Causes of deviated nasal septum

According to the etiological principle, deformations of the nasal septum can be divided into the following main groups: post-traumatic and those resulting from anomalies in the formation of the bone-cartilaginous skeleton.

Pathogenesis of nasal septum deviation

The pathogenesis of post-traumatic curvatures would seem to be extremely clear and does not require explanation. However, it is impossible to clearly distinguish between these two groups, which at first glance are dissimilar, since even minor injuries to the nose, which every person receives in early childhood when learning to walk, can affect the further growth and formation of the skeleton of the nasal septum and, consequently, the formation of its deformations. There is a theory proving that even birth trauma can lead to such developmental anomalies. It is unknown whether trauma always serves as a trigger for the curvature of the nasal septum or whether there are other provoking factors

In newborns and young children, the nasal septum is usually straight, and its skeleton consists of separate, non-contiguous islands of cartilaginous tissue (growth zones). These fragments, partially ossified, begin to grow and connect with each other, forming a full-fledged bone-cartilaginous skeleton that provides support for the bridge of the external nose. Due to injury and other, as yet unknown, reasons, in some cases, a failure occurs in the physiological process of growth and formation of the skeleton of the nasal septum. As a result, fragments of the future skeleton grow towards each other, ahead of normal development times, overlap each other in the area of joints, bend, not fitting into the space allotted to them, and form spikes and ridges along the sutures. The formation of the skeleton of the nasal septum is completed by the age of 16-18 years, by the same period the nasal septum acquires its final form, which will either provide its owner with free nasal breathing throughout life or, conversely, will create problems and lead to the development of a number of diseases and, possibly, will require surgical correction. However, the growth process does not occur in isolation, but is associated with the formation of surrounding structures - if the upper sections of the nasal septum are displaced to the side, then the free space on the opposite side is filled with a pneumatized middle nasal concha. Pneumatization of the bone skeleton of the lower nasal concha in the wider half of the nasal cavity is observed less often, usually the volume of this concha increases due to hypergenesis of the bone skeleton and hypertrophy of its cavernous tissue. Understanding these processes is important for the correct planning of surgical treatment, since one operation on the nasal septum without appropriate correction of the nasal concha is often not enough.