangular cartilage .

In the growth period, the nasal septum acts as a growth plate that affects surrounding bones and facial skeletal tissues .Thus, nasal septum deviation affects facial morphologic parameters such as interalveolar distance and maxillary rotation distance, causing compensatory changes in the lateral nasal wall and septal deviation,which are associated with nasal floor and palatal region asymmetries .

Nasal septum deviation is the most common anatomic variation in up to 80% of healthy adults .

From the initial growth stages, the maxillary bone and nasal structure have significant anatomic connections because of their close embryologic development.

The severity of septal deviation also affects the ipsilateral lateral lamina of the cribriform plate width and ipsilateral middle turbinate length . Nasal septal deviation may affect nasal bone growth and facial morphology .Knowledge of nasal morphologic parameters plays an important role in planning successful rhinoplasty and septoplasty operations.

Some morphological characteristics of the nose such as bone length and thickness may present different forms according to factors correlated with age, gender, climate and race.

Recruitment & Eligibility

Inclusion Criteria

Patients over 18 years old who attending to Ear,Nose and throat department out patients complaining of nasal septum deviation causing nasal symptoms are exposed to maxillofacial CT.

Exclusion Criteria

Patients with a history of rhinoplasty,
Patients with cranial and facial trauma or bone deformity (e.g. S-shaped septum deviation).
Patients with a mass or polyp in the nasal cavity.
Patients with adenoid .
Patients with nasopharyngeal lesions.
Patients with craniofacial anomalies.

Arm && Interventions

Group	Intervention	Description
patients with nasal septal deviation	Maxillofacial CT	Maxillofacial CT scan

Primary Outcome Measures

Name	Time	Method
The nasal deviation angle	10 minutes	It will be measured on coronal CT images as the angle between the most deviated point of the septum and the midline which is the line from the crista galli to the palatum
Nasal bone length	10 minutes	The nasal bone length will be measured from frontonasal suture to the endpoint of the nasal bone on the sagittal plane
Internasal angle	10 minutes	The internasal angle will be measured on coronal CT images at the site of the nasion point
The lateral and intermediate nasal bone thickness	10 minutes	The nasal bone thickness will be measured in axial images at the site of the lateral and intermediate osteotomy lines. The lateral osteotomy lines run along nasomaxillary suture and intermediate (or midline) osteotomy lines runs along the internasal suture. The lateral nasal bone thickness will be measured at the nasomaxillary suture. Intermediate nasal bone thickness was measured at the midpoint between the nasomaxillary suture and the rhinion .

Secondary Outcome Measures

Name	Time	Method

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