Frequency and Classification of Septal Deviation Types in Patients Undergoing Septorhinoplasty

Authors : Yakup Avsar, Ali Yılmaz

Pages : 654-661

Doi:10.18663/tjcl.1844214

View : 31 | Download : 97

Publication Date : 2026-01-01

Article Type : Research Paper

Abstract :Aims: Nasal septal deviation (NSD) patterns are typically described by shape, but the anatomical distribution in septorhinoplasty patients—and its relation to symptoms—is not well established. This study aimed to (i) determine the frequency and anatomical levels (high, central, base, caudal) of SD and its morphological subtypes, and (ii) compare findings between symptomatic and asymptomatic patients Methods: We retrospectively analyzed 378 consecutive septorhinoplasty cases using standardized rhinoscopic/endoscopic data. NSD was classified by localization (high, central, base, caudal), presence of crest/spur, and new hierarchical morphology: Type I (localized), Type II (septal tilt), Type III [C-shape; Anteroposterior (AP) / Cephalocaudal (CC); ±crest/spur], Type IV (S-shape; AP/CC; ±crest/spur). Result: Central SD was most common (81.2%), followed by caudal (61.1%), high (48.9%), and base (40.7%). Caudal deviation (74.3% vs 53.0%, P<0.001), external nasal deformity (64.2% vs 50.4%, P=0.009), and septal crest (77.7% vs 62.6%, P=0.002) were more frequent in symptomatic patients. AP C-shape (38.4%) was the most prevalent morphology; CC S-shape (26.2%) exceeded CC C-shape (8.7%). Type IIIC was the most frequent pattern in the overall cohort, followed by Type IVD. In the subgroup comparison, Type IIIA was significantly more common in asymptomatic than in symptomatic patients (8.3% vs. 1.4%, p=0.019). Conclusion: NSD in septorhinoplasty patients shows a central-dominant pattern, with caudal deviations and crests linked to symptoms. Our novel classification system—integrating location, shape, and lesions—may enhance clinical evaluation and surgical planning.
Keywords : septal deviasyon, kaudal septum, septorinoplasti

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