Topographic and Morphometric Variations of the Nasal Septum and Their Clinical Implications in Septal Surgery

Abstract

Background: The  nasal  septum  is  a  complicated  osteocartilaginous structure that regulates nasal airflow, provides structural support, and helps with facial symmetry. The morphological diversity of its cartilaginous and bony  components  may  have  an  impact  on  both  functional  and reconstructive septal surgeries.
Objective: The purpose of this study was to investigate the topographic and  morphometric  changes  of  the  nasal  septum  using  computed tomography (CT) and to determine the clinical consequences in septal surgery.
Materials  and  Methods:  This  observational  CT-based  investigation involved 120 images of the nasal cavity and paranasal sinuses. Subjects were divided into three age groups: A1 (18-30 years), A2 (31-50 years), and A3 (≥51 years), stratified by gender. The measurements comprised septal length, width, curvature, vomer length and width, perpendicular plate of  the  ethmoid  (PPE)  length  and  width,  and  average  septal  cartilage thickness.  Statistical  analysis  was  done  with  one-way  ANOVA  and independent-samples t-tests.
Results: Significant age-related changes were found in septal length, septal width, vomer length, vomer width, PPE length, and cartilage thickness (p < 0.05). Septal curvature and PPE width did not differ significantly with age. Males had significantly bigger morphometric dimensions than females for  most  variables,  but  cartilage  thickness  was  marginally  greater  in females. When comparing the oldest age group to the youngest, cartilage thickness dropped by 19.4%.
Conclusion: The nasal septum exhibits significant morphometric variation with  age  and  sex.  CT-based  morphometric  analysis  gives  clinically important  information  for  septoplasty,  graft  harvesting,  and  structural support maintenance.