Published: 2022-02-23

Deviated nasal septum in children: a review

Santosh Kumar Swain


Deviated nasal septum (DNS) is a common clinical entity in human beings. Deviated nasal septum (DNS) may also result in upper respiratory infection, sinusitis, headache, epistaxis, middle ear infection, and hyposmia which increase the morbidity of the child and hamper the quality of life.  The common clinical symptoms associated with DNS among children are nasal obstruction and postnasal discharge. The chronic nasal block in DNS has an adverse effect on the development of the child. DNS has an important effect on the faciomaxillary growth and development, particularly in the first decade of life. The treatment of DNS in childhood has received challenges among otolaryngologists because of its concern about the role of the nasal septum in the overall growth of the midface. So, otolaryngologists are often cautious during the correction of the DNS in children. DNS and its impact on nasal breathing impairment in children are often underestimated by clinicians. Clinicians often have little knowledge on the impact of DNS, its clinical manifestations in children, and its appropriate management. Early intervention for DNS in children is helpful to prevent morbid symptoms and their complications. This review article discusses etiopathology, epidemiology, clinical presentations, diagnosis, and current treatment of the DNS in children.


Deviated nasal septum, Children, Septoplasty, Nasal obstruction

Full Text:



Alekseenko SI, Karpishchenko SA, Melnik BO. Correction of the nasal septum in children with surgical pathology of the paranasal sinuses (literature review). Consilium Medicum. 2021;23(3):226-30.

Saniasiaya J, Abdullah B. Critical review of the literature on conventional septoplasty in children. B-ENT. 2021;17(3):186-91.

Smith MM, Ishman SL. Pediatric nasal obstruction. Otolaryngologic Clinics of North America. 2018;51(5):971-85.

Swain SK, Das A, Sahu MC. Anatomical variations of nose causing rhinogenic contact point headache-a study at a tertiary care hospital of eastern India. Polish Annals of Medicine. 2018;25(1):51-5.

Swain SK, Janardan S, Mohanty JN. Endoscopy guided eustachian tube balloon dilation: Our experiences. Iranian Journal of Otorhinolaryngology. 2020;32(112):287-94.

Šubarić M, Mladina R. Nasal septum deformities in children and adolescents: a cross sectional study of children from Zagreb, Croatia. International journal of pediatric otorhinolaryngology. 2002;63(1):41-8.

Bhattacharjee A, Uddin S, Purkaystha P. Deviated nasal septum in the newborn- a 1-year study. Indian Journal of Otolaryngology and Head and Neck Surgery. 2005;57(4):304-8.

Podoshin L, Gertner R, Fradis M, Berger A. Incidence and treatment of deviation of nasal septum in newborns. Ear Nose Throat J. 1991;70:485-7.

Van Cauwenberge PB, Derycke A. The relationship between nasal and middle ear pathology, Acta Otorhinolaryngol. Belg. 1983;37:830-41.

Roberts J, Federico JV. Hearing sensitivity and related medical findings among children, Vital Health Stat.—Series1: Programs and Collection Procedures. 1972;11 (114):1-72.

Taghiloo H, Halimi Z. The frequencies of different types of nasal septum deviation and their effect on increasing the thickness of maxillary sinus mucosa. Journal of dental research, dental clinics, dental prospects. 2019;13(3):208-14.

Harari D, Redlich M, Miri S, Hamud T, Gross M. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope. 2010;120:2089-93.

Luu NN, Friedman O. Septal Deviation after Septorhinoplasty: Causes and Surgical Management. Facial Plastic Surgery. 2020;36(01):072-7.

Swain SK, Das A, Mohanty JN. Acute otitis media with facial nerve palsy: our experiences at a tertiary care teaching hospital of eastern India. Journal of Acute Disease. 2019;8(5):204-7.

Swain SK. Middle turbinate concha bullosa and its relationship with chronic sinusitis: a review. International Journal of Otorhinolaryngology and Head and Neck Surgery. 2021;7(6):1062-67.

Cottle MH, Loring RM, Fischer GG, Gaynon IE. The maxilla-premaxilla approach to extensive nasal septum surgery. AMA archives of otolaryngology. 1958;68(3):301-13.

Guyuron B, Uzzo CD, Scull H. A practical classifi cation of septonasal deviation and an eff ective guide to septal surgery. Plast Reconstr Surg. 1999;104(7):2202-9.

Sharma VK, Sharma R. Rhinomanometric Assessment of Nasal Airflow in Deviated Nasal Septum. Clin Rhinol Int J. 2012;5(1):17-8.

