Correlation of Deviated Nasal septum severity with objective nasal airway obstruction

Abstract

Background: Deviated nasal septum (DNS) is a common structural cause of nasal obstruction, but the relationship between anatomical severity and objectively measured airway impairment remains variable. This study aimed to evaluate the correlation between DNS severity and objective nasal airway obstruction.

Methods: A hospital-based observational analytical study was conducted at Saraswathi institute of Medical Sciences, Hapur, from January 2023 to June 2025. A total of 126 eligible patients with DNS presenting to the ENT outpatient or inpatient department were included. Septal deviation was classified as mild, moderate, or severe based on clinical and endoscopic assessment.

Results: Of 126 patients, 35 (27.8%) had mild, 51 (40.5%) moderate, and 40 (31.7%) severe DNS. Mean deviated-side nasal resistance increased significantly from 0.25 ± 0.07 Pa/cm³/s in mild DNS to 0.59 ± 0.14 Pa/cm³/s in severe DNS (p < 0.001), while airflow decreased from 625 ± 120 mL/s to 338 ± 92 mL/s (p < 0.001). DNS severity showed a strong positive correlation with nasal airway resistance (ρ = 0.69, p < 0.001) and an inverse correlation with airflow (ρ = −0.65, p < 0.001). Severe anterior deviations were associated with the greatest obstruction. DNS severity remained the strongest independent predictor of airway resistance.

Conclusion: Increasing severity of DNS is significantly associated with greater objective nasal airway obstruction. Anatomical severity and location should therefore be considered together when evaluating patients with nasal obstruction and planning treatment.