The morphological association between nasal septal deviation and craniofacial asymmetry

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INTRODUCTION: The nasal septum plays a pivotal role in craniofacial growth and development, and nasal septum deviation (NSD) is a common finding in clinical practice. This study aims to investigate the morphological relationship between the NSD and craniofacial transversal asymmetry. MATERIALS AND METHODS: Cone-beam computed tomography (CBCT) scans from 114 patients were collected and analyzed to examine the association between NSD parameters and transverse metrics of the maxilla, dentoalveolus, and cranium. Additionally, craniofacial transverse parameters were compared across subgroups stratified by NSD variables, including Septal Deviation Angle (SDA), Deviated Septal Width (DSW), and Deviated Septal Curve Angle (DSCA), to evaluate their efficacy in predicting transverse asymmetry. RESULTS: NSD variables (SDA, DSW, and DSCA) were significantly associated with transverse asymmetry of the maxilla, dentoalveolus, and cranial base. Specifically, maxillary parameters reflecting transverse asymmetry of the maxillary sinus lateral wall around the palatal plane level and dentoalveolar parameters reflecting transverse asymmetry of the alveolar bone and dental arch exhibited significant differences across subgroups with varying NSD severity, as classified by SDA, DSW, and DSCA. CONCLUSIONS: Our findings confirm a robust relationship between NSD and transverse asymmetry of multiple craniofacial structures. SDA and DSW demonstrate higher sensitivity, while DSCA shows greater specificity in identifying craniofacial asymmetry. Collectively, these parameters play key roles in the development of transverse asymmetry within the nasomaxillary skeleton.

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