D’Ascanio L, Lancione C, Pompa G, Rebuffini E, Mansi N, Manzini M. Craniofacial growth in children with nasal septum deviation: a cephalometric comparative study. Int J Pediatr Otorhinolaryngol. 2010;74:1180-83.

Swain SK, Sahu MC, Samantray K. An unusual cause of otalgia in a child–A case report. Pediatria Polska. 2016;91(5):480-3.

Saniasiaya J, Abdullah B. Quality of life in children following nasal septal surgery: A review of its outcome. Pediatr Invest. 2019; 3:180-4.

Swain SK, Sahu MC. An unusual complication of nasal foreign body in a pediatric patient: A case report. Pediatria Polska. 2017;92(1):111-3.

Bayrak S, Ustaoglu G, Demiralp KÖ, Çakmak ES. Evaluation of the characteristics and association between schneiderian membrane thickness and nasal septum deviation. Journal of Craniofacial Surgery. 2018;29(3):683-7.

Tasca I, Compadretti GC. Nasal growth after pediatric septoplasty at long-term follow-up. Am J Rinol Allergy. 2011;25:7-12.

Verwoerd CD, Verwoerd-Verhoef HL. Rhinosurgery in children: basic concepts. Facial Plast Surg. 2007;23:219-30.

Swain SK, Choudhury J. Nasal foreign bodies in children–our experiences at a tertiary care teaching hospital in Eastern India. Menoufia Medical Journal. 2021;34(2):740-4.

Tikanto J, Pirilä T. Effects of the Cottle's maneuver on the nasal valve as assessed by acoustic rhinometry. Am J Rhinol. 2007;21(4):456-9.

Lawrence R. Pediatric septoplasy: a review of the literature. Int J Pediatr Otorhi-nolaryngol. 2012;76(8):1078-81.

Swain SK, Baliarsingh P. Rhinogenic contact point headache in pediatric age group: a review. International Journal of Contemporary Pediatrics. 2022;9(1):135-9.

Tran TP. Rhinomanometric Assessment of Nasal Airflow in Deviated Nasal Septoplasty and Coblation Turbinate Reduction. International Journal of Medical Research & Health Sciences. 2018;7(11):160-5.

Swain SK, Behera IC, Mohanty S, Sahu MC. Rhinogenic contact point headache–Frequently missed clinical entity. Apollo Medicine. 2016;13(3):169-73.

Shah J, Roxbury CR, Sindwani R. Techniques in septoplasty: traditional versus endoscopic approaches. Otolaryngologic clinics of North America. 2018;51(5):909-17.

Van Loosen J, Van Zanten GA, Howard CV, Verwoerd-Verhoef HL, Van Velzen D, Verwoerd CD. Growth characteristics of the human nasal septum. Rhinology. 1996;34(2):78-82.

Derkay CS. A conservative role for septoplasty in young children. Arch Otolaryngol Head Neck Surg. 1999;125:702-3.

Rettinger G, Kirsche H. Complications in septoplasty. Facial Plast Surg. 2006;22:289-97.

Jena A, Swain SK. A study of anatomical variations in chronic rhinosinusitis with special reference to deviated nasal septum. IJAR. 2019;5(4):15-7.

Verwoerd CD, Verwoerd-Verhoef HL. Rhinosurgery in children: basic concepts. Facial Plastic Surgery. 2007;23(04):219-30.

Verwoerd CD, Verwoerd-Verhoef HL. Rhinosurgery in children: Development and surgical aspects of the growing nose. Laryngorhinootologie. 2010; 89:46-71.

Cupero TM, Middleton CE, Silva AB. Effects of functional septoplasty on the facial growth of ferrets. Arch Otolaryngol Head Neck Surg. 2001;127:1367-69.

Martins MB, Lima RG, Lima FV, Barreto VM, Santos AC, Júnior RC. Demystifying septoplasty in children. Int Arch Otorhinolaryngol. 2014;18:54-6.

Funamura JL, Sykes JM. Pediatric septorhinoplasty. Facial Plast Surg Clin North Am. 2014;22:503-8.

Swain SK, Mohanty JN. Chondroma of the nose. Libyan Journal of Medical Sciences. 2020;4(2):87-9.

Fuller JC, Levesque PA, Lindsay RW. Functional septorhinoplasty in the pediatric and adolescent patient. Int J Pediatr Otorhinolaryngol. 2018; 111:97-102.

Swain SK, Choudhury J. Pediatric airway diseases. Indian Journal of Health Sciences and Biomedical Research (KLEU). 2019;12(3):196-201.