jin rh new description method and classification system of septal deviation

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27 KISEP Original Article J Rhinol 14(1), 2007 NewDescriptionMethodandClassificationSystem forSeptalDeviation Hong-RyulJin,MD 1 ,Joo-YunLee,MD 2 andWoo-JinJung,MD 3 1 Department of Otorhinolaryngology, Seoul National University, College of Medicine, Boramae Hospital, Seoul; and 2 Hana Otorhinolaryngology Clinic, Cheongju; and 3 Department of Otolaryngology, Chungbuk National University Hospital, Cheongju, Korea ABSTRACT Background and ObjectivesThe purpose of this study is to develop an efficient method of description and a new classi- fication system for septal deviations (SD) and to study the applicability of the new description method and classification system to a clinical setting. Materials and MethodsSixty-five patients with nasal obstruction (symptomatic group) and thirty-five patients without nasal obstruction (asymptomatic group) were included in this prospective study. The characteristics of SD were analyzed according to the new description method based on the morphology, site, severity, and its influence on the external nose. Based on these observations, four classification categories of SD were introduced: localized deviation (type I ), curved/angulated deviation (type II ), curved/angulated deviation combined with type I (type III ), and curved/angulated de- viation with associated dorsal nasal deviation (type IV). The incidence of each type of SD was calculated. ResultsIn both groups, all pathologies of the SD could be precisely described using the new description method. In both groups, the curved deviation (type II ) was the most common pathology. Anterior/mid was the most common site of deviation. In the symptomatic group, moderate was the most common form of severity while mild was the most common form in the asymptomatic group. In both groups, type II was the most common. Types III and IV were significantly more common in the symptomatic group while type I was predominant in the asymptomatic group (p<0.05). ConclusionThe new description method provides a precise descriptive term for SD. The proposed classification system is suitable for documentation and determination of the severity of SD. KEYWORDSNasal septum·Classification·Nasal septal deviation·Description. INTRODUCTION Deviation of the nasal septum has particular signific- ance because it is involved in almost all rhinological pro- blems to some degree. However, commonly used descri- ptions such as “severe septal deviation to right” or “left septal spur” are based on subjective descriptors, and they do not reflect the precise morphology and location of the septal deviation (SD). Moreover, deviation of the nasal dorsum, which is commonly combined with SD, is usually not addressed together. Procedures on SD can present a great challenge even for experienced surgeons. The diversity of SD and variety of correction methods contribute to this difficulty. This has prompted many attempts to establish a classification system, which has failed to acquire widespread acceptance. Thus, the ambiguity in description still causes communication difficulties between surgeons and, in combination with the absence of an efficient classification system, poses diffi- culty in interpreting the clinical implication of the SD, and provides no assistance in choice of surgical techniques. The purposes of this study are twofold: first, to develop an efficient method to describe the various pathologies of SD and introduce a new classification system that provides reproducible guidelines for the severity and correction of SDsecond, to study the applicability of the new descri- ption method and classification system in a clinical setting. MATERIALSANDMETHODS One hundred consecutive patients visiting our depart- Address correspondences and reprint requests to Hong-Ryul Jin, M.D., De partment of Otorhinolaryngology, Seoul National Uni- versity, College of Medicine, Boramae Hospital, 425 Shindae- bang-2 dong, Dongjak-gu, Seoul 156-707, Korea Tel82-2-840-2412, Fax82-2-831-2826 E-mail[email protected] Received for publication on August 7, 2006 Accepted for publication on December 14, 2006

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Jin RH New Description Method and Classification System of Septal Deviation

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27 K I SEPOr i gi nalAr t i c l eJ Rhinol 14(1), 2007NewDescriptionMethodandClassificationSystemforSeptalDeviation Hong-RyulJin,MD1,Joo-YunLee,MD2andWoo-JinJung,MD31Department of Otorhinolaryngology, Seoul National University, College of Medicine, Boramae Hospital, Seoul;and 2Hana Otorhinolaryngology Clinic, Cheongju;and 3Department of Otolaryngology, Chungbuk National University Hospital, Cheongju, Korea ABSTRACT Background and ObjectivesThe purpose of this study is to develop an efficient method of description and a new classi-fication system for septal deviations (SD) and to study the applicability of the new description method and classification system to a clinicalsetting.MaterialsandMethodsSixty-fivepatientswithnasalobstruction(symptomaticgroup)andthirty-five patientswithoutnasalobstruction (asymptomaticgroup)were includedinthisprospectivestudy. ThecharacteristicsofSD wereanalyzedaccordingtothenewdescriptionmethodbasedonthemorphology,site,severity,anditsinfluenceonthe external nose. Based on these observations, four classification categories of SD were introduced: localized deviation (type I), curved/angulated deviation (type II), curved/angulated deviation combined with type I (type III), and curved/angulated de-viation with associated dorsal nasal deviation (type IV). The incidence of each type of SD was calculated. ResultsIn both groups, all pathologies of the SD could be precisely described using the new description method. In both groups, the curved deviation (type II) was the most common pathology. Anterior/mid was the most common site of deviation. In the symptomatic group, moderate was the most common form of severity while mild was the most common form in the asymptomatic group. In both groups, type II was the most common. Types III and IV were significantly more common in the symptomatic group while typeIwaspredominantinthe asymptomaticgroup(p