THE RELATIONSHIP OF NASAL SEPTUM DEVIATION WITH FACIAL ASYMMETRY

Yıl 2019, , 157 - 161, 27.08.2019

Çiğdem Özer Gökaslan

https://doi.org/10.18229/kocatepetip.507229

Cited By: 1

Öz

OBJECTIVE: Facial asymmetry is the size or ratio mismatch between the two sides of the face. Nasal morphology and maxillary bone have important anatomical connections due to close embryological development. Some studies have shown a positive relationship between nasal septal deviation (NSD) and facial asymmetry. The aim of this study was to determine the presence of orbital and ocular asymmetry and investigating their relationship with nontraumatic NSD.

MATERIAL AND METHODS: Thirty-four patients who underwent a paranasal sinüs computed tomography (CT) examination without face or head trauma, nasal bone fracture and previous history of septal surgery were evaluated retrospectively. NSD angle was measured in CT. The anterior diameter of the eyeball was measured. The relationship between these was investigated by spearman correlation test.

RESULTS: The right orbital floor angle and proptosis increased significantly in those with right deviation. There was a relationship between the left proptosis and orbital floor angle at the left deviation but it was not statistically significant. When partial correlation was made in terms of age, the orbital floor angle and proptosis were correlated with deviation angle in both right and left sides.

CONCLUSIONS: Non-traumatic nasal septal deviation seems to be associated with growth differences in the bones around the nasal septum.

Anahtar Kelimeler

Facial asymmetry, Nasal septal deviation, Computed tomography

NAZAL SEPTUM DEVİASYONUNUN FASİYAL ASİMETRİ İLE İLİŞKİSİ

Öz

AMAÇ: Fasiyal asimetri yüzün iki tarafı arasındaki boyut veya oran uyumsuzluğudur. Nazal morfoloji ve maksiller kemik yakın embriyolojik gelişim nedeniyle önemli anatomik bağlantılara sahiptir. Bazı araştırmalar nazal septum deviasyonu (NSD) ve yüz asimetrisi arasında pozitif bir ilişki olduğunu göstermiştir. Bu çalışmada, orbital ve oküler asimetri varlığının nontravmatik NSD ile ilişkisinin araştırılması amaçlanmıştır.

GEREÇ VE YÖNTEM: Yüz veya kafa travması, burun kemiği kırığı ve önceden septal cerrahi öyküsü olmayan, paranazal sinüs bilgisayarlı tomografi (BT) tetkiki yapılmış 34 hasta retrospektif olarak incelendi. NSD açısı, sert damak ile orbita tabanı arasındaki açı ve interzigomatik hatta göre göz küresinin anterior yarıçapı ölçüldü. Bunlar arasındaki ilişki spearman korelasyon testi ile incelendi.

BULGULAR: Sağ deviasyon olanlarda sağ orbita tabanındaki eğim ve proptozis istatistiksel olarak anlamlı olarak artış gösterdi. Sola deviasyon olanlarda sol proptozis ve orbita tabanındaki eğim arasında korelasyon mevcut olup istatistiksel olarak anlamlı değildi. Yaş açısından kısmi korelasyon yapıldığında hem sağ hem de solda deviasyon açısıyla orbita tabanındaki eğim ve proptozis ilişkiliydi.

SONUÇ: Travma dışı nazal septal deviasyonun, nazal septumun çevresindeki kemiklerin büyüme farklılıkları ile ilişkili olabileceği gösterilmiştir.

