Volume 24, Issue 104, July - August, 2020

A new endoscopic and anatomical classification of Deviated Nasal Septum with clinical relevance

Shraddha Jain^1♦, Prajakta Bhalerao², Chandraveer Singh³

¹MBBS, MS(ENT), PhD, Professor, Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Wardha, Maharashtra, India-442004; Email: sjain_med@yahoo.co.in
²MBBS, Resident, Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Wardha, Maharashtra, India-442004; Email: prajaktabhalerao9693@gmail.com
³MBBS, MS(ENT), Assistant Professor, Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Wardha, Maharashtra, India-442004; Email: cheer7us@yahoo.com

^♦Corresponding author
Professor, Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Sawangi (M), Wardha, Maharashtra, India; Email: sjain_med@yahoo.co.in

ABSTRACT

Introduction: The current classifications of deviated nasal septum (DNS) are based on geometry and lack standardization, giving variable results for correlation between Eustachian dysfunction and DNS. Hence, there was a need for anatomic classification of DNS, taking into account the deviation of individual parts of the septum, which is possible now due to advances in endoscopic surgery and imaging. Objective: To devisean endoscopic anatomic classification of deviated nasal septum (DNS), for studying their role in causation of Eustachian dysfunction. Methods: The present Cross-sectional study was conducted in the Otorhinolaryngology Department of tertiary care teaching hospital of central India on200 consecutive patients in the age group of 18 to 70 years with nasal and/or ear complaints, diagnosed with DNS and/or chronic otitis media. Diagnostic nasal endoscopy along with Dynamic slow motion video endoscopy and CT scan of paranasal sinuses were done. Endoscopic septoplasty was performed, where indicated. The different types of septal deviations were classified, based on endoscopic, surgical and radiologic findings on CT scan, as per new classification, and correlated with the Eustachian function. Results: The new classification (Jain Bhalerao classification) has 10 types, which include the anatomic categories of maxillary crest displacement, vomerine deviation, deviation of perpendicular plate of ethmoid, caudal dislocations, septal spur and C shaped cartilaginous deviation. Conclusion: The new classification helps classify all types of DNS and study their role in causation of Eustachian dysfunction.

Keywords: Nasal septum; Deviation; Eustachian tube; Function; Dynamic; Endoscopy; Anatomic; Classification

Medical Science, 2020, 24(104), 2544-2554

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