Abstract

Background: Symptomatic deviated nasal septum is one of the most common diagnosis in otolaryngology. Nasal obstruction is most common presentation of the symptomatic DNS. Diagnosis can be made reliably through patient symptoms and examination. The diagnostic accuracy can be increased greatly by anterior rhinoscopy and diagnostic nasal endoscopy (DNE) Aim: To evaluate Anterior Rhinoscopy and Diagnostic Nasal Endoscopy findings in patients with symptomatic Deviated Nasal Septum (DNS). Methods: A profile of 120 Patients with chief complaints of nasal obstruction and findings of deviated nasal septum with or without inferior turbinate hypertrophy on anterior rhinoscopy  attending the department of Otorhinolaryngology and Head and Neck Surgery, Government Medical College Srinagar, over a period of 18 months were included after fulfilling the inclusion criteria in this study. Results: In this study,120 patients were enrolled, majority of the patients (~80%) were young <30 years old. Most common presentation was nasal obstruction in 120(100%) patients. On examination C shaped DNS was seen in 93 (77.5%) patients followed by S shaped DNS in 17 (14.2%) patients and C/S shaped DNS with spur was noted in 10 (8.3%) patients, among 120 patients, 22 (18.3%) had hypertrophied inferior turbinate on anterior rhinoscopy. On DNE Most common type of DNS (Mladina classification) was type 2 in 52 (43.3%) patients, followed by type 3 in 35 (29.2%) patients, type 4 in 18 (15.0%) patients, type 5 in 6 (5.0%) patients, type 1 in 5 (4.2%) patients and type 6 in 4 (3.3%) patients. 10 (8.3%) had bullous middle turbinate. Middle meatus discharge was seen in 10 (8.3%) patients. Sphenoethmoidal recess secretions were seen in 1(0.8%) patient.  Paradoxical middle turbinate and accessory ostia were seen in 12 (10%) patients and 2 (1.7%) patients respectively. Conclusion: Preoperative evaluation with anterior rhinoscopy and diagnostic nasal endoscopy is adequate in most of the cases of symptomatic DNS. It is particularly important in developing countries were CT scans are not readily available and that x ray exposure can be avoided by a thorough clinical examination.