Anahtar Kelimeler

Fasiyal asimetri, Nazal Septum Deviasyonu, BT

Kaynakça

• 1. Maheswari S, Verma SK, Gaur A, Dhiman S. Diagnosis and management of facial asymmetries. J Orthodontic Res. 2015;3:81-7.
• 2. Vig PS, Hewitt AB. Asymmetry of human facial skeleton. Angle Orthod 1975;45:125-9.
• 3. Shah SM, Joshi MR. An Assessment of asymmetry in the normal craniofacial complex. Angle Orthod.1978;48:128-41. 4. Farkas LG, Cheung G. Facialasymmetry in healthy North American Caucasians. An anthropometrical study. AngleOrthod.1981;51:7-70.
• 5. Kim WA, Lee KH, Hwang HS. Comparison of asymmetric degree between maxillofacial hard and soft tissue in facial asymmetric subjects using three dimensional computed tomography. Korean J Orthod. 2005;35:163-73.
• 6. Pirttiniemi PM. Associations of mandibular and facial asymmetries-a review. Am J Orthod Dentofacial Orthop. 1994;106:109-200.
• 7. Wang J, Dou X, Liu D, Song P, Qian X, Wang S, et al. Assessment of theeffect of deviatednasalseptum on thestructure of nasal cavity. Eur Arch Otorhinolaryngol. 2016;273(6):1477–80.
• 8. Kajan ZD, Khademi J, Nemati S, Niksolat E. Theeffects of septaldeviation, Concha bullosa, and their combination on the depth of posterior palatal arch in cone-beam computed tomography. J Dent Shiraz Univ MedSci. 2016;17(1):26–31.
• 9. Roblin DG, Eccles R. What, ifany, is thevalue of septal surgery? Clin Otolaryngol. 2002;27:77–80.
• 10. VanEgmond MMHT, Rovers MM, Hendriks CTM, vanHeerbeek N. Effectiveness of septoplasty versus nonsurgical management for nasal obstruction due to a deviated nasal septum in adults: study protocol for a randomized controlled trial. Trials. 2015;16:500.
• 11. Fabiana B, Alberto B, Salvatore R, Alessandro N, Paola C. Is there a correlation between nasal septum deviation and maxillary transversal deficiency? A retrospective study on prepubertal subjects. Int J Pediatr Otorhinolaryngol. 2016;83:109–12.
• 12-Moore KL PT, Yıldırım M Oİ, Dalçık H, .TheDeveloping Human Clinically Oriented Embryology İnsan Embriyolojisi (çeviri). Nobel Tıp Kitapevleri, İstanbul 2002:236-242. 13. Hartman C, Holton N, Miller S, Yokley T, Marshall S, Srinivasan S, et al. Nasal septal deviation and facial skeletal asymmetries. AnatRec. 2016;299:295–306.
• 14. Poorey VK, Gupta N. Endoscopic and computed tomographic evaluation of influence of nasal septal deviation on lateralwall of nose and its relation to sinüs diseases. Indian J Otolaryngol HeadNeckSurg. 2014;66(3):330–5.
• 15. Delaire J, Precious D. Influence of the nasal septum on maxillonasal growth in patients with congenital labiomaxillarycleft. CleftPalate J 1986;23:270–277.
• 16. Hafezi F, Naghibzadeh B, Nouhi AH, et al. Asymmetric facial growth and deviated nose. Ann Plast Surg2010;64:47–51.
• 17. Taban M, Jarullazada I, Mancini R, et al. Facial asymmetry and nasal septal deviation in acquired nasolacrimalduct obstruction. Orbit 2011;30:226–229.
• 18. Kim YM, RhaKS,Weissman JD, et al. Correlation of asymmetric facial growth with deviated nasal septum. Laryngoscope2011;121:1144–1148.
• 19. Hafezi F, Naghibzadeh B, Nouhi A, Yavari P. Asymmetric facial growth and deviated nose: a newconcept. Ann Plast Surg. 2010;64:47–51.
• 20. Rajpara Y, Shyagali TR An assessment of sexual dimorphism in relation to facial asymmetry in esthetically pleasing faces. Acta Inform Med. 2015 Feb;23(1):44-8.
• 21. Grymer LF, Pallisgaard C, Melsen B. The nasal septum in relation to the development of the nasomaxillarycomplex: a study in identicaltwins. Laryngoscope1991;101:863–868.
• 22. Freng A, Kvam E, Kramer J. Facialskeletaldimensions in patients with nasal septal deviation. Scand J Plast Reconstr Surg Hand Surg 1988; 22:77–81.
• 23. Lee JS, Lee H, Kim JW, et al. Association of facial asymmetry and nasal septal deviation in acquired nasolacrimal duct obstruction in East Asians. J Craniofac Surg 2013;24:1544–1548.