© Borgis - New Medicine 2/2005, s. 26-27
Lechosław P. Chmielik
Nasal septum deviation and chronic sinusitis in children
Clinic of Paediatric ENT, Medical University of Warsaw, Poland
Head: Prof. Mieczysław Chmielik MD, PhD
Deviations of the nasal septum disrupt the airflow through the nose. This is what has given rise to the idea that over a certain period of time, this would cause problems in the paranasal sinuses.
Most ENT handbooks state that one of the main causes of chronic rhinosinusitis may be nasal septum deviations. There are only a few publications concerning this condition, and the conclusions are often in disagreement with each other.
The subject of the present study is the analysis of the problem, based on 162 patients with nasal septum deviations, and a control group consisting of 80 pupils of secondary school age. In the present analysis, a direct dependence between deviation of the nasal septum and chronic sinusitis was not established.
Respiration is a basic function of every living organism. The human respiratory system is extremely complex and allows accurate coverage of the oxygen requirement in almost all climatic conditions. The complicated functions of this system have been intensively investigated, yet the system has not been fully explored. Various parts of the respiratory system cooperate, which, in normal health conditions, ensures efficient ventilation of the alveoli. A healthy upper respiratory system is a functional entity. Certain abnormalities of its various parts may have a negative impact on neighbouring and distant organs. A deviation of the nasal septum, which changes the airflow in this part of the respiratory tract, can affect the state of the paranasal sinuses as well as the functions of the auditory tube (1.3). One of those deviation-locating classifications is Cottle´s division of the nasal septum. Mladina´s classification is another, more modern approach, which includes the morphology of lesions
In the last decades, a dynamic development of developmental age nose surgery may be noticed. While in the first half of the 20th century most ENT manuals, describing Killian´s method, stated that surgery should be postponed until the age of 16 or 18, after introducing Cottle´s method of septum surgery, nose surgeries were carried out regardless of age, in any situation that caused the deformation to make breathing difficult. A deviated septum in a child impairs patency of the upper airways, thus causing recurrent infections of this area. An evaluation of influence of septum deviation on adenoiditis or prolonged inflammatory sinus disease has been mentioned many times in numerous scientific publications, while there are very few and poorly documented reports describing how the septum deviation affects the auditory tube, hence the state of hearing.
AIM OF THE STUDY
The objective of the paper is to analyse the lesion incidence in paranasal sinuses when nose septum deviated, considering their location, deviation shape and all concurrent diseases.
MATERIAL AND METHOD
We have analysed medical histories of 162 patients with treated and operated nasal septum at the Clinic of Paediatric Otorhinolaryngology of the Medical University of Warsaw, in the years 1999-2004 and a control group consisting of 80 pupils of secondary school age.
The analysis concerned:
– Morphology of nasal septum deviation (classification according to Mladina and Cottle)
– Analysis of concurrent symptoms
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