Deviated Nasal Septum (DNS)

Etiology:

1. Trauma : usually in childhood, may even be during delivery.
   
2. Developmental
3. Hereditary
4. Racial predisposition

Types:

1. Anterior dislocation.
2. C-shaped
3. S-shaped
4. Spur
5. Septal thickening.

Clinical Features:

1. Nasal obstruction (more if high deviation)
2. Headache
3. Sinusitis
4. Epistaxis
5. Anosmia (partial of complete)
6. External deformity.
7. Middle ear infection.

Treatment:

Surgical treatment is adviced if nasal obstruction is complete, total anosmia is present and in  cosmetic indications.

2 types

1. SMR (Sub-mucosal Resection) operation: Not done anymore because of the numerous complications involved and now with the availability of better options.
2. Septoplasty: (treatment of choice) The mucoperichondrial flap of one side is elevated after giving a modified Killian's incision. The defect in the cartilage &/or bone is removed. This surgery can be combined with a rhinoplasy if necessary.

Advantages of Septoplasty:

1. Conservative operation.
2. Can be done in children.
3. Can be combined with rhinoplasty.
4. Revision possible in case of recurrance/unsatisfactory results.
5. Less complications.