[Radiological findings of the nasal septum in CT scan in patients with deviated noses].

Objective: The bony-cartilaginous crooked nose is characterized by a deviation of the nasal dorsum from the median sagittal plane. Since the nasal dorsum and the septum form an anatomical entity, a deviation of the external nose always results in a deviation of the cartilaginous and bony nasal septum. The aim of this study was to analyze the pathologies of the septum in patients with crooked noses based on CT images of the midface.
Methods: The CT images of patients with a documented crooked nose, who presented between 2005 and 2011 in our hospital, were analyzed retrospectively considering photo documentation and nasal findings. The CT scans were performed due to suspected sinusitis unrelated to the study.
Results: The study includes a total of 138 patients. In all patients a deviated septum was found in the CT. In particular, there was not only a deviation of the cartilaginous septum, but also a deviation of the perpendicular plate (PP) in 86% of the cases. This PP deviation distorted to the opposite side of the deviation of the crooked nose in 79% of the cases. However, the base of the PP at the cribriform plate was in a median position in 99% of the cases of the patients. Furthermore, in 96% of cases, the caudal septum was located in midline on the anterior nasal spine, -although 15% presented clinically a dislocation of the caudal septum.
Conclusions: The bony-cartilaginous crooked nose usually results in a deviation of the cartilaginous and bony septum. In particular, a high deviation of the PP to the opposite side of the deviation of the external nose was present in a majority of the -cases. Therefore, a septo-rhinoplasty with particular consideration of the deviation of the PP is necessary in patients with a deviated external nose.
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